In 2008, Working Group members identified a critical need to break the cycle of homeless PHAs:
becoming ill → entering hospital/Emergency Room (E.R.) → being discharged → becoming ill → entering hospital/E.R.
The Service Coordination Pilot Project for Homeless PHAs was developed to expand collaborative responses being tried in the community, and was coordinated by McEwan Housing and Support Services (LOFT Community Services). THN helped to facilitate initial planning meetings, contributed towards a Needs Assessment and became one of the twelve formal partners to the Project. The pilot project was successful and has developed into a program of McEwan Housing and Support Services (LOFT Community Services), with an ongoing multi-agency partnership and, in 2011, funding from the provincial AIDS Bureau. See Service Coordination Program for Homeless People Living with HIV/AIDS further below for more information.
The Housing Working Group went on to identify its next priority as housing and service issues facing people living with HIV, who are aging, and have complex care needs that may include cognitive impairment. A Community Roundtable on HIV, Housing, Aging, Complex Care & Cognitive Issues was held on June 22, 2011. For more information see the Roundtable report.
The Housing Working Group also provides representation to the annual Opening Doors Toronto planning committees to bring housing issues.
Participating agencies in the Working Group include HIV specific organizations and programs, homeless shelters, hospital clinics, infirmaries and other agencies providing housing, support and care services.
HIV, Housing, Aging, Complex Care & Cognitive Issues
Toronto is experiencing a demographic shift in the population of people living with HIV/AIDS (PHAs), resulting in an aging PHA population and a population of PHAs experiencing the effects of accelerated aging. Care needs are increasing and many PHAs who have been stably housed for years are losing their housing or experiencing destabilized housing, and the sectors are not adequately meeting the current needs. Furthermore, there is a demographic bubble of aging PHAs that will increase the demand for services and challenge the sectors to find collaborative solutions. A Community Roundtable was convened to begin to find those solutions.
A Community Roundtable on HIV, Housing, Aging, Complex Care & Cognitive Issues was held on June 22, 2011 at the Ramada Plaza Hotel in Toronto. The Roundtable was organized by the Housing Working Group of the Toronto HIV/AIDS Network (THN) and included fifty-six participants from sectors involved in the response to people living with these challenges.
- Report of the Roundtable (30 pages)
- Report of the Roundtable with Appendices (73 pages) that provide more detail on the discussions and information shared at the Roundtable.
The collaborative community process being undertaken on these issues reflects lessons learned from the process that led to the very successful Service Coordination Program for Homeless PHAs.
Service Coordination Program for Homeless People Living With HIV/AIDS
The Service Coordination Program provides intensive case management services to homeless people living with HIV/AIDS who face health and mental health crisis. It helps break a cycle of homelessness and hospitalization.
The Program began as a Pilot Project as a result of work of the Housing Working Group of the Toronto HIV/AIDS Network and involvement of an initial twelve formal partners. The Pilot Project (April 2009-March 2010), was primarily supported with one-year funding from the Public Health Agency of Canada (PHAC) and was assisted in its partnership development through the Ontario Organizational Development Program, a program supported by the AIDS Bureau, Ministry of Health and Long-Term Care.
The Pilot proved effective in dramatically reducing Emergency Room visits and hospitalizations for its clients. The pilot project has developed into a program of McEwan Housing and Support Services (LOFT Community Services), with an ongoing multi-agency partnership and, in 2011, funding from the provincial AIDS Bureau. Throughout the program's development, not only have hospitalizations and E.R. visits been dramatically reduced, but there has also been an incredible rate of success in stably housing people which is a key goal and outcome.
- The Service Coordination Program For Homeless People Living With HIV/AIDS:
- Service Coordination Pilot Project for Homeless People Living with HIV/AIDS: Background, Objectives, Project Deliverables, And Outcomes (June 2, 2010)
- Evaluation of the Service Coordination Pilot Project for Homeless People - Living with HIV/AIDS: Final Report (March 31, 2010)
- Needs Assessment For A Centralized Service Coordination Pilot Project for Homeless PHAs Facing Health and Mental Health Crises: Final Report (August 7, 2009)
Positive Spaces, Healthy Places: Community-based research exploring HIV, Housing & Health (Ontario)
North American Housing and HIV/AIDS Research Summit V (June 2010): presentations, interim report and action strategies
The Wellesley Institute: advances population health through rigorous research, pragmatic policy solutions, social innovation, and community action. See
- Precarious Housing in Canada (2010)
- The Blueprint to End Homelessness in Toronto (2007)