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HEALTH SERVICES & HOMELESSNESS
FINAL SUMMARY REPORT (V1) SEPTEMBER 28, 2011 – NOVEMBER 11, 2011
Submitted by Jane Parkinson, Facilitator
December 2011
HEALTH SERVICES & HOMELESSNESS
Page 1
HEALTH SERVICES & HOMELESSNESS F I N A L S U M M A R Y R E P O R T ( V 1 )
EXECUTIVE SUMMARY
Ryunosuke Satoro’s statement aptly reflects the underlying premise of the Health Service and Homelessness
Project. Key London leaders formed a partnership with health service providers as well as individuals who
have experienced homelessness. They began with the belief that a collaborative effort is an imperative for
successful change. To address the magnitude of the issues associated with creating a system to meet the core
health service needs of individuals and families experiencing homelessness in London, Ontario requires the
engagement and effort of many. The commitment to collaborate was what inspired the formation of an ad
hoc working group of five partners gratefully supported by London Community Foundation and Ashley Leanne
Powell Fund.
The Health Services and Homelessness Project involved bringing together health and other service providers
dedicated to working with individuals and families experiencing homelessness. It was agreed from the
beginning that, before applying solutions, it was important to engage people who have directly experienced
homelessness and to build a deep understanding of the issues they experience in accessing core health
services. Further there was overwhelming consensus to better understand the current state of care and services
from the providers’ perspective; building on their successes and minimizing barriers would serve as the basis
for future improvement in the health services provided to those experiencing homelessness.
This summary provides a collation of the important ideas generated from two well-orchestrated sessions (held
on September 28, 2011 and November 11, 2011), and forms the basis for the collaborative work that lies
ahead. This summary includes data collected from participants during these two sessions. The data is largely
unedited so as to preserve the integrity of the commentary. It is expected that a working group will be
established with the leadership of Dr. Abe Oudshoorn to review this information. This report, combined with
other existing research and planning documents, will lead to the identification of solutions and a plan to apply
them system-wide. Again, those involved in the future will take a collaborative approach to health service
system improvements, in the planning, implementation and evaluation phases to address the needs of people
experiencing homelessness.
"Individually, we are one drop.
Together, we are an ocean."
-Satoro
HEALTH SERVICES & HOMELESSNESS
Page 2
PARTNERS AND PURPOSE
This collaborative project was intended to be the initial step in a long-term process of improving health
services for individuals and families experiencing homelessness. Strong commitment to the effort was
demonstrated and the process evolved as partners clarified the purpose and outcomes.
PARTNERS PROJECT PURPOSE
Arthur Labatt Family School of Nursing, Faculty of Health
Sciences, University of Western Ontario
(Abe Oudshoorn)
To provide an opportunity for input and
engagement in a process intended to
increase understanding of health services
currently provided to individuals and families
experiencing homelessness. City of London Community Services, London CAReS
(Jan Richardson)
London InterCommunity Health Centre
(Pam Murray)
OUTCOME
Middlesex London Health Unit, Communicable Diseases
(Cathie Walker & Rhonda Brittan )
A snapshot of the “as is” state. To capture
what is happening now; to understand the
strengths, challenges and opportunities
before implementing solutions. Regional HIV/AIDS Connection(Sheila Coad)
PROJECT SCOPE AND DEFINITIONS
What do we mean by health?
While recognizing the importance of all the determinants of health, such as food, clothing, transportation,
education and shelter, the scope of this effort was focused on what might be best described as direct health
services. This component of the project was intended to increase understanding of the health services which
are sometimes considered to be more related to the “medical” side of health and encompass primary care,
mental health, and acute care. This specific focus was not intended to negate the importance of all
determinants of health, but rather to refine and deepen understanding of the current state of these services
and the unique experiences of those at greatest risk.
What do we mean by homelessness?
Homelessness is a broad concept and often includes individuals and families who experience homelessness
once in a lifetime as well as those who are under-housed and at risk of homelessness, in addition to those who
have no fixed address or are commonly referred to as “couch surfing”. The focus of this project was limited to
understanding the health services needs of those who are at high risk and experiencing what may be
referred to as ”absolute homelessness”. This project was seeking to understand the health service needs of
individuals and families who are most street involved, sleeping “rough” and residing in shelters.
HEALTH SERVICES & HOMELESSNESS
Page 3
PROCESS
The Health Services and Homelessness Project started by gathering information using a questionnaire which
was completed by 100 individuals who have lived experiences of homelessness (See Appendix A). The
responses to the questionnaire were useful in organizing two main events designed to encourage maximum
engagement and information exchange. The first event, a half-day interactive session was held on September
28, 2011 and was attended by over 60 health care and service providers (See Appendix B), and included
all of the organizations identified in the questionnaire plus several others subsequently identified.
The second meeting, a full day session, was held on November 11, 2011 and included nearly 100 individuals
who have lived experience of homelessness (See Appendix C). Both sessions were designed and facilitated
with an external consultant, in collaboration with expert partners, skilled community service providers and
highly committed individuals who have lived experience of homelessness.
This process was designed to be very interactive and to encourage forthright information sharing. From the
feedback gained, it is clear that the group was highly successful in this regard.
CLOSING The input from these sessions will be shared with providers who participated in the process and offers
tremendous potential for developing a system map. A working group will be established to review the
information and ultimately, to identify an action plan to improve access to health care services and health
outcomes. Special thanks is extended to the partners and facilitators from a variety of service organizations
as well as those who were considered to be peers of those with lived experience of homelessness. As a result
of the involvement of many this process was a success.
HEALTH SERVICES & HOMELESSNESS
APPENDIX A QUESTIONNAIRE
ITEM 1: HEALTH CARE IN LONDON SURVEY ..................................................................... 1
ITEM 2: HEALTH CARE IN LONDON SURVEY RESULTS....................................................... 2
HEALTH SERVICES & HOMELESSNESS
APPENDIX A: 1
ITEM 1: HEALTH CARE IN LONDON SURVEY
You can also do this online at: http://www.surveymonkey.com/s/L92V6DL
1. Where are all the places you go to for health care in London?
2. What kind of health care issues do you get help for?
3. What has helped with your health care in London?
4. What is frustrating about health care in London?
5. What kind of health care are you looking for?
Please Return To Christy Tran: ctran49@uwo.ca
For more info go to: http://www.londonhon.ca/?page_id=114
HEALTH SERVICES & HOMELESSNESS
APPENDIX A: 2
ITEM 2: HEALTH CARE IN LONDON SURVEY RESULTS
Data is presented in raw form, and categories of data are not mutually exclusive. Data will be distilled by
the already established working group for 2012.
1. Where are all the places you go to for health care in London?
Respnses Total
Centre of Hope 10
Family Doctor 15
Hosptial (University Hospital, St. Joeseph’s HC, Victoria Hospital) 58
Intercommunity 20
London Health Centre 5
London psychiatric hospital 1
Men's Mission 2
Methadone Clinics 6
Middlesex London Health Unit 3
None 3
RHMC 1
Street Scape 1
Walk-in clinics 32
2. What kind of health care issues do you get help for?
Responses Total
Addictions help/ Detox 16
Allergies, Colds, Flu, acute sickness 14
Asthma 7
Blood related problems (one surveyed bleeding issues") 8
Cardiac 1
Chiropractic care/ Bone related issues 13
Counselling 0
Dental 2
Dermatology 1
Diabetes 4
Dialysis 2
Emergency 3
Gastric problems 4
High blood pressure/ High cholesterol 8
Immune disorders 3
Mental Health (PTSD, depression, bi-polar, etc.) 25
Neurologlogy (eg sleep disorders) 5
(Responses for Question 2 continue on next page)
HEALTH SERVICES & HOMELESSNESS
APPENDIX A: 3
Responses Continued Total
None 1
Physiotherapy 5
Prescription 4
Sexual Health 0
Shaking, trembling, twitches 6
Various 3
Women's Health (Ultrasounds, pre/post natal care, etc.) 5
Wound, infection, injury care 10
3. What has helped you with your health care in London?
Responses Total
Advice and suggestions 3
Ambulance/ paramedics 3
ER 1
Getting proper medications 13
Getting proper procedures done (xrays, blood tests) 4
Having the available resources (EG: doctor, SW, agencies) 20
Helpful staff and doctors 4
My doctor 6
Not much 1
Nothing 12
OHIP 14
Transportation and accessibility 6
Social benefits 6
4. What is frustrating about health care in London?
Responses Total
Distance of services and where it's situated 5
Everything 2
Having good care 1
I don't have anywhere to go 1
Lack of empathy or sympathy from doctors and/or staff 2
Lack of knowledge on where to get services 0
Not getting desired meds 2
Not getting the proper diagnosis 1
Nothing 19
Shortage of doctors (trouble finding a doctor) 25
Wait times 41
HEALTH SERVICES & HOMELESSNESS
APPENDIX A: 4
5. What kind of health care are you looking for?
Responses Total
All inclusive health care 10
Counselling of any sort 13
Dental 9
Getting a stable doctor 22
Having good quality health care (fast, efficient, nonjudgemental) 20
Health care that is long term/permanent 1
More prescription coverage 2
None 17
Physiotherapy 8
Psychiatric help 4
Readily available emergency treatment 1
Reduce the wait time 4
Rehab 2
Vision 1
HEALTH SERVICES & HOMELESSNESS
APPENDIX B SEPTEMBER 28, 2011
OVERVIEW OF SEPTEMBER 28, 2011 WITH SERVICE PROVIDERS ....................................... 1
ITEM 1: SEPTEMBER 28, 2011 AGENDA ............................................................................. 3
ITEM 2: SEPTEMBER 28, 2011 ATTENDEES ......................................................................... 4
ITEM 3: SEPTEMBER 28, 2011 FEEDBACK FORM ................................................................ 5
ITEM 4: SEPTEMBER 28, 2011 SAMPLE WORKSHEET .......................................................... 6
ITEM 5: SEPTEMBER 28, 2011 WORKSHEET RESPONSES .................................................... 7
ITEM 6: CURRENT AND MISSING SERVICES, SEPTEMBER 28, 2011 .................................. 19
ITEM 7: SUCCESSES AND CHALLENGES, SEPTEMBER 28, 2011 ........................................ 22
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 1
There seemed to be
openness as providers
shared common
challenges and
significant successes.
OVERVIEW OF SEPTEMBER 28, 2011 WITH SERVICE PROVIDERS
The September 28th session was held at the Kinsmen Recreation Centre and was attended by approximately
60 health care and service providers. At the outset of the session, group agreements and definitions were
clarified and were adhered to over the course of the session. The influence of all the determinants of health
was underscored while the focus on health services was in the foreground of the discussion throughout this
session.
Discussion Questions
1. Who are the organizations providing health services/programs to individuals and families
experiencing absolute homelessness?
• What services are provided?
• A specific focus on understanding who provides what services related to:
• Immunization
• Common acute conditions (EG: cough, colds, diarrhea, aches)
• Dental care
• Medication replacement
• First aid
• Overdose
• Addiction treatment
• Wound/abscess care
• Mental health support/counselling treatment
• Dermatology/skin care
• Foot care
• Sexual health
• Basic health advice
• Pre/post natal care
2. What are the current health services your organization provides to individuals and families
experiencing absolute homelessness?
• Where are these services/programs located?
• What are the hours?
• Who is eligible to use your services/programs?
3. What are some of the successes and challenges you are currently experiencing in providing health
services to individuals and families experiencing absolute homelessness?
This very successful session was marked by higher attendance of organizations than expected with substantial
interaction. There seemed to be openness as providers shared common challenges and significant successes as
highlighted in the following chart.
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 2
Key Provider Successes Key Provider Challenges
Strong positive willingness to collaborate and build
community partnerships.
Ensure that the people who need the services are
aware of and can access the array of services,
supports and resources available across
organizations. Deep respect for those experiencing homelessness.
At the end of the session, participants were asked to indicate their interest in being a member of an on-going
Homelessness and Health Services Committee. Individuals from a variety of organizations expressed their
interest, and a 15 person working group (for 2012) was formed. A session feedback form was completed by
participants, and the overall message communicated was that the process was positive. There seemed to be
tremendous benefit to sharing across this diverse group to improve the understanding of the complex needs of
individuals and families experiencing absolute homelessness.
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 3
ITEM 1: SEPTEMBER 28, 2011 AGENDA
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 4
ITEM 2: SEPTEMBER 28, 2011 ATTENDEES
NAME ORGANIZATION EMAIL ADDRESS
Andrea Sereda Soho FHT ASereda@sohofht.ca Anne Finigan LIHC afinigan@lihc.on.ca April Quinn WAYS aquinn@ways.on.ca Brenda Marchuk MLHU Brenda.Marchuk@mlhu.on.ca Brian Lester RHAC BLester@hivaidsconnection.ca Carole Lambkin Salvation Army clambkin@centreofhope.ca Cassandra Brubacher MLHU cassandra.brubacher@mlhu.on.ca Cathie Walker MLHU Catherine.Walker@mlhu.on.ca Chandelle Kelly UWO Nursing Kelly-Chandell.Kelly@LHSC.ON.CA Christy Tran UWO Nursing ctran49@uwo.ca Darryl Reckman Sanctuary dc.reckman@gmail.com Doug Nemeth Mission Services DNemeth@missionservices.ca Erica Zarins MLHU erica.zarins@mlhu.on.ca Gil Clelland Sanctuary clellandgil@hotmail.com Heather McDonald London Public Library heather.mcdonald@lpl.london.on.ca Helen Padega LHSC Helen.Padega@LHSC.ON.CA Jeff Buchanan Family Court jeff_buchanan7@hotmail.com Jeff Lounsbury Wotch J.Lounsbury@wotch.on.ca Jody Shepherd MLHU jody.shepherd@mlhu.on.ca John Curtis Physician gaborst@sympatico.ca Justine Jewell LHSC Justine.Jewell@lhsc.on.ca Karen Laverty YOU KarenL@you.on.ca Kathie Chiu Salvation Army kchiu@centreofhope.ca Kelly Gregory John Howard Society kgregory@jhslondon.on.ca
Kim Reid ADSTV kreid@adstv.on.ca Kristin Heard UWO Nursing kebeer@uwo.ca Lucia Vermeulen LHSC Lucia.Vermeulen@lhsc.on.ca Lynda Murray-Crozier CAS lmurray-crozier@caslondon.on.ca Martha Connoy Mission Services mconnoy@missionservices.ca Martha Kirkwood MLHU martha.kirkwood@mlhu.on.ca Mary-Ellen Jacobs Salvation Army mejacobs@centreofhope.ca Michelle Shelley MLHU Michelle.Lee.Shelley@gmail.com Mike Godin CMHA mgodin@london.cmha.ca Nancy Powers Salvation Army npowers@centreofhope.ca Nancy Summers MLHU Nancy.Summers@mlhu.on.ca Pam Murray LIHC pmurray@lihc.on.ca Patty Chapman LHIN Patty.Chapman@LHINS.ON.CA Richardson, Jan City of London jarichar@london.ca Sandra Coleman CCAC sandra.coleman@sw.ccac-ont.ca Sandra Fieber sfieber@fanshawec.ca Sandra Fieber Fanshawe HVanPatter@fanshawec.ca Sheena Ewen LHSC Sheena.Ewen@lhsc.on.ca Sheila Coad RHAC SCoad@hivaidsconnection.ca Shelley Milos Housing Registry londonhousingregistry@bellnet.ca Sherri Zavitz CCAC sherri.zavitz@sw.ccac-ont.ca Stacey Thibodeau Salvation Army sthibodeau@centreofhope.ca Susan Butler Soho FHT SButler@sohofht.ca Yvonne Rimbault John Gordon Home yvonnerimbault@lrah.ca
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 5
ITEM 3: SEPTEMBER 28, 2011 FEEDBACK FORM
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 6
ITEM 4: SEPTEMBER 28, 2011 SAMPLE WORKSHEET
HEALTH SERVICE FOCUS AREA: Medication Replacement
Organization Services Provided Location of Service Hours of Service Eligibility
1.
2.
3.
4.
5.
HEALTH SERVICE FOCUS AREA: First Aid
Organization Services Provided Location of Service Hours of Service Eligibility
1.
2.
3.
4.
5.
HEALTH SERVICE FOCUS AREA: Immunization
Organization Services Provided Location of Service Hours of Service Eligibility
1.
2.
3.
4.
5.
HEALTH SERVICES AND HOMELESSNESS IN LONDON
Sample Worksheet # 1a
Question #1: What are the current health services your organization provides to
individuals and families experiencing absolute homelessness? Where are these
services located? What are the hours? Who is eligible to use your services?
Health Service Focus Areas: (1) Immunization, 2) Medication Replacement, 3) First Aid, (4) Overdose, (5) Addiction
Treatment, (6) Wound/ Abscess Care, (7) Mental Health Support/Counselling/Treatment, (8) Dermatology/Skin Care, (9) Foot Care, (10) Sexual Health, (11) Cough/ Colds/Diarrhea/Aches, (12) Dental Care, (13) Basic Health Advice, (14) Pre/Post Natal
Care, and (15) Additional areas
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 7
ITEM 5: SEPTEMBER 28, 2011 WORKSHEET RESPONSES
The following charts contain data that is largely unedited so as to preserve the integrity of the commentary.
ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY
IM
MU
NIZ
AT
IO
NS
Centre of Hope
Family Health
Team (FHT)
Flu services
All immunizations
Children and adults
Seasonal flu clinic
All vaccinations,
measles, mumps, etc
281 Wellington
Rd. M-F, 8-4
W, 5-8
Rostered patients
Health card
Centre of Hope Middlesex Health Unit
Flu shots
281 Wellington
Rd.
As
required
No health Card
London Health
Sciences Centre Emergency
Tetanus
Rabies
Flu
Prophylaxis
Victoria
Hospital
University
Hospital
24/7 Health card
preferred
London
InterCommunity
Health Centre
Seasoned clinic 457 York St.
MSC CMHP
1 day
annually Health Card
No referrals open
Centre of Hope
Family Health
Team (FHT)
Flu services
All immunizations
Children and adults
Seasonal flu clinic
All vaccinations,
measles, mumps, etc
281 Wellington
Rd. M-F, 8-4
W, 5-8
Rostered patients
Health card
Urgent Care Emergency
Tetanus
Rabies
Flu
Prophylaxis
St Joseph’s HC M-F, 8-4 Health Card
preferred
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 8
ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY
ME
DIC
AT
IO
N R
EP
LA
CE
MW
NT
Centre of Hope
FHT Medical care
Assessments
Prescriptions and
medications
281 Wellington
Rd. M-F, 8-4
W, 5-9
Registered clients
Health Card
Emergency Room/
Urgent Care Prescriptions and
medications
Outpatient
referrals
Victoria Hospital
University
Hospital
St Joseph’s
Health Centre
Hospitals
24/7
St Joseph
8-4
All
London
InterCommunity
Health Centre
Family medicine 659 Dundas St. 9-5 No Health Card
Registered clients
London
InterCommunity
Health Centre
No services to
homeless individuals
Huron and
Highbury
Walk-In Clinics Various Health Card
ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY
OV
ER
DO
SE
Emergency/Urgent
care Acute medical
treatment
Admission for med
care only
Outpatient referral
Victoria Hospital
University Hospital
St Joseph’s HC
24/7
24/7
8-4
No Restrictions
Emergency Medical
Services
Acute med treatment City wide mobile 24/7 All
London Police Safety management
Transportation of
aggressive/ reluctant
clients
City wide mobile 24/7 All
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 9
ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY F
IRS
T A
ID
Centre of Hope
FHT Assessment
Prescriptions
Treatments
Medical care
281 Wellington Rd. M-F, 8-4
W, 5-8
Rostered clients
Health Card
Emergency
Medical Services
24/7 No Health Card
London Health
Sciences Centre Emergency
Admission to
medicine
CCTC
Sepsis treatment
Victoria Hospital
University
Hospital
24/7 Health card
preferred
Salvation Army
Centre of Hope
All staff are First Aid
and CPR trained
281 Wellington Rd. 24/7 Maybe required
Salvation Army
Operation
Mobilizing Hope
(street RV)
Minor wound care
Counseling
Referral to other
services
Nursing assessment
Vitamins
London Coffee
House
Across from Ark
Aid on Dundas St.
Thurs,
7:30-
8:30 pm
Thurs,
8:30-
9:30 pm
Drop in
No Health Card
ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY
AD
DIC
TIO
N T
RE
AT
ME
NT
Addiction Services
Thames Valley Heartspace for women,
mothers
Freshstart (employment
barriers)
Substance abuse
counseling
CAReS
200 Queens Ave
Suite 260 M-T,
8:30-8
W-F,
0:30-
16:30
Self referral
No Health Card
Some restrictions
with hours
Centre of Hope Non medical withdrawal
assessment
281Wellington
Rd.
24/7 Self referral
Male and female
16 years of age
No HC needed
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 10
ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY
AD
DIC
TIO
N T
RE
AT
ME
NT
C
ON
TIN
UE
D
Centre of Hope
FHT Withdrawal meds and
assessment
Addiction counseling
Harm reduction
281 Wellington
Rd. M-F,
8-4
W, 5-8
Rostered patients
Shelter patients
Counterpoint
Harm Reduction
Needle Syringe
Needle syringe program
Outreach-exchange
186 King St.
City wide
M-F,
9-5
M-F,
11-6
Self referral
Dr. Sadex Methadone
Suboxone
Oxford/
Wharncliffe
Health Card
No referral
London Drug
Treatment Court
Intensive rehabilitation London Court
House
Tu, 12-3 Must be court
referred
Methadone
Clinic
Methadone maintenance
program 502 Oxford St
528 Dundas St
Middlesex-
London Health
Unit
Needle Exchange Program 50 King St M-Th,
8:30-7 Drop-in
No health card
Quintin Warner
House
Residential treatment Queens/Maitland 24/7 Fit admission
criteria
Referral including
self
Supported
Housing for
Addictions
(WOTCH/ADSTV)
Housing for persons
struggling with substance
abuse
39 Tecumseh 24/7 Must be referred by
ADSTV
Turning Point Residential treatment
programs for male and
female
Mornington Ave
Wharncliffe
24/7 Fit admission criteria
Westover
Treatment Centre
Aftercare and family
groups
Dundas/
Waterloo
Tu-W,
PM
Graduates of
residential
treatment
Youth Action
Centre
Needle exchange Dundas St. M-S, 3-7 Under 25 years old
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 11
ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY
ME
NT
AL
H
EA
LT
H S
UP
PO
RT
/C
OU
NS
EL
LIN
G/
TR
EA
TM
EN
T
Canadian Mental
Health
Association
Advocacy
Counseling
Support
Referrals
Court House,
London
M-F, 9-5 18+ incurred criminal
charges, Axis I
No health card
Centre of Hope Full service 281
Wellington M-F, 8-4
W, 5-8
Rostered clients
Health card
Elgin Middlesex
Detention Centre Trauma crisis
Social workers
711 Exeter M-F Selected inmates
John Howard
Society Trauma Counseling
Anger management
Mental health
counseling services
Healthcare referrals
601 Queens
Ave M-F, 8:30-
4:30
Closed F, 3
Closed 12-1
Youth support 16-24
Homeless or at risk
Persons/families
involved/at risk in
crime/justice
London
InterCommunity
Health Centre
Social workers 659 Dundas
St.
9-5 M-F
Adults
Regional Support
Associates
London Office
Mental
health/counseling
Behaviour
management
Psychiatric support
633
Colborne St. M-F, 8:30-
4:30
After hours
available
Adults with
intellectual disabilities
Referral from
Developmental
Services Ontario- SW
St. Leonard’s
Community
Services
Social workers
Main office
405 Dundas
Adults
SLCCS clients only
Western Area
Youth services Short term crisis
support
Referral to youth
Mental health
assessments
Community
based-will
travel to
client
714 York St
M-F, days
Flexible
evenings
Youth 13-18
Referral needed from
crisis and intake team
Western Ontario
Therapeutic
Community
Hostel
Mental health support
Case management
Housing
Family med
Psychiatrist
Clinic support
534
Queens
My Sister’s
Place
8:30-4:30 Referred
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 12
ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY
WO
UN
D A
BC
ES
S C
AR
E
Centre of Hope
FHT Prescriptions
Assessment
Medical care
Follow-up
281 Wellington St. M-F, 9-4
W, 5-8
Rostered patients
Health Card
London
InterCommunity
Health Centre
Prescriptions
Assessment
Medical care
Follow-up
659 Dundas St. M-F, 9-5
Th,
10:30 -5
Rostered clients
London Heath
Sciences Centre Prescriptions
Assessment
Referrals
Emergency
Medicine
Outpatient care
University
Hospital
Victoria Hospital
24/7
Specific
days
Health Card
preferred
Referrals
St. Elizabeth
Community Care
Access Centre
(CCAC)
Prescriptions
Homeless specific
Assessment
Referral
CMHP MSL
457 York St
10-11AM No referrals
No health card
St. Joseph’s
Urgent Care Prescriptions
Assessment
Referral
St. Joseph’s HC Referral
ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY
FO
OT
C
AR
E
Centre of Hope FHT Foot care clinic 281
Wellington
Thurs 8-4 Rostered clients
Health Card
London
InterCommunity
Health Centre
Advanced foot care 659
Dundas St. M-F, 9-5
No Th AM
Reigstered clients
(some first aid)
Mission Services
CMHP
Foot care volunteers 457 York
St.
Announced 16 and above
Western Ontario
Therapeutic
Community Hostel
Footcare
Diabetes support and
screening
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 13
ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY
CO
MM
ON
A
CU
TE
C
ON
DIT
ION
S
Centre of Hope FHT Common acute
condition assessment
Wellington Rd M-F 8-4
W 5-8
Rostered clients
Elgin-Middlesex
Detention Centre
Common acute
condition assessment
711 Exeter 7-12 Women and men
in custody
No Health Card
London Health
Sciences Centre
Emergency (Social
work, referrals and
payment of meds)
Victoria
Hospital
University
Hospital
24/7` Health card
preferred
London
InterCommunity
Health Centre
Common acute
condition
assessment
Doctor/NP/RN
Minor first aid
659 Dundas St
Men’s Mission
York St
M-F
No Th AM
Adults
No Health Card
Middlesex-London
Health Unit
Common acute
condition assessment Wellington Rd.
450 Clarke
42 Stanley St
Hill St
M-F
Dependent
on shelter
Half day
per week
Women and
children
No Health Card
No referrals
At shelter
St. Elizabeth CCAC Emergency 456 York 10-11AM Drop-in
Urgent Care St Joseph’s HC 8-4 M-F Health card
preferred
Walk-In clinics London Health Card
Western Ontario
Therapeutic
Community Hostel
Common acute
condition assessment
534 Queens
MSP M-F, 8:30-
4:30
M-F 10-3
Referred and non
referred
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 14
ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY
BA
SIC
H
EA
LT
H A
DV
ICE
Centre of Hope
Family Health
Team
Full service medical
care
NP/Doctors/
Nurses/Social Workers
Specialist physician
referrals
281 Wellington Rd. M-F, 8-4
W, 5-8
Rostered
patients
Health Card
Emergency/Urgent
Care Acute medical
Treatment/ Counselling
Outpatient referral
Victoria Hospital
University
Hospital
St. Joseph’s HC
24/7
24/7
8-4
No restrictions
London Public
Library (MLHU, St
Joseph’s, LHSC,
LHS providers)
Health info programs,
Q& A
Books, pamphlets
In person experts
251 Dundas and 15
other locations 9-9 F-T
9-6 F
9-5 Sat
All
Middlesex-
London Health
Unit
Ask a nurse
Pre/postnatal
Communicable Disease
Acute illness
referrals
Rothelome
WCH
101 Wellington
2nd Stage (450
Clarke St)
Zhaawanong
M -W, PM
Th, AM
F, AM
Residents of
shelter
Middlesex-
London Health
Unit
Phone/in-person
advice through Family
Health Services
Communicable
diseases
Sexual health services
Bed bugs and
environmental health
50 King St.
Health connection
phone # 519 850
2280
CD 519 663
5317 ext 2330
Bed bugs- 519
663 5317 ext?
SHS 663 5446
Health
Connection
8:30-4:30
CD 24/7
Bed bugs
24/7
Self, no
referrals
No Health
Card,
No fee
Drop-in
St. Leonard’s
Community
Services
Family services
Food issues
405 Dundas St. Clients
Telehealth Phone advice From any phone 24/7
Western Ontario
Therapeutic
Community
Hostel
Nutrition, diabetes
support
534 Queens Ave
also MSP
M-F 8:30-
4:30
Referrals and
non referrals
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 15
ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY
PR
E/
PO
ST
N
AT
AL
&
P
RE
GN
AN
CY
ADSTV Heartspace Addiction Treatment
High risk infant
Development worker
Parenting supports
260-200 Queens M-F,
8:30-4:30 Self referral
Facilitated
referrals
0-6 Children
Centre of Hope
FTH
Pre/postnatal care 281 Wellington
St M-F 8-4
W 5-8
Rostered patients
Women in shelter
Emergency/Urgent
Care Acute medical
treatment
Referral for
outpatient OB,
Womens Health
Victoria
Hospital
University
Hospital
St Joseph’s HC
24/7
24/7
8-4
All
London’s Crisis
Pregnancy Centre Support services to
pregnant women and
couples
Referrals
261 Piccadilly
St
London
InterCommunity
Health Centre
MD/NP/RN 659 Dundas St. M-F 8-4
W 5-8
Rostered clients
Middlesex-London
Health Unit
Pre/postnatal
education
WCH M, 1-3
W, 1-3
Shelter residents
No health card
Middlesex-London
Health Unit
Pre/post natal outreach Salvation Army
Centre of Hope On call
M-F,
8-4
Women in shelter
No fee
No health Card
Middlesex-London
Health Unit
PHN Roth home 42
Stanley St
54 Riverview
Besthesda
Th 9-12
M, 3-4
W, 9:30
-10:30
Women in shelter
No fee
No health card
Smart Start For
Babies Prenatal classes
Nutrition advice
Bus tickets
Food vouchers
Dundas OEXC
MLHU- 50 King
Tu, 6-8
W, 6-8
Registration less than
20 weeks gestation
Thames Valley
Midwives Pre/post natal care
Midwives
Travel
WCH
Facilitated by My
Sister’s Place
Women’s Health
Care-LWSC
Prenatal care
Prenatal care
TA
Baseline/
Wellington Rd.
M-F Health Card
No referrals
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 16
ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY
SE
XU
AL
H
EA
LT
H
Centre of Hope (FHT) Full services related
to sexual health
281 Wellington
St M-F, 8-4
W, 5-8
Rostered clients
Health card
Elgin Middlesex
Detention Centre Sexual Health
Harm reduction
(LMHU) provide
services
711 Exeter Rd M,1:30-3 Women
Emergency/
Urgent Care Emergency
STI testing and
treatment
Education
Victoria
Hospital
University
Hospital
St. Joseph’s HC
24/7
24/7
M-F, 8-4
Card preferred
All welcomed
London
InterCommunity
Health Centre
Options
(anonymous testing) 659 Dundas St.
Outreach
9-5 Some
Middlesex London
Health Unit
Sex health groups
clinics WCH
450 Clarke
101 Wellington
Scheduled No Health card
No Referrals
Middlesex London
Health Unit, The
Clinic
STI testing/treatment
Birth control
50 King St.
F, 8:30-
10:30
M,W, 5-7
Any age
No OHIP
No referrals
Middlesex-London
Health Unit, Sexual
Health Promotion
Student support
Health promotion
On site at
facility
EMDC
Western,
Fanshawe
CAS, Families
First LFCC
M-F PM
Weekends
No health card
No referrals
Western Ontario
Therapeutic
Community Hostel
Sex worker support
Counseling
My Sister’s Place M-F, 10-3 Walk in
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 17
ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY
DE
RM
AT
OL
OG
Y/
SK
IN
C
AR
E
St. Elizabeth
CCAC
Mission services
MOU
Cellulitis/Wound care Various
457 York
CMHP
7-? Clinic
hours
10-11
daily
No card
No referrals
Health Card is
mandatory for
CCAC to assist
Western Ontario
Therapeutic
Community
Hostel
Foot care 534 Queens
My Sister’s Place
140 Langarth
Referrals
Salvation Army
Family Health
Team
London
InterCommunity
Health Centre
Doctor/NP 281 Wellington
659 Dundas St.
9-5 Must be
registered
patient
COH will see
shelter patients
Middlesex-
London Health
Unit
NP clinics Sherwood Forest
Mall
550 Hamilton Rd
Northbrae
South Lon
119 Jalna Blvd
Emergency/
Urgent care Acute medical
treatment
Follow up
CCACA referral
Outpatient referral
Burns
Cellulitis Clinic
University
Hospital
Victoria Hospital
St Joseph’s HC
24/7
24/7
8-4
No restrictions
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 18
ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY
DE
NT
AL
C
AR
E
Docs Basic 184 Horton None
Middlesex-London
Health Unit
Basic care 50 King St. 8:30-
4:30 Clients under 18
Healthy Smiles Ontario
Private dental office Any Anywhere Discretionary benefits
OW
St Joseph’s Dental
Clinic
Dental Mt Hope
346 Platt’s Lane
ODSP
OW
UWO Dental
Emergency
Emergency LHSC 24/7 None
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 19
ITEM 6: CURRENT AND MISSING SERVICES, SEPTEMBER 28, 2011
Who are the organizations providing health services/programs to
individuals and families experiencing homelessness?
ORGANIZATION SERVICES
Addiction Services of Thames Valley WOTCH- MSP
Centre of Hope Family Health Team
ASH-TV
HS
S.A Program
Freshstart
CAReS Bethesda Centre
Pre/postnatal care
Public health nurse
Counsellor- Family court Community Care Access Centre (CCAC) Home Care/St. Elizabeth
Centre of Hope Family Health Team (FHT)
Addiction Services
Volunteer Chiropractic Services
Shelter
Withdrawal Management
Drug Stores
Elgin Middlesex Detention Centre (EMDC) Health department housing
Health care Health Zone Nurse Practitioner
Clinics at 3 sites
Outreach clinics opening soon
o MSP
o Glen Carin
o WCH
Intercommunity Health
John Gordon Home
London Family Clinic
London Health Sciences Centre (LHSC) Emergency Rooms
St. Joseph’s Health Centre
Obstetrics clinic
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 20
ORGANIZATION SERVICES
London Public Library Middlesex-London Health Unit (MLHU)
Western Ontario Therapeutic Community Hostel (WOTCH)
Canadian Mental Health Association (CMHA)
Men’s Mission
Methadone Clinic
Middlesex-London Health Unit – London
(LMHU) Family Health
Dental
Sexual Health
Infectious disease
Vaccines
Healthy Babies Healthy Children (HBHC)
Nurse Practitioners
Clinic
Free Sexually Transmitted Infection medication
Needle exchange
Sexually Transmitted Infection testing and referrals Mission Services of London Quinton Warner House
Addiction services My Sister’s Place Diabetes and foot care
Smoking cessation
Sexual health
Primary care (soon through Nurse Practitioner)
Men’s health through MLHU on site
Needle exchange Regional HIV/AIDS Connection Counterpoint Harm Education
Regional Support Associates - London Supporting adults with intellectual disabilities
Mental health/behaviour management
Psychiatric support
Primary care/medical management Salvation Army: Operation Mobilizing
Hope Nurse at London Coffee House across from Ark Aid
Wound care
Counseling
Vitamins
Referral to other resources St. Leonard's Community Services Facilitates residents to get initial medications at
emergency rooms Streetscape Provide ADAT
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 21
What organizations are missing?
ORGANIZATION SERVICES
Western Ontario Therapeutic Community
Hostel (WOTCH) Psychiatry
Family doctor
Diabetes clinic
Foot clinic
Hoarding groups and consultation
Women’s Community House Shelters
Outreach
Help line
Addictions support counselor
Mental health counselors through CHMA
Public health nurse
Sexual health
Nurse practitioner
CHMA: Access team Infectious Disease Care (St. Joseph’s HC)
Dale Brown Injury Service LHSC Women's Health
Dental Outreach London Crisis Pregnancy Centre
Dental Outreach Community Services Methadone clinics
Emergency Response Services
(EMS, Fire, Police)
Pharmacies
First Nation Services RMHC
Health Zone (Nurse Practitioners) Youth Access Centre Addiction services
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 22
ITEM 7: SUCCESSES AND CHALLENGES, SEPTEMBER 28, 2011
SUCCESSES RESPONSES
Ability to make appropriate referrals for treatment 2
Ability to help clients complete follow-up 1
Ability to provide bus tickets to clients for appointments 1
Building one-to-one relationships 2
CAReS 1
Changes are emerging in patients (diet is better) 1
Community collaborations and partnerships 8
Diagnosis and treatment of complex mental health issues 1
Diversity and team approaches when working with clients 2
Drop-ins for medications such as Plan B 1
Exiting relationships (need to build)*
Focus on health care for the homeless population 1
Free drop-in clinics 1
Free sexual health services and medications (EG: STI testing) 1
Good quality health care by agencies 1
Graduation from ASH-TV 1
Great partnerships exist*
Housing support 1
Implementation of plans or resources 2
Inclusion of outreach workers/support network 3
Increase "open door" approach 2
Increase awareness about needs and services 3
Increase collaboration among services 1
Increase in support funding (e.g ODSP) 1
Increased numbers of individuals served/getting referrals 1
LDTC 1
Less "silo-ing" 1
London CAReS collaborative (EG: NEP partnerships at MSP)*
Mental health focus (LHINS)
MSP 1
Network of services 4
New housing (transitional for homeless addicted: ASH) 2
No health card required for STI clinic 1
Opportunities for students at UWO*
People are excited about changes 1
People who discover recovery 1
Portable services 1
Providing correct information 1
Range/Diversity in this Region is Amazing*
Reducing discharge from psychiatric ward to homeless shelters 1
Research UWO-focused/common data*
Services more portable than in past*
Social work 1
Speaking engagements where experts answer questions 1
Successful withdrawal of individual 1
This summit itself (Reassuring to see a multidisciplinary) 1
Variety of health services/ support and resources 11
Willingness to discuss this difficult topic*
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 23
CHALLENGES RESPONSES
Ability attend scheduled appointments 2
Ability to focus on health when daily housing is a struggle 1
Adherence 1
Affordable housing 4
Attitudes of staff (tend to give up easily and easily frustrated) 1
Consent required from agencies also working with clients 1
Continuity of care vs. confidentiality 1
Continuity of relationships in care 1
Criteria not meeting all needs 1
Dual diagnosis (some services won't support if there are dual present) 2
Effectiveness of services? 2
Emergency long waits*
Expectations; criticism of the addict. System 1
Feedback, perspective of lived experience*
Fees for referrals when there is no family doctor 1
Follow up (Cannot contact individual) 7
Funding sustainability* 9
Health coverage 2
Historical perspective sometimes missing (to assess growth/success)*
Identification of who is homeless, addicted/identification in general 2
Immediate services for "crisis" 1
Inability to access med clearance from pregnant women 1
Inability to access medical support (EG medications, wound care and support) 3
Inconvenient of hours 2
Increased illness or disease (EG: brain injury and Hepatitis C) 2
Integration with other determination of health 1
Lack of awareness of services 6
Lack of communication within supports being accessed/among agencies 5
Lack of medical history*
Lack of physicians 2
Lack of primary care providers who will treat without health card 1
Limited services for new clients 1
Limited time for treatment 1
Literacy (paperwork, forms to fill-out) 2
Little flexibility with legal system (advocacy can be difficult) 1
Managing the expectation of providers in the systems 1
Measurement of outcomes 1
Mobilizing similar services 1
Navigating through the system 1
Need for more portable services 1
Need more outreach services 1
No shows*
Not enough long term support 1
Number of homeless experiencing mental health issues (diagnosed or not) 1
Obtaining referrals in timely manner 4
Ongoing health care 1
Orientation of provider*
Outreach shelter on site work more immediate in shelter care 1
HEALTH SERVICES & HOMELESSNESS
APPENDIX B: 24
CHALLENGES CONTINUED RESPONSES
Patient funded system (working with it)*
Perception of need: Provider v. client 2
Physical space (too small) 1
Physician lack knowledge about where to send homeless people for care 1
Post client negative experiences 1
Pre/post pregnancy onsite rather than at agency 1
Relationship quality, continuity with provider*
Right treatment, time, place, hours*
Safe housing for 18 under 1
Services only cover individual until their 18th birthday (such as dental) 4
Stigma surrounding homeless 2
Strict policies (EG: One "no show" and client is discharged) 1
The limits in length of shelter say 1
The relationship of non-medical models and medical models 1
Thinking creatively 1
Time and staffing 2
Time commitments elsewhere (no crossover with them day-to-day) 1
Transportation problems/accessibility 7
Treat all humans with respect and grace/making them feel comfortable 4
Trying new ways to deliver service 1
Waitlists/wait time for treatment or resources 6
Weighing consumer responses equitably 1
Working through resistance to change with clients 1
Youth focused services (adult-youth dynamic)*
* denotes response expressed during the large group session
HEALTH SERVICES & HOMELESSNESS
APPENDIX C NOVEMBER 11, 2011
OVERVIEW OF NOVEMBER 11, 2011 WITH INDIVIDUALS EXPERIENCING HOMELESSNESS ...... 1
ITEM 1: NOVEMBER 11, 2011 AGENDA ..................................................................................... 2
ITEM 2: SERVICES USED .............................................................................................................. 3
ITEM 3: IDENTIFIED SUCCESSES AND AREAS OF IMPROVEMENT .............................................. 7
HEALTH SERVICES & HOMELESSNESS
APPENDIX C: 1
OVERVIEW OF NOVEMBER 11, 2011 WITH INDIVIDUALS EXPERIENCING
HOMELESSNESS
The November 11th full day session with individuals experiencing homelessness was held at CitiPlaza, London
so that access would be easier if participants were using public transportation. The agenda was developed in
consultation with two individuals with prior experience of homelessness who provided some very helpful
suggestions. For example, it was determined that it was best to have “peers encouraging peers.” For this
reason, three members of the Regional HIV/AIDS Connection Harm Reduction Services were stationed at
CitiPlaza entrances to provide a “peer to peer” welcome and to give directions to the storefront location. A
nourishing meal was available all day long and enjoyed by 99 individuals with lived experiences of
homelessness.
It was decided that there would be no formal presentations and that those caregivers and service providers
who have worked with individuals and families experiencing homelessness would best explain the purpose and
obtain the information. Twelve small group facilitators were prepared in advance and during the day
masterfully created a safe and open space for individuals to share their experiences. Staff from Regional
HIV/AIDS Connection, Western Ontario Therapeutic Community Hostel (WOTCH), Middlesex London Health
Unit (MLHU) and London Intercommunity Health Centre (LIHC) served as facilitators and guided individual and
small group discussions using a common set of questions.
Discussion Questions:
1. What services have you used?
2. How would you describe your experience?
What worked well for you?
What didn’t work for you?
What would make it better or easier for you?
3. How did the different services that you used seem to work together?
What worked well?
4. How could the movement (transfer) from one service to another be improved for you?
This session was characterized as respectful, calm and focused as a multitude of individuals and small groups
shared their experiences and reflected on the questions posed by facilitators. Highlights of the conversations
were posted on wall charts for all to see. A summary of the input is provided and the common challenges and
successes that could be readily distilled are noted below:
Key Service Successes Identified by Individuals
with Lived Experience of Homelessness
Key Challenges Identified by Individuals with
Lived Experience of Homelessness:
Many services were identified More financial support/subsidy to assist with housing
Service providers were frequently felt to be
respectful
Concern about the stigma and discrimination attached
to having a history of being a drug user
Not surprisingly, participants responded favorably to sharing a meal and being given space to talk about their
personal experiences with interested facilitators. Special thanks are extended to all facilitators and members
of the Peer Program at the Regional HIV/AIDS Connection for their support which led to a smooth and well
organized and well attended session.
HEALTH SERVICES & HOMELESSNESS
APPENDIX C: 2
ITEM 1: NOVEMBER 11, 2011 AGENDA
HEALTH SERVICES & HOMELESSNESS
APPENDIX C: 3
ITEM 2: SERVICES USED
The following charts contain data that is largely unedited so as to preserve the integrity of the commentary.
SERVICE USED COMMENTS
Atlousa Good program, lack of funding
Provides lunch
Blood labs on Central
Canadian Mental Health
Association
Centre of Hope Food bank
Centre Point Great, friendly staff
Childrens Aid Society Good place to go if pregnant
Give up
Change their visitation policy.
Chiropractor Staff is nice
First come first serve
Accommodating
Coffeehouse
Community clothing centers Lacks clothing for bigger people
Dental for adults $20 cleaning
Family Health Tem Nurses are very nice
Food bank/Meal programs
Hospitals Takes too long
Urgent care: provided good treatment for one week
Sometimes there is too much judgment and discrimination
among the homeless and those who are suffering from
addiction. Assumed that those who are addicted are just
seeking out more pills however in actuality they are seeking
help or in real pain
Good, helpful people
Improve hours of operation
Accessibility
Be less restrictive
HEALTH SERVICES & HOMELESSNESS
APPENDIX C: 4
SERVICE USED COMMENTS
Intercommunity Service
Practical services. Great
”Dr. Harris is welcoming and great”
Library Have addiction counselor there
Safe injection site
Good overall
Not enough help finding stuff
London Cares Helpful
Basic needs
Good service
London Crisis Centre
London Health Sciences Centre
Emergency Was treated nicely
London Housing
London InterCommunity Health
Centre (LIHC)
Men’s Mission Not too bad
Good food
Good people
Agreeable staff
Dirty
Too many shooters
Jim Henderssen and Megan Vander are always happy with
people and services
From one male: lived there, a good place to live when he was
homeless
Methadone Clinics “Should not be able to just cut you off”
Middlesex-London Health Unit
(MLHU) “Had to watch what was being said”
Doesn’t want to say anything bad or they won’t help you
“Excellent”
Mission Resource Centre Meals and a cot
Puts you on your feet quickly
Better answers rather than just kicking people out into the
street
HEALTH SERVICES & HOMELESSNESS
APPENDIX C: 5
SERVICE USED COMMENTS
My Sister’s Place More health needs are met
Laundry
Food
Good programs
“Donna is very good” (foot lady from WOTCH)
“The best”
Needle exchange Good experience
Ontario Disability Support
Program
Ontario Works
OTHER We need better services for the drug users and Listerine
drinkers
The kids shooting drugs on the streets are a danger to the
public, they need a place to go
Why did they shut down the drop ins. We need more places
for street people to go not less and longer hours on
weekends.
Health care services are well coordinated
More recovery homes for street addicts
Number of food providers such as the SAcOH, Mission, and
Daily Bread
Some services did not really help.
o Made excuses for poor health.
o Did not believe individual was ill, but found out she
was ill, suffering in pain, in/out of hospitals all her
life.
o Diagnosed with osteoarthritis after being in a lot of
pain.
Doctors found it in every bone, originally from
pelvic bone and then it transferred throughout
individual's body.
Paramedics “Worked well”
Charge of 45 dollars for a ride
Pharmacies According to one female: they are always nice to her
Explains things clearly
United Way Pharmacy treats everyone well and waived fees
(sometimes)
HEALTH SERVICES & HOMELESSNESS
APPENDIX C: 6
SERVICE USED COMMENTS
Police Have a hard time being believed by the police when making
a complaint
Quinten Warner House They are awesome
Regional HIV/AIDS Connection
(RHAC) Awesome
Non judgmental
Thorough
Really care
SACoh They treat individuals with respect
They do a great job
Salvation Army Good experiences overall
People are kind, courteous, treat patients well
Never had a problem in 6 years”
“Homeless this year for the first time and stayed at the Sally”
St Leonard’s “We will support your drug habit”
St. Paul’s
Stratford Free sex clinic
More around London, cleaner
"Staff doesn’t know how things are ran and everyone has an
opinion"
Streetscape
Turning Point Good staff
Really care
Walk-in clinics From one male: use the walk ins because he doesn’t have a
GP
Different doctor you don’t always have the same one
Never had a doctor since he was married
Western Ontario Therapeutic
Community Hostel Friendly
“Management people don’t know the policies”
YOSWA
Youth Action Community Good service
Nice staff
Zhaawanong Shelter
HEALTH SERVICES & HOMELESSNESS
APPENDIX C: 7
“Staff is friendly,
resourceful and
respectful, and
services are easily
accessible.”
ITEM 3: IDENTIFIED SUCCESSES AND AREAS OF IMPROVEMENT
What is working?
(The following data is largely unedited so as to preserve the integrity of the commentary.)
Very fast service
Within walking distance
From an older lady: “my experience has been very good”
o Therapy was needed for a full year after being blown over by the wind
o Treated with respect and dignity by the staff
Overall, it’s okay
Staff is friendly, resourceful, and respectful and services are easily accessible.
Good overall
Youth services are really good
OW was more easily accessible
My Sister's Place meets basic needs and has been good
o Clients are respected, feelings and privacy- don’t have to put up with rowdy behaviour
o Good information (educational health)
o No appointments needed or required.
o Talk to a nurse, really friendly
Most are working fine just need to fine up a few things
A lot of service staffs are welcoming most of the time
The shelters treat people nicely and with dignity, they are also supportive
Great health care at the hospitals
Greater access like Peer Day event where common needs are met
The services that have been acquired were very good. Staff was very friendly and helpful.
I know where to go (LIHC) to get medical supplies. Was told by a staff at the walk in clinic that he
needed to buy medical supplies, but due to lack of $ this was difficult. LIHC supplied the medical
necessities.
Access to services, very supportive, assisting with forms
Happy to access walk-ins
Supportive of client issues
Investing time in client
Compassionate and thorough
Client followed up with clients
Personable
HEALTH SERVICES & HOMELESSNESS
APPENDIX C: 8
“Constant
presumptions by health
care workers that I
don’t know anything
about my health.”
What is not working? How can it be improved?
Wish there are places that didn’t require health card in order to use services
“Too many children”
I want to know why I am getting less money through ODSP
Not enough shelter for women
Single abused fathers need a place for them and their kids to go
Want support person for legal matters, medical appointments,
dental surgery, transportation, extra medical prescriptions
Getting extra medical prescriptions
Getting extra clothing for winter and summer
Paying rent
if in medical distress or incarcerated, cannot work or unable to get
ODSP/ OW forms in on time.
Funding for a scooter
Funding for school supplies for grand children
Funding for family deaths/ transportation etc
Funding for new beds because of bed bugs
Funding to move women into new apartments (packers and movers needed)
“Highly paid health care people. Ridiculous wages. Why?”
Judgmental and untrusting paramedics
o “Paramedics called the cops and made assumptions about my health status. They wouldn’t believe
me.”
“Constant presumptions by health care workers that I don’t know anything about my health”
GP won’t listen to me because she thinks my judgment is impaired due to mental health issues.
Dr. won’t release a quantity of prescriptions so I can’t get out of town because of suicide
I don’t often get fair treatment because health care providers have a view point that I don’t need the help
because I am a service user and a service provider (peer worker)
o “What are you doing here?”
We need a paid social planning council staffed with people who have lived experience.
o It should be inclusive and broad in scope
o Fundamental question being always asked: “What kind of community do we want?”
I am a “wounded healer” but health care professionals do not grant me the same respect or value as they
do with their colleagues
We need 24/7 safe drop-ins with a supervised injection site
“Where do folks go to be safe if they are zoned?”
Split the detox from SACoh
More places like Coffeehouse on Dundas which are out of the core
Judgmental healthcare providers who are unwilling to accept people as they are
Portland Hotel Society in London
Ask more “what do you need” not “what you should do.”
Don’t like that the police are providing the health care services. If police are going to be the health care
providers they need to have a higher level of training, have higher regard for the vulnerable people, and
be more sympathetic
HEALTH SERVICES & HOMELESSNESS
APPENDIX C: 9
More access within a community for diabetes support, psychiatric services
Help people apply for health card
Interpreters
Social workers
Dieticians,
“HIV on-site”
Pay to stay policy at some shelters
Walk-in clinics unwilling to prescribe medications that individual has been using for a long time
Nurses cannot give prescriptions without doctors
Family doctor or psychiatrist would be easier to go to
“Hate the police”
Need more doctors
Need more visual art to raise awareness
Incorporate art therapy
Limited supply at food banks (30 days)
o No meat
o Not enough food
o Too much hoop jumping
“Treated poorly” at Ontario Works
o Unrealistic
o “Just horrible”
o Not interested in clients circumstances
Salvation Army provides good services, however, too quick and impersonal
Coffeehouse is not wheelchair accessible
Have hangout places for people who don’t have homes
Put the money in the important places
Forced to stop using drugs and judged by society
Need more mental health support
More stuff for kids
Need more education for parents
Doctors talk down to you when you have abscesses and other injection drug issues
Doctors don’t listen to you when you talk about pain because you are an addict
Waiting in the emergency room until they are pill sick and end up leaving
I won’t tell the doc about any drug use because of stigma of how other people have been treated
Hospitals have a stigma about homeless people
Housing is difficult to get into because process of references
Lack of services for adults
Food programs doesn’t provide enough
Finding a doctor is like “entertainment in community”
Fair chance housing
Better services could make quality of service/life easier
Have more affordable housing
HEALTH SERVICES & HOMELESSNESS
APPENDIX C: 10
“Recognize the
coordination
need.”
Stigma about intravenous drug users
Obtaining a health card is a difficult process
Lack of resources for the homeless
Too many unrealistic rules and regulations
“Native shelters?”
No doctors, no access to medicine
No access to phone
Legal system is too slow
My Sister’s Place doesn’t work for health reasons
o Workers get really busy and forget to help one on one
o Cleanliness is most important
o Only serve homeless people
Didn’t feel safe as a woman
Change the actual delivery of services
Just get a “smile” on their faces will relax people
Show people that they are just people not just a number for more services
Explanation of why you have to wait for medical appointment
OW needs more money
Need transportation to get to appointments
Medical operations
Can shelters prescribe medication?
o Are shelters giving medications to clients on time
“People using these organizations, why the things are they way they are?”
“Why send clients from Toronto/elsewhere to go to the methadone clinic? Who is paying?”
Housing is difficult because some landlords will not rent to people who are new to the area, especially
immigrants.
Assistance and resources for recent immigrants seeking employment
Recognize the coordination need
“We need more places where people can have shelter and food”
“Despite having a roof over their heads, people also need clothes and other necessities”
Ongoing support is needed after people have found a home.
Organizations need to regularly meet as a group to examine what is working and what are the gaps
Need to keep busy in order to feel like a part of something beyond current struggles.
Denied family doctor at InterCommunity because of an open file at walk-in clinic
Need family doctor to get on ODSP
No information on how to get a family doctor
Wait times are just too long for family doctor
Refuse to access Centre of Hope because clients and staff “too much drama”
Police are not helpful, understanding, or supportive
Enough care is offered, but not enough communication between agencies or staff at agency
More screening or intake needed
HEALTH SERVICES & HOMELESSNESS
APPENDIX C: 11
At Salvation Army there are clients from different backgrounds who cannot relate to each other and cause
fights.
o Doesn’t work for any clients
Not all staff follow proper protocol
Inconsistent service
Clients not treated with dignity or respect
StreetScape needs longer hours
Nothing for homeless to get shelter for the day
Centre of Hope has “dirty residents”
Need more help with finding a place to live
More “stuff” for youth in crisis
Food Banks do not have enough food choices, healthy options and variety.
Looking for a GP is very difficult
Services are far and transportation is an issue
Need subsidized bus passes
Everyone dumps their feelings , and people don’t have time to listen
Treatment by the police is not good
Lack of respect for client concern with addiction
Very unfriendly
Need a baseline assessment
Reduce stigma
Adequate pain management for clients
Reassess client needs on individual basis
Don’t clusters us into groups; each individual is unique
Identify gaps in services
Wait times
Ability to access interpreters, for some staff it is important to be more sensitive for new comers when
English is not their first language.
Increasing support during transition from new country
Appreciation of different languages.
Male doctors need to be more accepting of different cultures and open to explain therapies and
importance of identifying each individual’s uniqueness
Time to invest in each individual
Respect client concerns
Make medication more accessible
Cost can be a barrier to needed medications
Hospitals only help working people.
Treat you better according to your address
Hospitals need to take people seriously, when going to the hospital.
Don’t just send them away when they are talking “suicide”
Health care is adequate in this city