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Reducing chronic homelessness through collaboration, community partners

by Canadian Alliance to End Homelessness
in Housing

Bright Spot: Ottawa reduces chronic homelessness by 19 percent through collaboration and great efforts from community partners

The City of Ottawa made some targeted changes to their system that left a major impact. These changes included reaching and holding a 10 percent or greater reduction in the number of people experiencing chronic homelessness since June 2021. As of May 2022, they are reporting a 19 percent reduction.

Several housing-focused system improvements played a significant role in reaching this milestone. But the city emphasized that the collective efforts of community partners was invaluable to their success. “This achievement is truly a testament not just to the city, but to all the community partners and homelessness response agencies that work tirelessly to reduce and resolve homelessness in the Ottawa community,” said Paul Lavigne, the City of Ottawa’s Manager of Homelessness Programs and Shelters.

Housing-Focused Outreach and Shelter

Ottawa’s street outreach and shelter services have both shifted to a robust housing-focused approach. This strengthened their By-Name List and housing outcomes for sheltered and unsheltered individuals. The staff and leadership within Ottawa’s shelter system and outreach services have been vital to their success.

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“The city’s housing-focused approach first seeks to understand clients’ housing needs and preferences and then match them to services, assist them in becoming document-ready, and support them to find housing,” Lavigne explained.

Under this model, significant efforts are made to help clients who arrive at contact shelters to maintain housing or divert from shelter. Furthermore, with expanded resources, street outreach services have tripled their impact on the unsheltered population since the beginning of the COVID-19 pandemic.

Housing First Team Approach

The redevelopment of Housing First team roles identified in a 2019 assessment by the Canadian Alliance to End Homelessness (CAEH) led to key improvements in Ottawa’s system and supported their efforts in reaching this milestone. The city’s approach for housing searches was redeveloped in 2015 and evolved again in 2019. This is when the city shifted the role of Housing Specialists to work in tandem with the housing-based case managers to form Housing First teams. Housing-based case managers and housing specialists not only provide direct support to chronically homeless individuals for finding housing, but they also work to ensure that they remain housed.

“The housing specialists build relationships with landlords and vet units, along with procuring housing options for clients. Youth housing specialists, for instance, are able to connect with 500 landlords per quarter,” Lavigne added.

Commitment to Supportive Housing

Another major factor in Ottawa’s chronic homelessness reduction is their commitment to increasing the availability of supportive housing units. The City of Ottawa’s 10-Year Housing and Homelessness Plan, updated in 2020, requires that 10 percent of new affordable housing units are supportive housing units. The city’s shift over the past decade from a traditional shelter model to the creation of more supportive housing units has led to the creation of close to 800 supportive units across the city since 2006.

Ottawa’s Built for Zero chronic homelessness baseline was set in January 2020. Since that time, three supportive housing buildings and several scattered units have become operational. These new builds have added a combined total of 95 units to Ottawa’s supportive housing inventory, which have been used to house people experiencing chronic homelessness who have complex needs.

Family Strategy

The city has also been looking at ways to reduce family homelessness as a target area. Reductions in family homelessness have played a major role in their overall reductions in chronic homelessness. Built for Zero communities include all people experiencing chronic homelessness in their overall chronic homelessness numbers, including families. In January 2020, when the baseline was set for chronic homelessness in Ottawa, there were 928 chronically homeless family members (individuals who are part of families). As of May 2022, that number has reduced to 617 chronically homeless family members.

This reduction in family members experiencing chronic homelessness is a result of multiple factors. These factors include adding resources to the city’s Housing First Program, which supports families moving from shelter to maintain housing. Additionally, the city added the role of Rapid Rehousing Worker to their emergency shelter staff. Rapid rehousing workers focus on finding and securing housing for families as quickly as possible when they arrive at the shelter. Finally, the border closures that occurred as a result of COVID-19 had a major impact on the inflows to family homelessness in Ottawa.

Collective Efforts

Ottawa’s use of their By-Name List data, in conjunction with case conferencing, has helped their system shift to a more team-based approach across different agencies. This has led to more wrap-around supports and a shared understanding of what individual clients need. According to Lavigne, “the staff and leadership of our community partners have been the most important stakeholders in this achievement through their tireless work to find housing and provide the necessary supports for clients experiencing chronic homelessness.”

The First Nations, Inuit, and Métis service providers ensure Indigenous clients secure culturally appropriate and safe care. The veteran’s working group has provided focused support to veterans, seeking to improve their access to appropriate housing and support services. The Canadian Mental Health Association (CMHA) provides targeted services to chronically homeless clients with significant mental health needs in order to assist them in getting and remaining housed. CAEH, in addition to their advocacy efforts, has provided the Built for Zero coaching, tools, and platform to allow us to reach and recognize this achievement.

By specifying areas of impact and collectively diving deep into the By-Name List with representatives across multiple areas, the City of Ottawa is better able to focus on each individual’s needs and how their specific circumstances can be resolved.

Unique and Effective Approach to Youth Case Conferencing

Case conferencing has been an invaluable tool, and has allowed for great success in many areas, especially for chronically homeless youth.

The Youth Coordinated Access Group (YCAG) in Ottawa has developed a unique approach to case conferencing, from a systems lens rather than problem solving for individual clients. This creates a space to foster solutions for systemic issues impacting youth experiencing homelessness. The model builds upon the monthly meetings that members of the YCAG attend, but adheres to a four meeting structure.

The first three meetings are for prep work. These meetings focus on identifying the theme of the issue; identifying client case studies; identifying and inviting pertinent guests; and reviewing relevant data or information pertaining to the issue. The fourth meeting serves as the case conferencing meeting. At this point, a facilitated discussion occurs to discuss solutions and identify next steps. The development of this approach began in November 2020 with support from CAEH and cumulated in the first session being held in January 2022.

Challenges and Lessons Learned

The COVID-19 pandemic led to many challenges in the housing and homelessness sector, including a need to open physical distancing centres (PDCs). These centres were meant to ensure the shelter system could meet public health directives, outbreaks, and staff shortages. The PDCs, which were first opened to provide extra capacity to the shelter system when the pandemic began, have reduced the number of people at any given site, allowing the emergency shelter staff to focus more efforts on providing housing support to clients.

The city also highlights housing affordability as a major challenge in Ottawa and, as a result, the sector is always working diligently on securing housing for clients.

“Challenges have been overcome and continue to be overcome. Along with housing affordability, which continues to be a major issue, another challenge surrounds client consent and data sharing within agencies who are all working towards the same goals and for the same clients but can’t always share information,” said Lavigne. “The goal is to continue to establish methods so that case conferencing can be expanded, and we can continue to concentrate on collaboration and supporting clients in housing.”

Along with the challenges came lessons learned – including the necessity of a team-based approach and testing methods on smaller populations before scoping out and applying them to larger ones.

“The most effective way to test the efficacy of an approach to chronic homelessness is to begin with a smaller population, see how the intervention goes, and then ‘scope out’ as the lessons are learned about how to be successful. We can then apply the approach to another population along with the lessons learned,” Lavigne explained.

Despite the set of challenges that the pandemic posed, the city and its community partners were able to pivot when needed and strive ahead.

Next Steps

Moving forward, the City of Ottawa plans to continue improving the sector’s capacity for housing procurement.

“Ottawa has a very low vacancy rate, and we continuously look for ways to work around those challenges that are client-focused,” Lavigne said.

Ottawa also intends to continue improving their data in the Homeless Individuals and Families Information System (HIFIS). Many homelessness response agencies in the sector have recently begun to use this software, which Ottawa’s emergency shelters have used for many years.

“There’s always more work to be done, but we’re excited to continue seeing progress in our goal of ending chronic homelessness,” Lavigne said.  MW

This article originally appeared as a blog post in the Canadian Alliance to End Homelessness Bright Spot series and is reprinted here with permission from CAEH.


Municipal World Insider and Executive Members: You might also be interested in Carolyn Whitzman, Alexandra Flynn, Penny Gurstein, and Craig Jones’ article: Affordable housing leadership.

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