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The at Home/Chez Soi Project Sustainability of Housing and Support Programs Implemented at the Winnipeg Site Scott Mccullough and Sarah Zell January 2016

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The at Home/Chez Soi Project Sustainability of Housing and Support Programs Implemented at the Winnipeg Site Scott Mccullough and Sarah Zell January 2016 THE INSTITUTE OF URBAN STUDIES, THE UNIVERSITY OF WINNIPEG The At Home/Chez Soi Project Sustainability of Housing and Support Programs Implemented at the Winnipeg Site Scott McCullough and Sarah Zell January 2016 THE INSTITUTE OF URBAN STUDIES, THE UNIVERSITY OF WINNIPEG Mailing Address: 515 Portage Avenue Winnipeg, Manitoba R3B 2E9 Offices: 599 Portage Avenue, Winnipeg phone: (204) 982-1140 fax: (204) 943-4695 general email: [email protected] The At Home/Chez Soi Project: Sustainability of Housing and Support Programs Implemented at the Winnipeg Site The findings and analysis in this publication are those of the authors and are based on interviews conducted with project stakeholders. They do not necessarily reflect the opinions or positions of the organizations mentioned or of the Mental Health Commission of Canada. The research protocol for this study was reviewed and approved by the University of Manitoba Bannatyne Campus Research Ethics Boards in January 2014. Authors: Scott McCullough and Sarah Zell The Institute of Urban Studies (IUS) is an independent research arm of the University of Winnipeg. Since 1969, the IUS has been both an academic and an applied research centre, committed to examining urban development issues in a broad, nonpartisan manner. The Institute examines inner city, environmental, Aboriginal and community development issues. In addition to its ongoing involvement in research, IUS brings in visiting scholars, hosts workshops, seminars and conferences, and acts in partnership with other organizations in the community to effect positive change. Contents Executive Summary ....................................................................................................................................... i I. Introduction and Context ........................................................................................................................... 1 Community Context ......................................................................................................................... 1 Overview of the Project Site ............................................................................................................ 2 Previous Assessments of Program Fidelity ...................................................................................... 3 II. Methodology ............................................................................................................................................ 4 Sample Description .......................................................................................................................... 4 Methodological Steps....................................................................................................................... 5 Coding and Analytical Approach ..................................................................................................... 6 Positionality and Research Limitations ........................................................................................... 6 III. What Happened: The Sustainability Story .............................................................................................. 7 Sustainability Planning Period ......................................................................................................... 7 Transition Period .............................................................................................................................. 7 New System Period .......................................................................................................................... 8 IV. Sustainability Outcomes ......................................................................................................................... 8 Funding ............................................................................................................................................ 8 Staff Retention and Effects on Staff .............................................................................................. 10 Effects on Participants ...................................................................................................... 12 Loss of Administrative Staff ............................................................................................. 13 Lived Experience Circle ................................................................................................................ 13 Local Partnerships .......................................................................................................................... 14 Housing Coordination ....................................................................................................... 14 Landlord Partners .............................................................................................................. 15 EIA and Medical Systems ................................................................................................. 15 An Evolving System: New Partnerships and Integration ............................................................... 16 V. Fidelity and Consistency of Practice ...................................................................................................... 18 VI. Dissemination and Influence of Housing First ..................................................................................... 20 Public ............................................................................................................................................. 21 Homeless-Serving Sector ............................................................................................................... 22 The Health and Housing Systems .................................................................................................. 23 And Beyond ................................................................................................................................... 23 VII. Factors Influencing Sustainability ....................................................................................................... 24 Policy and Funding Context ........................................................................................................... 24 Community Context ....................................................................................................................... 28 Strategies, Organizational Support and Local Leadership ............................................................. 31 Implementation Model and Organizational Support ......................................................... 32 Local Leadership and Messaging...................................................................................... 33 Research Findings .......................................................................................................................... 35 VIII. Cross-Cutting Themes and Reflections .............................................................................................. 37 IX. Concluding Remarks ............................................................................................................................ 39 References ................................................................................................................................................... 41 Appendix: Fidelity Self-Assessment Scores ............................................................................................... 43 Definitions and Acronyms ACT Assertive Community Treatment (program) CMHA Canadian Mental Health Association EIA Employment and Income Assistance Program, Government of Manitoba HSSI Housing, Supports and Services Integration, Winnipeg Regional Health Authority, Manitoba Health Housing Plus Pre project end: social agency that handled move-in/outs and provided furniture to participants Post project: a new program that sources units for Housing First programs in Winnipeg, operated by the Winnipeg Rental Network HPS Homelessness Partnering Strategy, Employment and Social Development Canada, Government of Canada ICM Intensive Case Management (program) IUS Institute of Urban Studies, University of Winnipeg LEC Lived Experience Circle MB Housing Department of Housing and Community Development, Government of Manitoba MGR Manitoba Green Retrofit: a social enterprise developed out of the At Home/Chez Soi project that provided repair and construction services MHCC Mental Health Commission of Canada NiApin Program name of the site-specific ICM intervention of the Winnipeg site, At Home/Chez Soi project PACT Program of Assertive Community Treatment, of the Winnipeg Regional Health Authority – Community Mental Health Program PWLE People with Lived Experience SRO Single Room Occupancy hotel Wi Che Win Program name of the ICM intervention of the Winnipeg site, At Home/Chez Soi project Wiisocotatiwin Program name of the ACT intervention of the Winnipeg site, At Home/Chez Soi project WRHA Winnipeg Regional Health Authority, one of five RHAs under Manitoba Health Executive Summary This report is the final Winnipeg Site Report of the Mental Health Commission of Canada’s At Home/Chez Soi project. The research examined the sustainability of Canada’s At Home/Chez Soi Housing First (HF) programs for homeless persons with mental illness leading up to and after the end of the demonstration phase of the randomized controlled trial. It covers the final period of the project when Sustainability of the project was being planned and implemented, and tells the sustainability story of the project—what happened and why. The objective was
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