London’s Community Plan...Community Plan Regarding Street Level Women at Risk1 the consultation...

London’s Community PlanRegarding Street Level Women at RiskExecutive Summary June 2015

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London’s Community Plan Regarding Street Level Women at RiskHard to Stop….Harder to Stay Stopped

The Centre for Organizational Effectiveness gratefully acknowledges the City of London, Neighbourhood Children and Fire Services particularly the Homeless Prevention Team and Jan Richardson, for the guidance and support provided during the consultation process to develop the Community Plan Regarding Street Level Women at Risk. The leadership of the London Police Service Persons at Risk Program and Sergeant Lorna Bruce’s dedication to street level women at risk and to this project cannot go without mention.

We are deeply grateful to the thirty three women with lived experience who shared their stories, wisdom and insights with us. These women who participated in the consultation process breathed life into the Community Plan and the Model of Service.

A special thank you to all the service providers, local researchers and community leaders who participated in one-on-one or group interviews:

Acknowledgements

Abe Oudshoorn, Western UniversityAlexis Chaddwich, Youth Opportunities UnlimitedAndre McKenzie, London and Middlesex Housing CorporationAngela Minielly, London Health Sciences CentreAnthoula Doumkou, London InterCommunity Health CentreApril Quinn, Western Area Youth ServicesAshley Cochrane, London Health Sciences CentreAshley Griffin, City of London,Ontario WorksAshley Liltevreaux, London Health Sciences CentreAura Burditt, The Salvation Army Correctional & Justice ServicesBob Newman, City of London, Ontario WorksBrandon Agnew, London CAReSBrandy Dobbs, Women’s Community HouseBrenda Hall, Western Area Youth ServicesBrenda Malott, Children’s Aid Society London/MiddlesexBrian Lester, Regional HIV/AIDS ConnectionCarole Lambkin, The Salvation Army Centre of Hope –

Withdrawal ManagementCass Wender, CMHA Middlesex/My Sisters’ PlaceChanda Kennedy, At’Lohsa Native Family Healing ServicesCharlene Lazenby, Unity Project for Relief of HomelessnessCheryl Smith, City of London, , Community Partnerships &

FundingCheryl Patience, City of London, Ontario WorksClaire McKenzie, London Health Sciences CentreCyndy Ballantyne, City of London, Ontario WorksDave Morris, Children’s Aid Society London/MiddlesexDeanie McClinchy, Children’s Aid Society London/MiddlesexDerek Muir, Western Area Youth ServicesDr. Anne Bodkin, London InterCommunity Health CentreDr. Christopher Mackie, Middlesex London Health UnitDr. Sharon Koivu, Palliative Care, London Health Sciences CentreEleanor Weekmark, City of London, Ontario WorksElizabeth Hall, Freedom FightersGordon Russell, Mission Services of LondonGrant Martin, London CAReS

Heather Wharam, London Abused Women’s CentreHeather Davidson, London Health Sciences CentreHeather Lokko, Middlesex London Health UnitHeather Lumley, St. Leonard’s Community Services of London

& RegionHenry Eastabrook, London InterCommunity Health CentreJane McGregor, Sexual Assault Centre of LondonJennifer McIntosh, Children’s Aid Society London/MiddlesexJesse Huntus, Regional HIV/AIDS ConnectionJodi Hall, Fanshawe CollegeJohn Griffith, Goodwill IndustriesJudy Miller, London Abused Women’s Centre Karen Burton, Regional HIV/AIDS ConnectionKate Cowan, United Way London & MiddlesexKate Wiggins, Women’s Community HouseKelly Miller, London Health Sciences CentreKelly Wright, Regional HIV/AIDS ConnectionKeri Wheatley, Regional HIV/AIDS ConnectionLeanna Zeyl, London InterCommunity Health CentreLinda Cunningham, John Howard SocietyLinda Sibley, Addiction Services of Thames ValleyLouise Pitre, Family Services Thames ValleyLynn Lamb, The Salvation Army Centre of HopeLynne Livingstone, City of London, Neighbourhood, Children &

Fire ServicesMartha Connoy, Mission Services of LondonMary O’Sullivan, Elgin Middlesex Detention CentreMegan Walker, London Abused Women’s CentreMegan Yates, London Health Sciences CentreMichelle Hines, The Salvation Army Centre of HopeMichelle Hurtubise, London InterCommunity Health CentreMike Cretkovich, Children’s Aid Society London/MiddlesexMirella Bryant, Youth Opportunities UnlimitedNancy Powers, The Salvation Army Centre of HopeNatalie Spruce (Student Placement), Nokee KweNeena Gupta, Children’s Aid Society London/Middlesex

DRAFT

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Nick Scrivo, Regional HIV/AIDS ConnectionPam Hill, Addiction Services of Thames ValleyPatty Swartman, City of London, Ontario WorksPeter Rozeluk, Mission Services of LondonRebecca Jesney, London Health Sciences CentreRegina Bell, Children’s Aid Society London/MiddlesexRichard MacDonagh, Regional HIV/AIDS ConnectionRobyn Carsey, London Health Sciences CentreSandra Oakes, London Health Sciences CentreSaundra-Lynn Coulter, London Abused Women’s CentreSandy Bannister, City of London, Ontario WorksSarrah Boyd, London Health Sciences Centre

Sgt. Lorna Bruce, London Police Service Sheena Ewen, , London Health Sciences CentreSheryl Manzara, City of London, Ontario WorksSonja Burke, Regional HIV/AIDS ConnectionStacey Thibodeau, The Salvation Army Centre of HopeSue Slomer, London Health Sciences CentreSusan Macphail, CMHA Middlesex/My Sisters’ PlaceTaylor Rae Starrett, SafeSpaceTina Lightfoot, City of London, Ontario WorksTina Riccobon, City of London, Ontario WorksTreena Orchard, Western University

We are also grateful to those who participated in the conceptual model review sessions and provided much needed feedback to refine the Model as well as the Women with Lived Experience Advisory Council:

Advisory Council - Women with Lived Experience Abe Oudshoorn, Western UniversityAmy Lobb, London and Middlesex Housing Corporation Anthoula Doumkou, London InterCommunity Health CentreAshley Fisher, John Howard Society Ashley Fisher, St. Joseph’s Health Care LondonAura Burditt, The Salvation Army Correctional & Justice ServicesBrandon Agnew, London CAReSBrandy Dobbs, Women’s Community House Brian Lester, Regional HIV/AIDS ConnectionBruce Rankin, John Gordon HomeCass Wender, CMHA Middlesex/My Sisters’ PlaceChuck Lazenby, Unity Project for Relief of HomelessnessDr. Anne Bodkin, London InterCommunity Health CentreEleanor Weedmark, City of London Ontario Works Grant Martin, London CAReSHeather Lumley, St. Leonard’s Community Services of London & RegionHeather Wharam, London Abused Women’s CentreHolly Weaver, SafeSpaceJaclyn Seeler, United Way London & MiddlesexJan Richardson, City of London, Homeless PreventionJane McGregor, Sexual Assault Centre of LondonJanet Tufts, United Way London & MiddlesexJodi Hall, Fanshawe CollegeKaren Jenkins, Fanshawe College - School of Nursing Kate Wiggins, Women’s Community HouseLinda Sibley, Addiction Services of Thames Valley

Louise Pitre, Family Services Thames ValleyLynne Livingstone, City of London, Neighbourhood,

Children & Fire ServicesMartha Connoy, Mission Services of LondonMary O’Sullivan, Elgin Middlesex Detention CentreMbaka Wadham, Regional HIV/AIDS ConnectionMegan Walker, London Abused Women’s CentreMichelle Hines, The Salvation Army Centre of HopeMichelle McIntyre, Children’s Aid Society London/MiddlesexMirella Bryant, Youth Opportunities Unlimited Nancy Powers, The Salvation Army Centre of HopeNatasha Falle, London Abused Women’s Centre Nici Hamilton, London and Middlesex Housing CorporationPam Hill, Addiction Services of Thames ValleyPeter Rozeluk, Mission Services of LondonPina Sauro, City of London, Ontario WorksRegina Bell, Children’s Aid Society London/MiddlesexRhonda Brittan, Middlesex London Health Unit Saundra-Lynn Coulter, London Abused Women’s CentreSgt. Lorna Bruce, London Police Service Shaundra Law, St. Joseph’s Health Care LondonSheena Ewen, London Health Sciences CentreStacey Clarke, London and Middlesex Housing CorporationSusan Hocking, London InterCommunity Health CentreSusan Macphail, CMHA Middlesex/My Sisters’ PlaceTaghrid Hussain, John Howard Society Treena Orchard, Western UniversityYvonne Rimbault, John Gordon Home

Finally, to team members at the Centre for Organizational Effectiveness who worked on this consultation process:

Amy Fox, Research AssociateAnne-Marie Sánchez, Research & Development AssociateCarolyne Dee, Graphic DesignerDanielle Carr, Small Group FacilitatorElizabeth Zimmer, Project AssistantLinda Lustins, Small Group Facilitator

Louise Vandenbosch, Small Group FacilitatorMaria Sánchez-Keane, Principal ConsultantShirley Mitchell, Administrative AssistantShawna Lewkowitz, Small Group Facilitator Susan Ralyea, Small Group FacilitatorTracey Lipp, Small Group Facilitator

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Why a Community Plan Regarding Street Level Women at Risk?

In 2010, the City of London Council and the London Homeless Coalition approved the Community Plan on Homelessness and in 2013 the London Homeless Prevention System Implementation Plan was introduced. The System focuses on applying a Housing First philosophy and approach to succeed at addressing, reducing and preventing homelessness in London. One key area of focus is to develop a community plan regarding street involved sex workers. In 2014 an extensive community consultation was undertaken including meeting with women with lived experience, service organizations working within multiple systems, conducting an international literature review and reviewing housing models in other communities who serve street involved sex workers. The consultation demonstrated a need to focus on women that are involved in street level sex work, and/or trading sex for food, drugs or a place to stay. The Community Plan Regarding Street Level Women at Risk will focus on addressing the housing, exit strategies, health and well-being outcomes of women.

The Community Plan is grounded in the lived experience of street-involved women, and feedback from our city’s service providers who work with street level women at risk as well as evidence informed practices collected through an international literature review. A “Housing First” approach is the underlying approach of the plan and focuses on improving housing, exit strategies, health and well-being outcomes. A “Housing First” approach shifts the priority to move individuals and families quickly into a home with the supports needed to support their stability. This approach is in contrast to other models which expect individuals and families to first address the issues that led to their homelessness such as addiction, trauma, and mental illness before they were housed. This evidence-based philosophy has proven positive results that health and well-being improves by quickly housing and stabilizing individuals and families who are in a housing crisis or who are experiencing homelessness.

What did we hear from women with lived experience and how is this linked with the experience of service providers, other communities and the literature?

As a key guiding principle of the consultation process for the development of the Community Plan Regarding Street Level Women at Risk1 the consultation process began by interviewing women with lived experience which included current and former street

1 Street Level Women at Risk ~ women involved in street level, transactional, survival sex work

Executive Summary

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involved sex workers. The key themes that emerged from these interviews were echoed in the interviews with service providers and confirmed in the literature.

Addiction: By far the most common theme discussed by almost every woman interviewed was the role that substance use and addiction played in their initial and ongoing involvement in survival sex work. Women noted that their introduction to drugs was often by male family members (brothers, fathers) or their male significant others. A common observation from the women who were interviewed was that sex work was often directly related to their addiction. As one former sex worker explained, the only time she would resort to sex work was when she was excessively using drugs and could not afford her next hit. Additionally, many women interviewed had complex histories of abuse and trauma which often led to substance use as a way to self-medicate, self-sooth and numb out. Many women attributed addiction to leading them to their involvement in survival sex work.

Housing: Women interviewed agreed that the ability to find stable housing was key to becoming healthier and making smart choices. They suggested that the ability to have their own space and a place to call their own was important in terms of stability, dignity and independence. However, most women did note that they would still require significant supports (e.g., “someone you can call”) when they first “get off the streets”. Many women expressed concern that their housing was often dependent on their significant others which repeatedly left them in vulnerable situations. When women shared positive experiences with landlords or housing, it was because the landlords were patient and respectful with the women and they believed in them. Based on the interviews, a continuum of housing options is needed to meet the needs of women – not all women want or need the same type of housing. Some of the women interviewed wanted to be away from old neighbourhoods which reminded them of old ways of living; some women expressed the desire to live in a single unit away from the downtown core, or affordable housing in neighbourhoods, so that they would not run into enablers. Still others discussed the importance of living with women in similar situations so they could provide each other with support, while others mentioned not wanting to live with anyone because it often leads to infighting, mistrust, and conflict. In contrast, other women expressed the need for shared accommodation with a private room versus having their own apartment as that would be an overwhelming responsibility. A few wished for the opportunity to leave the London area completely. Children: Of the women interviewed who were mothers, the impact of having their children in the care of child welfare was traumatic. Women frequently shared how difficult it was for them to lose their children and how this often led to a downward spiral leading to more frequent and intense use of substances. The determination, resiliency and motivation to ‘stay clean ‘ and aim to change

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their current situation was tied to the goal of regaining custody of their children. Many women cited being overwhelmed and not knowing the appropriate steps to regain custody of their children. It was also noted that caseworkers do not seem to be prepared for, or familiar with, working with those impacted by addiction and active substance use. Women identified that this often creates an added layer of misunderstanding and tension between the mother and caseworker. The women who shared their experiences with child welfare want the process to be less adversarial and more inclusive of the mothers who genuinely want their children back.

Safety: Most women related their level of safety to housing and many expressed that likely only stable housing would assist them in feeling safe. Women often felt unsafe on the streets, as much as they did in shelters where there is little supervision and the constant threat of conflict and predators. Several women also suggested that the feeling of safety would increase with stable income. The lack of safety related to survival sex work was constantly on their mind and evident as they shared stories of being beaten, violated, raped and held against their will. Most women interviewed shared their stories of abuse related to their street level sex work. Additionally, while many women and even service providers assess safety from a housing and lifestyle perspective, many women talked about safety from a perspective of trust and acceptance. Women lamented often never truly feeling accepted and consequently never feeling safe among circles of friends or within their living conditions with significant others or family.

Supports: Many women noted that it was when they were able to truly connect with a support worker that believed in them and whom they could trust that things started to come together in a positive way. Women stressed the importance of peer support and ideally one support worker that can advocate for them and connect them with a variety of resources such as counselling or workshops on how to achieve employment. Women also emphasized the importance of having this support worker available immediately as they leave jail, as those first few days are often when they get back to old habits such as use of substances and reconnecting with negative influencers.

How does the Community Plan Address the Issues Named by Women?

The title of the Community Plan was created by an advisory group of former street involved sex workers, the sub-title Hard to Stop, Harder to Stay Stopped is a direct quote from a woman with lived experience who summarized her experience in those words and also reflect succinctly what other women shared.

The Community Plan was developed based on the experience of women with lived experience and supported by research, review of other models and the experience, expertise of local service providers and builds upon London’s many community assets.

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During interviews with service providers, many expressed a commitment to shift the way that their resources were used to align with this Community Plan. The City of London is committed to realigning resources to support the implementation. Service providers and local researchers reviewed the Model over a three-session consultation in November and December 2014. An advisory group of women with lived experience also reviewed the Model. Feedback from participants informed the final version of the Community Plan. The Model for the Community Plan has been endorsed by 22 service organizations in the community. These organizations have also committed to the implementation of the model outlined in the Community Plan.

The Community Plan is meant to strengthen what is already taking place in London and to design a collaborative, integrated Housing First response to improve the housing, exit strategies, health and well-being outcomes of street based sex workers.

Overview:

The Community Plan is an important component of the London Homeless Prevention System, and as such is driven by the same vision and guiding principles. The core purpose and guiding principles that are specific to this Community Plan were developed based on what women with lived experience articulated as essential elements needed to provide them with the supports they needed.

Vision The City of London’s Homeless Prevention System is a coordinated and integrated individual and family centred housing stability approach that is outcome focused and designed to address, reduce and prevent homelessness in London.

Core Purpose of the Community Plan Regarding Street Level Women at RiskGrounded in London’s Homeless Prevention System, the Community Plan Regarding Street Level Women at Risk is aimed at supporting housing stability, sustainable exit strategies, and long term health, wellbeing and community belonging for women involved in survival sex work. The Model is framed in a service collaboration providing rapid response, housing with intensive in-home support, and a system of supports focused on long term community integration and belonging.

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Guiding Principles

Guiding Principles – Homeless Prevention System

Guiding Principles: Community Plan Regarding Street Level Women at Risk

Safety: Factors, people, systems and other interactions to assist each woman to be out of danger and feel secure are considered and addressed

Housing with Support

Housing First: From the well-being of her home, each woman is provided with a variety of supports to meet her needsActive Engagement: Understanding the gravity of illness and death of women, and the impact of losing their children, we work from a place of urgency and assertiveness to support each woman in reaching her goalsAs Long as it Takes: We work toward continuous progress, focusing on long-term safety, health and well-being

Homelessness is a Solvable Problem

Housing with Support: We actively work toward each woman achieving housing stability

Individual and Family Centred and Inclusive

Women and Family Centred: The unique strengths and needs of each woman and her family will be respected, and solutions will be customized to her experience and situation in her community of choiceRelational Based: Strong relationships and trust ground our interactions with each womanStrength Based: We draw upon the personal resilience, experiences, resources, motivation and hope of each woman as we work toward viable, long-lasting solutions Trauma Informed: A deep understanding of the impact of trauma and violence in the lives of women and their families informs our work as we realize that the effect of trauma is pervasive and broad and touches many life domains

Partnership Based

Respect: Each woman and her family are always treated with dignity

Organizational Practices: We adapt our practices to respond effectively to address the housing and health outcomes of each womanJoint Agreements: We create concrete memorandums of understanding with participating agencies with clear roles and responsibilities so that they function as an effective system

London Driven Women’s Experience Leads the Way: Women with lived experience are an active part of the process at every step of the way

Neighbourhood Based

Community Education, Readiness and Support: We work toward involving Londoners in creating safe and accepting communities

Harm Reduction Harm Reduction: Practices encompass a continuum of interventions including prevention, education and minimizing risk of harm

Fiscally Responsible

Fiscally Responsible: Resources are used in effective, accountable ways

Outcome Focused

Sustainable Outcome Focused: Results are measured, reported and form the basis of change based on the Guiding Principles Developmental Evaluation: Learnings are captured and inform the continuous improvement of the Model

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The Community Plan contains a variety of elements that together create a comprehensive, collaborative and integrated strategy to address the many challenges facing street level women at risk. All elements of the Model identified in this Community Plan are essential components that support the successful achievement of the desired outcomes.

A Housing First philosophy, providing a permanent home with supports, is at the heart of the Community Plan.

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A Housing First approach is recognized as the combination of attainable permanent housing based on the choice of the women and integrated supports and services anchored in intensive in-home supports. The Model provides a continuum of integrated supports focused on permanent housing with in-home supports.

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Brief description of the Model elements:

Element Brief Overview Service Delivery Elements

Housing with Intensive In-Home Support through the Systems Integration Team

Assist women in attaining and retaining housing including those who continue to work in the sex trade and those who are seeking exit strategies.Provide intensive and ongoing service coordination, direction, coaching and support to the women by maintaining frequent, in-home contact and working with other service providers who are supporting her. Support is based on need and is available 7 days a week, 24 hours a day.

Intensive Support through Systems Integration Team – Ongoing & Regular Communication

Meet weekly, via a one-hour conference call, to identify steps and assign roles and review action plans to address high-risk situations for street involved sex workers who are not housed, not safely housed or recently housed.

Rapid Response Team Immediately assist and provide warm transfers for street involved sex workers whose housing, health, and physical safety are at risk, to emergency and community services and refer to the System Integration Team. The team works regular hours, after-hours and weekends.

Health, Well-Being & Belonging Team

Develop a strong support system for the participant and her family, with a focus on community integration and belonging and including in her team peers, natural supports, volunteers and professionals.

System-Level Supporting Elements

Governance & Collaboration

Provide effective leadership and accountability for all aspects of the Community Plan and work collaboratively to reach intended outcomes.

Peer Support Embed the voice and experience of street involved sex workers throughout the Community Plan, including the service delivery, governance and supporting elements.

Capacity Building through Competency Training & Coaching for Organizations

Deliver comprehensive training and coaching based on the core competencies of working with street involved sex workers to increase the capacity of organizations.

Policy Change Review, enhance and/or develop policy, at the system and organizational levels.

System Design Collectively work to achieve system change to ensure that barriers, prejudice and biases related to street level women at risk are removed.

Neighbourhood Belonging

Foster neighbourhood engagement and dialogue that focuses on the safety and health of communities and all residents, including the women themselves.

The service delivery component of the Model is comprised of three interactive, interdisciplinary, multi-agency teams: The Systems Integration Team, the Rapid Response Team and the Health, Well-Being and Belonging Team coordinated through a collaborative governance structure.

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Systems Integration

Team

RapidResponse

TeamHealth,

Well-BeingBelonging

Team

While the Model may appear static and linear on paper, it is clear from the women with lived experience consulted, the literature, and service providers, that life for street involved sex workers is dynamic, varied, and shifts regularly. The Community Plan is meant to be an active system that provides a coordinated and active commitment to street based sex workers. A brief overview of these three components follow:

The Systems Integration Team

While there are many service providers who work with street level women at risk, there is no systematic approach for service providers to regularly communicate and collaborate to support women. This issue was made clear by both women with lived experience and the service providers who were interviewed. Additionally, there is no systematic way to rapidly house women and provide intensive in-home case management.

Purpose: The purpose of the System Integration Team is to rapidly assist street involved women at risk in securing housing and providing ongoing intensive and integrated in-home support available as needed, and to assist with responding to a crisis 7 days a week 24 hrs a day through cooperative case management and weekly case conferences. This Systems Integration Team is meant to enhance the way service providers currently work and build on the many assets already established within the London community.

The Systems Integration Team will have dedicated Housing Finders and Intensive In-home Case Managers who will work toward housing street level women at risk rapidly.

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The goal is to provide a variety of housing options for individuals referred to the team based on their interest, choice of neighbourhoods, and need. The streamlined response includes the key service providers meeting on a weekly basis to focus on Housing First solutions that can be implemented within 24 to 48 hours in order to provide focused and continuous support to street level sex workers. The in-home case managers are based on existing community resources committed to working with those newly housed and augmented with available funding particularly to support the Housing Finders in securing attainable housing.

Models of the weekly case conference meetings in other communities such as Calgary, Alberta and Prince Albert, Saskatchewan have proven very effective in identifying individuals most at risk and addressing their unique needs.

The Intensive In-Home Case Workers focus on linking individuals with the right community support to address issues such as mental health, addiction recovery and trauma, and coach around basic life skills (e.g., shopping, cooking, cleaning, banking, financial planning, forging new friendships, using public transportation and social norming, being a good neighbour and tenant) and organizing meaningful daily activity opportunities (e.g., using the public library and belonging centres). As one woman stated, “I needed to relearn how to live a regular life again.”

The Rapid Response Team

It was evident from the interviews with women with lived experience that there are individuals in London who do not seek service with any service providers in the community and do not actively seek help or support even when it is urgently needed. The Rapid Response Team provides the ongoing street level intelligence, gathering much needed information related to the safety of women who are street involved in London. The team builds trust with street involved women and seizes opportunities to provide warm transfers for immediate and often urgent services. The team actively works to provide options to address the housing, health and safety of street involved sex workers.

Purpose: The Rapid Response Team is an interdisciplinary, multi-agency team whose integrated focus is to identify, actively refer and provide warm transfers for women at risk to resources that will meet immediate health, safety and housing needs. The Team is available 24 hours, 7 days a week.

This team will actively support individuals through a Housing First lens by connecting them to the Systems Integration Team and other necessary supports. The Rapid Response Team enhances the well-established London Police Service Persons at Risk Program.

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The Rapid Response Team is an essential component of the Community Plan; however, on its own the team will not effectively meet the needs of women identified. While this team is a required element of the Community Plan, it must link with the Systems Integration Team to ensure that women referred are rapidly housed and receive the supports they need in the comfort of their own homes.

The Health, Well-Being and Belonging Team

As articulated in the subtitle of the Community Plan: Hard to Stop, Harder to Stay Stopped, the ongoing support for women to successfully meet their life goals is essential. The Community Plan addresses this challenge with the Health, Well-Being and Belonging Team. This approach is further confirmed by the literature, the interviews conducted with other communities who use a Housing First approach, and the experience of local organizations. The supports needed vary from woman to woman, particularly as they progress in meeting their life goals.

Purpose: The Health, Well-Being and Belonging Team is created and led by each woman, and supported by a facilitator. Wraparound principles and processes are recommended for this team. These include formal and natural supports, use a strengths-based approach, consider all life domains and focus on the life goals of the woman and her family.

This team will not generally come together in the early days of housing with supports. Once the woman is more settled, the creation of her Health, Well-Being and Belonging Team supports her as she integrates and anchors herself in her community of choice. Many former sex workers who were interviewed discussed this process as being long and lonely. Over time, formal supports should play less of a role as a woman creates her natural community and develops a sense of belonging.

How will we know we have been successful?

Two primary outcomes guide the efforts and form the basis for the indicators of success of the London Homeless Prevention System:

• Individuals and families experiencing homelessness obtain and retain housing• Individuals and families at risk of homelessness remain housed

Once fully operational, the Community Plan will focus on these outcomes:

• Decrease the number of women experiencing cyclical, chronic homelessness• Earlier identification of new women becoming street involved through a housing

stability intervention• Increase the number of women who are living in their home• Increase the number of women exiting survival sex work• Increase the number of women who are raising their children in a safe environment

with appropriate supports

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• Increase the number of women actively engaged in their addiction treatment plan • Increase the number of women who are safer• Increase the number of women who have met or are working toward meeting realistic

life goals• Improve physical and mental health outcomes• Improve the well-being of street level women at risk • Increase the number of informal, natural supports to improve women’s social network

and sense of belonging• Achieve a high level of satisfaction with service providers that street level women at

risk will encounter

What are the next steps?

There are 22 service organizations in the city that have already made a commitment to the implementation of the Community Plan and an advisory council of women with lived experience who have also committed to being involved in supporting the implementation. There is a great need for everyone to work collaboratively, in an integrated way, and an expressed commitment to more effectively improve the housing, health and well-being of women involved in street based sex work. Street level women at risk have shared their experience in the hope of creating change in our community.

“Make my place my own close to my community” [woman with lived experience]

“A nice house, like a retreat setting, away from the downtown community.” [woman with lived experience]

“If I can just have a home, not just a place and just a few good people in my life, then I know I can make it.” [woman with lived experience]

London’s Community Plan...Community Plan Regarding Street Level Women at Risk1 the consultation...

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