Three types of supports

Housing First involves 3 kinds of service supports:

1. housing with supports to help clients find housing, move in and maintain that housing;
2. clinical supports providing or facilitating access to health and social care to clients to help them achieve housing stability and encourage well-being; and
3. complementary supports, such as assistance with finding employment, volunteer work and accessing training offered on a case-by-case basis to help clients improve their quality of life, integrate into the community and, to the extent possible, achieve self-sufficiency.

Collaborative service delivery

The collaboration of service providers who provide these supports is strongly encouraged and expected. The Housing First approach requires collaborative service delivery to ensure that persons who are chronically homeless receive the supports they need at the right moment and by the appropriate service. Housing, clinical and complementary service providers would work together to serve all of the needs of the individual.

Collaboration is also necessary to avoid the duplication of services within the community and to ensure the creation of a program that is sustainable.

1. Housing with supports

Under Housing First, the initial intervention is to provide clients with housing. Housing supports are also required to help clients stabilize and maintain their housing. Communities would therefore need to ensure that they have the capacity to provide housing with supports.

Housing and housing supports can be delivered using the services of existing housing service providers. In addition, communities may need to create supplementary housing teams or housing outreach workers to leverage or provide housing with supports. These teams would work with those who provide the clinical supports and complementary supports.

The main activities of those who provide housing and housing supports under Housing First could include:

• working with shelters and individuals living on the street to identify and locate Housing First clients
• securing housing for clients by working with groups like private and public local real estate and landlord associations to identify housing units
• determining clients' preferences and needs for housing and type of supports
• building and maintaining relationships with landlords
• providing apartment set-up assistance
• managing short-term, time-limited rent subsidies with the objective of transitioning clients either to provincial/municipal system of supports or other sustainable solutions for the long-term ( for example self-sufficiency)
• applying for or negotiating access to social housing, non-profit housing, provincial rent supplements and the like
• providing landlord mediation
• assisting with money management
• providing access to grants to cover utility bills
• assisting with repairs and cleaning to ensure general maintenance and to cover damages as needed
• providing other supports requested by the client (for example, obtaining legal advice)

2. Clinical supports

Recovery-oriented clinical supports are required for most clients to maintain housing stability, improve quality of life and, to the extent possible, foster self-sufficiency. Clinical services based upon client self-determination are provided by a case management approach, which either provides or links the client to needed mental health and addictions services.

The clinical case management approach includes support services from outreach/referral to existing treatment in communities or health services offered by provinces and territories, to more intensive coordination with multi-professional specialists. In all cases, the types of services offered through case management reflect the clients' self-determined needs assessment and would be carried out in the community setting. This approach ensures that clients receive the necessary support to maintain their housing. Case managers would also coordinate with the Housing Team and complementary service providers that are needed.

3. Complementary supports

Access to supports other than housing and clinical is often a priority for Housing First services. Although not necessarily the initial focus for an Housing First approach or intervention, they can help to foster the longer-term goals of community integration and autonomy.

These supports include providing access to:

• income supports to those who are entitled to them
• life skills (budgeting, meal preparation)
• pre-employment support and bridging to the labour market
• services to support educational opportunities (tutors)
• supports to reduce isolation (volunteer work)

One factor in improving clients' long-term housing stability and autonomy is to provide supports that help them to integrate within the community. For example, employment supports would help clients to take part in the labour market, where practical. Education supports and supports that promote volunteering in the community would help clients to learn skills to participate in the labour market or in the community as a whole.

Partnering with provincial/territorial programs

Service providers would be expected to provide access to existing provincial or territorial programs to the extent possible, and avoid creating new services where current supports already exist. Access to these programs could be provided by housing or complementary support teams, or by existing clinical support teams. Examples of existing programs include those that remove barriers to employment and those that provide skills enhancement to facilitate labour market readiness among Housing First clients who are capable of workforce attachment. There are also programs available in many communities that promote broader participation in the community.