Une introduction au logement supervisé et le Logement d’abord

by admin | Feb 20, 2021 | Canada, Ending Homelessness, Fiscal policy, Government, Government Funding, Harm Reduction, Homeless, Housing, Housing First, Ontario, Pitching new programs to government, Policy, Social Housing, Social Policy, Toronto

Une introduction au logement supervisé et le Logement d’abord

An English-language version of this blog post is available here.

Le 3 février 2021, j’étais conférencier dans le séminaire d’études supérieures de Greg Suttor au département de géographie et de planification de l’université de Toronto (un grand honneur puisque Greg est un de mes mentors depuis longtemps). Ma présentation portait sur les liens entre les univers du logement et du sans-abrisme au Canada (et plus particulièrement à Toronto).

La présentation entière et détaillée est disponible (en anglais) ici.

Voici 10 choses à savoir à ce sujet :

1. Au Canada, la plupart des gens qui réfléchissent à la question s’entendent pour dire que le logement subventionné est essentiel afin de le prévenir et de répondre au sans-abrisme. Toutefois, il existe des débats importants : la quantité additionnelle de logements abordables requis; à qui devraient servir le nombre limité de logements; quels sont les meilleurs modèles de logements subventionnés; et à quel degré chaque logement devrait-il être subventionné?

2. Les élus ne s’entendent pas sur la répartition des couts des subventions. À l’heure actuelle, le consensus est que le gouvernement fédéral canadien devrait s’acquitter des frais de développement (par exemple, le capital), mais on ne s’entend pas à savoir qui devrait financer les frais d’exploitation conséquents. Les paliers de gouvernements jouent en quelque sorte à voir qui cèdera en premier, ce qui limite la quantité de nouveaux logements abordables créés chaque année.

3. En Ontario, lorsque le sans-abrisme est survenu comme défi de politique publique dans les années 80, les personnes itinérantes sont devenues un point focal majeur de la politique sur le logement. Une approche de l’époque consistait à reloger les itinérants dans des logements abordables et leur offrir de l’assistance sociale. Aujourd’hui, cette approche s’appelle le logement supervisé (et de nos jours, Logement d’abord en est presque un synonyme). La plupart des résidents qui ont recours au logement supervisé au Canada sont des adultes célibataires n’ayant personne à charge et qui ont de sérieux défis de santé mentale.

4. Ce changement de cap n’est pas survenu dans un vacuum politique – assurément, le militantisme politique a joué un rôle central à son avènement. À Toronto, cela a compris la création du Singles Displaced Persons Project (ou « le projet des personnes célibataires déplacées »), du mouvement des « survivants/consommateurs » qui avait pour slogan « homes not hostels » (ou « un domicile, pas du dépannage ») ainsi que la mise sur pied d’organismes tels Houselink Community Homes, et Homes First Society.

5. Le genre d’appui social offert conjointement avec le logement supervisé fait l’objet de débat. Lorsque j’offrais de tels appuis en travaillant à Toronto, j’aidais les locataires à tenir compte de leurs rendez-vous (par exemple chez le médecin, avec de travailleurs sociaux pour le revenu, ou pour des comparutions en cour). Je les ai souvent accompagnés à leurs rendez-vous. Je les ai défendus s’ils étaient menacés d’éviction et les ai aidés à déménager lorsque cela était nécessaire. Il m’est souvent arrivé de les inviter à prendre un café également.

6. Le logement supervisé permanent adapté au milieu facilite l’organisation d’activités sociales en groupe. On parle ici d’un édifice entier où l’ensemble des locataires ont recours au logement supervisé (plutôt qu’une simple proportion de ses locataires). Ce genre de logement supervisé comprend habituellement du personnel d’appui sur place et dans certains cas, le personnel demeure sur place en tout temps. Le logement supervisé permanent adapté au milieu peut offrir un important appui avec la gestion d’invités et facilite la mise sur pied de programmes alimentaires, d’exercice physique, et de cours d’art.

7. Au Canada, le concept de Logement d’abord – qui est presque synonyme du logement supervisé – a commencé à être accepté au début des années 2000. La Ville de Toronto a beaucoup misé sur le concept à partir de 2005, et la Calgary Homeless Foundation s’y est intéressée également; les militants et les intervenants du domaine s’en servent maintenant à travers le Canada. La stratégie du Logement d’abord permet d’éliminer la condition exigeant qu’un locataire potentiel soit « prêt » à être logé pour l’être.

8. L’idéologie entourant le Logement d’abord ne se situe ni à droite ni à gauche de l’échiquier politique. Elle sert plutôt de “troisième approche” stratégique grâce à laquelle elle trouve des adeptes parmi les entrepreneurs chefs de fil, les élus de toute allégeance politique, et toute une gamme de militants. Cela s’explique en partie par le fait que le Logement d’abord promeut habituellement une redistribution des ressources existantes. Ça s’explique aussi par le fait que les adeptes du Logement d’abord favorisent l’usage de logements privés à but lucratif plutôt que des logements appartenu par des organismes à but non lucratif.

9. Le mérite de l’approche Logement d’abord a été démontré davantage par l’étude canadienne At Home/Chez soi. Dans cette étude randomisée et contrôlée, des participants de cinq villes avec des besoins modérés ont reçu une forme de Logement d’abord incluant une intervention de type Soutien d’intensité variable, tandis que les participants avec des besoins élevés ont reçu une forme de Logement d’abord incluant une intervention de type Suivi intensif. Les participants ont été interviewés tous les trois mois pendant deux ans. Les résultats étaient concluants et moins dispendieux.

10. La Stratégie nationale sur le logement, dévoilée en 2017, ne contient aucune provision spécifique pour le logement supervisé, et ne mentionne pas le Logement d’abord. Pourtant, dans le discours du Trône de septembre 2020, le gouvernement canadien s’engageait à « complètement éliminer le sans-abrisme chronique ». De plus, seulement 5% du nouvel argent a été mis de côté pour réduire le sans-abrisme chronique.

En conclusion, la bonne nouvelle c’est que la plupart des leadeurs du Canada croient que le logement supervisé est une bonne façon de prévenir et de répondre au sans-abrisme. Leur usage du langage de Logement d’abord en témoigne. La mauvaise nouvelle, c’est que la plupart des élus hésitent à engager les fonds nécessaires pour réduire le sans-abrisme – par exemple, la Stratégie nationale sur le logement semble insuffisamment financée pour atteindre l’objectif du gouvernement canadien de mettre fin au sans-abrisme chronique.

Je voudrais remercier Damian Collins, Stéphan Corriveau, John Ecker, Joshua Evans, George Fallis, Susan Falvo, Hayley Gislason, David Hulchanski, Michel Laforge, Steve Lurie, Geoffrey Nelson, Deborah Padgett, Angela Regnier, John Rook et Vincent St-Martin pour leur aide à la rédaction de ce billet.

A primer on supportive housing and Housing First

by admin | Feb 20, 2021 | Canada, Ending Homelessness, Government, Government Funding, Harm Reduction, Homeless, Housing, Housing First, Ontario, Social Housing, Social Policy, Toronto

A primer on supportive housing and Housing First

La version française de ce billet se trouve ici.

On 3 February 2021, I gave a guest lecture in Greg Suttor‘s graduate seminar course at the University of Toronto’s Department of Geography and Planning (Greg is a long-time mentor of mine, so this was a huge honour). My presentation focused on how the worlds of housing and homelessness connect in Canada (and in Toronto especially).

My full slide deck, which contains considerable detail, can be found here.

Here are 10 things to know:

1. In Canada, most leading thinkers agree that subsidized housing is key to both preventing and responding to homelessness. However, there are important debates about: how much more subsidized housing is needed; who should be prioritized for the limited number of available units; which models of subsidized housing are best; and how much subsidy should be attached to each unit.

2. Elected officials do not agree on who should finance subsidized housing. Right now, there’s broad agreement that Canada’s federal government should provide assistance with up-front development costs (i.e., capital costs), but there’s considerable debate over who should finance the ongoing costs after the housing is developed (i.e., operating costs). This ongoing game of chicken, whereby one order of government waits for another one to cave, limits the amount of new affordable housing that gets created each year.

3. In Ontario, when homelessness emerged as a pressing public policy challenge in the 1980s, persons experiencing homelessness started to become a major focus of housing policy. An approach emerged at that time that focused on re-housing persons into subsidized housing and providing them with social work support. This approach became known as supportive housing (today, the term Housing First means almost the same thing). Most residents of supportive housing in Canada are single adults without dependants and are experiencing serious mental health challenges.

4. This didn’t happen in a political vacuum—indeed, political advocacy played a major role in bringing it about. In Toronto, this included the Singles Displaced Persons Project, the “consumer survivor” movement, the slogan “homes not hostels” and the founding of organizations such as Houselink Community Homes, and Homes First Society.

5. The type of social work support provided with supportive housing is the subject of much debate. When I provided such support while working in Toronto, I helped tenants keep track of appointments (e.g., doctors’ appointments, appointments with income support workers, and court appearances). I often accompanied tenants to the appointments. I advocated for them if they were ever being threatened with eviction and (when necessary) helped them relocate to new units. I frequently took them for coffee as well.

6. Place-based supportive housing makes it relatively easy to organize group social activities. Place-based supportive housing refers to a situation where an entire building is occupied by tenants in need of supportive housing (as opposed to just a small percentage of a building’s units being occupied by a specific population group). This type of supportive housing typically involves on-site staff support (with some models, there are staff on site at all times). Place-based supportive housing can offer important assistance with guest management and makes it relatively easy to have meal programs, as well as exercise and art classes.

7. In Canada, Housing First—which means something very similar to supportive housing—became an effective narrative beginning in the early 2000s. The City of Toronto pushed this hard beginning in 2005, and the Calgary Homeless Foundation picked it up quickly as well; advocates and practitioners across Canada now use the term extensively. The Housing First narrative places great emphasis on the importance of not requiring housing readiness on the part of the prospective tenant as a condition of obtaining housing.

8. Ideologically, advocacy in favour of Housing First isn’t exactly left or right; rather, it entails a ‘third way’ political advocacy strategy. Largely because of that ‘third way’ approach, it has found traction among business leaders, elected officials of all stripes and a broad cross-section of advocates. Part of this stems from the fact that Housing First advocates often promote a reallocation of existing resources. It also stems from the fact that Housing First proponents tend to favour the use of housing owned by for-profit landlords (whereas proponents of supportive housing have historically favoured non-profit ownership).

9. Housing First was further advanced by Canada’s At Home/Chez Soi study. This was a five-city randomized controlled study in which participants with moderate needs received Intensive Case Management, while those with higher levels of need received Assertive Community Treatment. Participants were interviewed every three months over two years. Results demonstrated successful outcomes and cost savings.

10. Canada’s National Housing Strategy, unveiled in 2017, contains no specific provisions for supportive housing and makes no mention of Housing First. Yet, the September 2020 Federal Throne Speech includes a commitment to “completely eliminate chronic homelessness.” Further, just 5% of new funding under the National Housing Strategy has been earmarked towards the goal of reducing chronic homelessness.

In sum. The good news is that most of Canada’s thought leaders believe that supportive housing—often articulated via Housing First language—is an important way to both prevent and respond to homelessness. The bad news is that most elected officials are reluctant to commit the necessary funding to substantially reduce homelessness—for example, the National Housing Strategy appears insufficiently resourced to meet the Government of Canada’s objective of ending chronic homelessness.

I wish to thank Damian Collins, Stéphan Corriveau, John Ecker, Joshua Evans, George Fallis, Susan Falvo, Hayley Gislason, David Hulchanski, Michel Laforge, Steve Lurie, Geoffrey Nelson, Deborah Padgett, Angela Regnier, John Rook and Vincent St-Martin for assistance with this blog post. I also wish to thank HomeSpace Society for permission to use the photo used in this post.

Ten Things to Know About Homelessness in Canada

by admin | Sep 15, 2015 | Aboriginal Peoples, Alberta, Canada, Cities, Demographics, Employment, Employment Insurance, Fiscal policy, Homeless, Housing, Income, Income Support, Indigenous peoples, Labour Market, Macroeconomics, municipalities, Nunavut, Ontario, population aging, Poverty, seniors, Social Policy, taxation, Toronto, Unemployment

Ten Things to Know About Homelessness in Canada

This afternoon I gave a presentation at Raising the Roof’s Child & Family Homelessness Stakeholder Summit in Toronto. My slide deck can be downloaded here. To accompany the presentation, I’ve prepared the following list of Ten Things to Know About Homelessness in Canada.

1.Efforts to enumerate persons experiencing homeless have generally been spotty, but it is reasonable to assert that homelessness in Canada saw substantial growth in the 1980s and 1990s. On a nightly basis in Toronto, there were about 1,000 persons per night staying in emergency shelters in 1980. By 1990, that figure had doubled. And ten years later, there were 4,000 persons per night staying in Toronto’s emergency shelters. The Toronto figure of 4,000 per night has remained relatively constant for the past 15 years, though it has edged up in the aftermath of the 2008-2009 recession a phenomenon which I’ve previously written about here. (Admittedly, the number of persons living in emergency shelters on a nightly basis is a rather narrow gauge of homelessness. According to Canada Mortgage and Housing Corporation, approximately 13% of Canadian households are in core housing need; for Nunavut, the figure is a whopping 39%.)

2. Though it’s difficult to establish causation, I think relatively safe assumptions can be made about some of the major contributors to homelessness. Researchers are generally careful about using the term causation in fact, there are long-standing tensions among academic disciplines as to what methodological approaches are required to establish it. Statisticians, for example, generally believe that randomized controlled trials (RCTs) are needed to establish causation; but as David Freedman has argued, RCTs are often impractical or unethical (Freedman, 1999, p. 255). Rather, careful researchers are more likely to say things like these factors have likely contributed to this effect,” or “I think it’s likely that this effect caused this to happen And with that in mind, I’d like to suggest that there are probably three major factors that have contributed to homelessness in Canada: 1) macroeconomic factors (especially unemployment); 2) changes to our social welfare system (including a decrease in the availability of government-subsidized housing); and 3) the design and administration of policies whose specific intent is to respond directly to homelessness (often referred to as ‘systems responses’ to homelessness).

3. Homelessness has profound ramifications on the lives of children. As I wrote in 2012: Two studies have been done in Toronto looking at the role of housing with respect to children in care. Results of both studies indicate that the state of the family housing was a factor in one in five cases in which a child was temporarily admitted into care. Results from the Toronto research also indicate that, in one in 10 cases, housing status delayed the return home of a child from care (Falvo, 2012, p. 14). Other research estimates that, on an annual basis in Toronto alone, approximately 300 babies are born to mothers who are homeless. (Of course, homelessness can have profound ramifications on the lives of adults as well. For more on this, see this 2007 study.)

4. The role of Canada’s federal government in funding both housing for low-income persons and programming for homeless persons has varied considerably over time. Provinces and territories spend much more of their own money on housing for low-income persons when the federal government leads. Thus, a considerable amount of subsidized housing for low-income Canadians was built from the mid-1960s through to the early 1990s. Since the early 1990s, comparatively little subsidized housing has been built for low-income persons in Canada. I should also note that the annual, inflation-adjusted value of federal funding for homelessness today is worth just 35% of what it was worth in 1999.

5. Not every province/territory responds to homelessness in the same way. While much mores subsidized housing for low-income persons gets built when the federal government leads, provinces and territories don’t always respond to federal funding initiatives in the same way. For example, between 2002 and 2013, three times as many subsidized housing units were built in Alberta (on a per capita basis) than in Ontario. I would argue that a driving force behind this differential stems from Alberta’s strong economic performance during this same period relative to that of Ontario’s.

6. Though a careful researcher will be cautious in discussing what causes homelessness, I think we know a lot about what solves it. In many cases, a person who stays in an emergency shelter will exit homelessness without substantial public resources. In some cases, they might find housing on their own; in other cases, family and friends may provide them with short term assistance e.g. some financial support, a couch to sleep on, etc. (To learn more about lengths of stay in homeless shelters in a sample of Canadian cities, see this 2013 study.) Researchers and advocates for the homeless generally don’t view such short-term stays as a major public policy challenge the bigger challenge is in the case of persons who stay in emergency shelters (and outside) for longer periods of time. Even here though, I would argue that it’s hardly a mystery as to what constitutes an effective policy response.

Indeed, as early as the mid-1980s, small non-profit organizations in Ontario (and possibly in other provinces as well) found success in building subsidized housing for persons who had experienced long-term homelessness they did so by providing professional staff support to help such tenants live independently in those units. This was (and still is) known as supportive housing. The emergence of supportive housing in Ontario happened in large part due to strong advocacy by community-based groups. This included: the Singles Displaced Persons Project; the consumer/survivor movement; the slogan homes not hostels the founding of Houselink Community Homes; and the founding of Homes First Society. Conditions of eligibility for such housing varied from one provider to the next. In many cases, the tenant did not have to prove housing readiness before being offered a unit. In fact, Homes First Society got its name because its founders believed that its tenants needed homes first before addressing other challenges (i.e. mental health, substance use, employment, etc.).

Today, researchers, practitioners and advocates refer to this approach ashousing first. And very recently, a successful RCT of housing first was conducted in five Canadian cities; I’ve previously written about that study here.

7. There are several ways of making housing available to low-income households; all of them involve the private sector to varying degrees. Sometimes when government subsidizes housing for low-income persons, it provides money to a non-profit entity that develops, owns and operates the units. Other times, government provides a subsidy to landlords (either for-profit or non-profit); in exchange for the subsidy, the landlord agree to rent units at a reduced rate for a specified period of time (e.g. in some cases, for 10 years). And other times, government provides money (often known as a housing allowance) to low-income tenants who then rent a unit from a for-profit landlord. Of the three possible approaches, I personally have a preference for the option where a non-profit entity develops, owns and operates the units (and I have previously written about this here). Having said that, I think there’s a place for all three approaches, depending on local context.

8. Some jurisdictions have used sophisticated information management systems as part of their efforts to respond to homelessness. Many organizations serving homeless persons in Calgary enter client information into a database called the Homelessness Management Information System, a system that is also used in many American cities. Client-level information (such as age, health status, employment status and housing status) is entered into the database when an initial intake is done. While the client is receiving services, updated information is entered again; in the case of some programs, follow-up assessments are done every three months. In the case of some program types, there are both exit and post-exit follow-up assessments completed. All information-gathering is subject to provincial privacy legislation. There are many uses for the data once it’s gathered. For example, some organizations use the data to provide case management services to clients. Also, funders are able to assess each organization’s performance against benchmarks (i.e. percentage of clients who receive housing after a specific period of time).

9. When it comes to both preventing and responding to homelessness, the capacity of government to generate revenue matters a great deal.Governments typically use revenue generated from taxation to finance both subsidized housing and other important social programs. When tax revenue decreases, many governments have less ability to spend on such programs. Since the mid-1990s, tax revenue in Canada (measured as a percentage of our Gross Domestic Product) has decreased substantially. If this trend doesn’t reverse itself soon, it will be very challenging for many governments (especially provincial, territorial and municipal governments) to invest in important social programs. There is currently a move afoot by some Canadians to increase taxes; it is led by Alex Himelfarb, former Clerk of the Privy Council. Alex and his son Jordan recently co-edited a book that calls for the need for higher taxation in Canada. (Note: according to some schools of thought, it isn’t necessary for a sovereign government with its own currency to tax more in order to finance more social spending. While keeping in mind that such an approach would be most relevant to Canada’s federal government and much less relevant to provincial, territorial and municipal governments readers can read more about one such school of thought here.)

10. Over the course of the next decade, Canada will likely see substantial increases in homelessness among both seniors and Indigenous peoples (First Nation, Metis and Inuit). Seniors and Indigenous peoples are growing as a percentage of Canada’s total population. Further, the percentage of seniors living below Statistics Canada’s Low-Income Measure has grown substantially since the mid-1990s. I think all of this makes it likely that both of these groups will begin to grow as a percentage of Canada’s homeless populations.

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The following individuals were very helpful in helping me prepare the present blog post: Maroine Bendaoud, Lisa Burke, George Fallis, Greg Suttor, Francesco Falvo, Louise Gallagher, Ali Jadidzadeh, Lisa Ker, Jennifer Legate, Kevin McNichol, Richard Shillington, Blake Thomas and Mike Veall. Any errors are mine.