health services & homelessness - abe oudshoorn · health services & homelessness final...

HEALTH SERVICES & HOMELESSNESS

FINAL SUMMARY REPORT (V1) SEPTEMBER 28, 2011 – NOVEMBER 11, 2011

Submitted by Jane Parkinson, Facilitator

December 2011


Page 1

HEALTH SERVICES & HOMELESSNESS F I N A L S U M M A R Y R E P O R T ( V 1 )

EXECUTIVE SUMMARY

Ryunosuke Satoro’s statement aptly reflects the underlying premise of the Health Service and Homelessness

Project. Key London leaders formed a partnership with health service providers as well as individuals who

have experienced homelessness. They began with the belief that a collaborative effort is an imperative for

successful change. To address the magnitude of the issues associated with creating a system to meet the core

health service needs of individuals and families experiencing homelessness in London, Ontario requires the

engagement and effort of many. The commitment to collaborate was what inspired the formation of an ad

hoc working group of five partners gratefully supported by London Community Foundation and Ashley Leanne

Powell Fund.

The Health Services and Homelessness Project involved bringing together health and other service providers

dedicated to working with individuals and families experiencing homelessness. It was agreed from the

beginning that, before applying solutions, it was important to engage people who have directly experienced

homelessness and to build a deep understanding of the issues they experience in accessing core health

services. Further there was overwhelming consensus to better understand the current state of care and services

from the providers’ perspective; building on their successes and minimizing barriers would serve as the basis

for future improvement in the health services provided to those experiencing homelessness.

This summary provides a collation of the important ideas generated from two well-orchestrated sessions (held

on September 28, 2011 and November 11, 2011), and forms the basis for the collaborative work that lies

ahead. This summary includes data collected from participants during these two sessions. The data is largely

unedited so as to preserve the integrity of the commentary. It is expected that a working group will be

established with the leadership of Dr. Abe Oudshoorn to review this information. This report, combined with

other existing research and planning documents, will lead to the identification of solutions and a plan to apply

them system-wide. Again, those involved in the future will take a collaborative approach to health service

system improvements, in the planning, implementation and evaluation phases to address the needs of people

experiencing homelessness.

"Individually, we are one drop.

Together, we are an ocean."

-Satoro


Page 2

PARTNERS AND PURPOSE

This collaborative project was intended to be the initial step in a long-term process of improving health

services for individuals and families experiencing homelessness. Strong commitment to the effort was

demonstrated and the process evolved as partners clarified the purpose and outcomes.

PARTNERS PROJECT PURPOSE

Arthur Labatt Family School of Nursing, Faculty of Health

Sciences, University of Western Ontario

(Abe Oudshoorn)

To provide an opportunity for input and

engagement in a process intended to

increase understanding of health services

currently provided to individuals and families

experiencing homelessness. City of London Community Services, London CAReS

(Jan Richardson)

London InterCommunity Health Centre

(Pam Murray)

OUTCOME

Middlesex London Health Unit, Communicable Diseases

(Cathie Walker & Rhonda Brittan )

A snapshot of the “as is” state. To capture

what is happening now; to understand the

strengths, challenges and opportunities

before implementing solutions. Regional HIV/AIDS Connection(Sheila Coad)

PROJECT SCOPE AND DEFINITIONS

What do we mean by health?

While recognizing the importance of all the determinants of health, such as food, clothing, transportation,

education and shelter, the scope of this effort was focused on what might be best described as direct health

services. This component of the project was intended to increase understanding of the health services which

are sometimes considered to be more related to the “medical” side of health and encompass primary care,

mental health, and acute care. This specific focus was not intended to negate the importance of all

determinants of health, but rather to refine and deepen understanding of the current state of these services

and the unique experiences of those at greatest risk.

What do we mean by homelessness?

Homelessness is a broad concept and often includes individuals and families who experience homelessness

once in a lifetime as well as those who are under-housed and at risk of homelessness, in addition to those who

have no fixed address or are commonly referred to as “couch surfing”. The focus of this project was limited to

understanding the health services needs of those who are at high risk and experiencing what may be

referred to as ”absolute homelessness”. This project was seeking to understand the health service needs of

individuals and families who are most street involved, sleeping “rough” and residing in shelters.


Page 3

PROCESS

The Health Services and Homelessness Project started by gathering information using a questionnaire which

was completed by 100 individuals who have lived experiences of homelessness (See Appendix A). The

responses to the questionnaire were useful in organizing two main events designed to encourage maximum

engagement and information exchange. The first event, a half-day interactive session was held on September

28, 2011 and was attended by over 60 health care and service providers (See Appendix B), and included

all of the organizations identified in the questionnaire plus several others subsequently identified.

The second meeting, a full day session, was held on November 11, 2011 and included nearly 100 individuals

who have lived experience of homelessness (See Appendix C). Both sessions were designed and facilitated

with an external consultant, in collaboration with expert partners, skilled community service providers and

highly committed individuals who have lived experience of homelessness.

This process was designed to be very interactive and to encourage forthright information sharing. From the

feedback gained, it is clear that the group was highly successful in this regard.

CLOSING The input from these sessions will be shared with providers who participated in the process and offers

tremendous potential for developing a system map. A working group will be established to review the

information and ultimately, to identify an action plan to improve access to health care services and health

outcomes. Special thanks is extended to the partners and facilitators from a variety of service organizations

as well as those who were considered to be peers of those with lived experience of homelessness. As a result

of the involvement of many this process was a success.


APPENDIX A QUESTIONNAIRE

ITEM 1: HEALTH CARE IN LONDON SURVEY ..................................................................... 1

ITEM 2: HEALTH CARE IN LONDON SURVEY RESULTS....................................................... 2


APPENDIX A: 1

ITEM 1: HEALTH CARE IN LONDON SURVEY

You can also do this online at: http://www.surveymonkey.com/s/L92V6DL

1. Where are all the places you go to for health care in London?

2. What kind of health care issues do you get help for?

3. What has helped with your health care in London?

4. What is frustrating about health care in London?

5. What kind of health care are you looking for?

Please Return To Christy Tran: [email protected]

For more info go to: http://www.londonhon.ca/?page_id=114

http://www.surveymonkey.com/s/L92V6DL

mailto:[email protected]

http://www.londonhon.ca/?page_id=114


APPENDIX A: 2

ITEM 2: HEALTH CARE IN LONDON SURVEY RESULTS

Data is presented in raw form, and categories of data are not mutually exclusive. Data will be distilled by

the already established working group for 2012.

1. Where are all the places you go to for health care in London?

Respnses Total

Centre of Hope 10

Family Doctor 15

Hosptial (University Hospital, St. Joeseph’s HC, Victoria Hospital) 58

Intercommunity 20

London Health Centre 5

London psychiatric hospital 1

Men's Mission 2

Methadone Clinics 6

Middlesex London Health Unit 3

None 3

RHMC 1

Street Scape 1

Walk-in clinics 32

2. What kind of health care issues do you get help for?

Responses Total

Addictions help/ Detox 16

Allergies, Colds, Flu, acute sickness 14

Asthma 7

Blood related problems (one surveyed bleeding issues") 8

Cardiac 1

Chiropractic care/ Bone related issues 13

Counselling 0

Dental 2

Dermatology 1

Diabetes 4

Dialysis 2

Emergency 3

Gastric problems 4

High blood pressure/ High cholesterol 8

Immune disorders 3

Mental Health (PTSD, depression, bi-polar, etc.) 25

Neurologlogy (eg sleep disorders) 5

(Responses for Question 2 continue on next page)


APPENDIX A: 3

Responses Continued Total

None 1

Physiotherapy 5

Prescription 4

Sexual Health 0

Shaking, trembling, twitches 6

Various 3

Women's Health (Ultrasounds, pre/post natal care, etc.) 5

Wound, infection, injury care 10

3. What has helped you with your health care in London?

Responses Total

Advice and suggestions 3

Ambulance/ paramedics 3

ER 1

Getting proper medications 13

Getting proper procedures done (xrays, blood tests) 4

Having the available resources (EG: doctor, SW, agencies) 20

Helpful staff and doctors 4

My doctor 6

Not much 1

Nothing 12

OHIP 14

Transportation and accessibility 6

Social benefits 6

4. What is frustrating about health care in London?

Responses Total

Distance of services and where it's situated 5

Everything 2

Having good care 1

I don't have anywhere to go 1

Lack of empathy or sympathy from doctors and/or staff 2

Lack of knowledge on where to get services 0

Not getting desired meds 2

Not getting the proper diagnosis 1

Nothing 19

Shortage of doctors (trouble finding a doctor) 25

Wait times 41


APPENDIX A: 4

5. What kind of health care are you looking for?

Responses Total

All inclusive health care 10

Counselling of any sort 13

Dental 9

Getting a stable doctor 22

Having good quality health care (fast, efficient, nonjudgemental) 20

Health care that is long term/permanent 1

More prescription coverage 2

None 17

Physiotherapy 8

Psychiatric help 4

Readily available emergency treatment 1

Reduce the wait time 4

Rehab 2

Vision 1


APPENDIX B SEPTEMBER 28, 2011

OVERVIEW OF SEPTEMBER 28, 2011 WITH SERVICE PROVIDERS ....................................... 1

ITEM 1: SEPTEMBER 28, 2011 AGENDA ............................................................................. 3

ITEM 2: SEPTEMBER 28, 2011 ATTENDEES ......................................................................... 4

ITEM 3: SEPTEMBER 28, 2011 FEEDBACK FORM ................................................................ 5

ITEM 4: SEPTEMBER 28, 2011 SAMPLE WORKSHEET .......................................................... 6

ITEM 5: SEPTEMBER 28, 2011 WORKSHEET RESPONSES .................................................... 7

ITEM 6: CURRENT AND MISSING SERVICES, SEPTEMBER 28, 2011 .................................. 19

ITEM 7: SUCCESSES AND CHALLENGES, SEPTEMBER 28, 2011 ........................................ 22


APPENDIX B: 1

There seemed to be

openness as providers

shared common

challenges and

significant successes.

OVERVIEW OF SEPTEMBER 28, 2011 WITH SERVICE PROVIDERS

The September 28th session was held at the Kinsmen Recreation Centre and was attended by approximately

60 health care and service providers. At the outset of the session, group agreements and definitions were

clarified and were adhered to over the course of the session. The influence of all the determinants of health

was underscored while the focus on health services was in the foreground of the discussion throughout this

session.

Discussion Questions

1. Who are the organizations providing health services/programs to individuals and families

experiencing absolute homelessness?

• What services are provided?

• A specific focus on understanding who provides what services related to:

• Immunization

• Common acute conditions (EG: cough, colds, diarrhea, aches)

• Dental care

• Medication replacement

• First aid

• Overdose

• Addiction treatment

• Wound/abscess care

• Mental health support/counselling treatment

• Dermatology/skin care

• Foot care

• Sexual health

• Basic health advice

• Pre/post natal care

2. What are the current health services your organization provides to individuals and families

experiencing absolute homelessness?

• Where are these services/programs located?

• What are the hours?

• Who is eligible to use your services/programs?

3. What are some of the successes and challenges you are currently experiencing in providing health

services to individuals and families experiencing absolute homelessness?

This very successful session was marked by higher attendance of organizations than expected with substantial

interaction. There seemed to be openness as providers shared common challenges and significant successes as

highlighted in the following chart.


APPENDIX B: 2

Key Provider Successes Key Provider Challenges

Strong positive willingness to collaborate and build

community partnerships.

Ensure that the people who need the services are

aware of and can access the array of services,

supports and resources available across

organizations. Deep respect for those experiencing homelessness.

At the end of the session, participants were asked to indicate their interest in being a member of an on-going

Homelessness and Health Services Committee. Individuals from a variety of organizations expressed their

interest, and a 15 person working group (for 2012) was formed. A session feedback form was completed by

participants, and the overall message communicated was that the process was positive. There seemed to be

tremendous benefit to sharing across this diverse group to improve the understanding of the complex needs of

individuals and families experiencing absolute homelessness.


APPENDIX B: 3

ITEM 1: SEPTEMBER 28, 2011 AGENDA


APPENDIX B: 4

ITEM 2: SEPTEMBER 28, 2011 ATTENDEES

NAME ORGANIZATION EMAIL ADDRESS

Andrea Sereda Soho FHT [email protected] Anne Finigan LIHC [email protected] April Quinn WAYS [email protected] Brenda Marchuk MLHU [email protected] Brian Lester RHAC [email protected] Carole Lambkin Salvation Army [email protected] Cassandra Brubacher MLHU [email protected] Cathie Walker MLHU [email protected] Chandelle Kelly UWO Nursing [email protected] Christy Tran UWO Nursing [email protected] Darryl Reckman Sanctuary [email protected] Doug Nemeth Mission Services [email protected] Erica Zarins MLHU [email protected] Gil Clelland Sanctuary [email protected] Heather McDonald London Public Library [email protected] Helen Padega LHSC [email protected] Jeff Buchanan Family Court [email protected] Jeff Lounsbury Wotch [email protected] Jody Shepherd MLHU [email protected] John Curtis Physician [email protected] Justine Jewell LHSC [email protected] Karen Laverty YOU [email protected] Kathie Chiu Salvation Army [email protected] Kelly Gregory John Howard Society [email protected]

Kim Reid ADSTV [email protected] Kristin Heard UWO Nursing [email protected] Lucia Vermeulen LHSC [email protected] Lynda Murray-Crozier CAS [email protected] Martha Connoy Mission Services [email protected] Martha Kirkwood MLHU [email protected] Mary-Ellen Jacobs Salvation Army [email protected] Michelle Shelley MLHU [email protected] Mike Godin CMHA [email protected] Nancy Powers Salvation Army [email protected] Nancy Summers MLHU [email protected] Pam Murray LIHC [email protected] Patty Chapman LHIN [email protected] Richardson, Jan City of London [email protected] Sandra Coleman CCAC [email protected] Sandra Fieber [email protected] Sandra Fieber Fanshawe [email protected] Sheena Ewen LHSC [email protected] Sheila Coad RHAC [email protected] Shelley Milos Housing Registry [email protected] Sherri Zavitz CCAC [email protected] Stacey Thibodeau Salvation Army [email protected] Susan Butler Soho FHT [email protected] Yvonne Rimbault John Gordon Home [email protected]
























APPENDIX B: 5

ITEM 3: SEPTEMBER 28, 2011 FEEDBACK FORM


APPENDIX B: 6

ITEM 4: SEPTEMBER 28, 2011 SAMPLE WORKSHEET

HEALTH SERVICE FOCUS AREA: Medication Replacement

Organization Services Provided Location of Service Hours of Service Eligibility

1.

2.

3.

4.

5.

HEALTH SERVICE FOCUS AREA: First Aid


1.

2.

3.

4.

5.

HEALTH SERVICE FOCUS AREA: Immunization


1.

2.

3.

4.

5.

HEALTH SERVICES AND HOMELESSNESS IN LONDON

Sample Worksheet # 1a

Question #1: What are the current health services your organization provides to

individuals and families experiencing absolute homelessness? Where are these

services located? What are the hours? Who is eligible to use your services?

Health Service Focus Areas: (1) Immunization, 2) Medication Replacement, 3) First Aid, (4) Overdose, (5) Addiction

Treatment, (6) Wound/ Abscess Care, (7) Mental Health Support/Counselling/Treatment, (8) Dermatology/Skin Care, (9) Foot Care, (10) Sexual Health, (11) Cough/ Colds/Diarrhea/Aches, (12) Dental Care, (13) Basic Health Advice, (14) Pre/Post Natal

Care, and (15) Additional areas


APPENDIX B: 7

ITEM 5: SEPTEMBER 28, 2011 WORKSHEET RESPONSES

The following charts contain data that is largely unedited so as to preserve the integrity of the commentary.

ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY

IM

MU

NIZ

AT

IO

NS

Centre of Hope

Family Health

Team (FHT)

Flu services

All immunizations

Children and adults

Seasonal flu clinic

All vaccinations,

measles, mumps, etc

281 Wellington

Rd. M-F, 8-4

W, 5-8

Rostered patients

Health card

Centre of Hope Middlesex Health Unit

Flu shots

281 Wellington

Rd.

As

required

No health Card

London Health

Sciences Centre Emergency

Tetanus

Rabies

Flu

Prophylaxis

Victoria

Hospital

University

Hospital

24/7 Health card

preferred

London

InterCommunity

Health Centre

Seasoned clinic 457 York St.

MSC CMHP

1 day

annually Health Card

No referrals open

Centre of Hope

Family Health

Team (FHT)

Flu services

All immunizations

Children and adults

Seasonal flu clinic

All vaccinations,

measles, mumps, etc

281 Wellington

Rd. M-F, 8-4

W, 5-8

Rostered patients

Health card

Urgent Care Emergency

Tetanus

Rabies

Flu

Prophylaxis

St Joseph’s HC M-F, 8-4 Health Card

preferred


APPENDIX B: 8


ME

DIC

AT

IO

N R

EP

LA

CE

MW

NT

Centre of Hope

FHT Medical care

Assessments

Prescriptions and

medications

281 Wellington

Rd. M-F, 8-4

W, 5-9

Registered clients

Health Card

Emergency Room/

Urgent Care Prescriptions and

medications

Outpatient

referrals

Victoria Hospital

University

Hospital

St Joseph’s

Health Centre

Hospitals

24/7

St Joseph

8-4

All

London

InterCommunity

Health Centre

Family medicine 659 Dundas St. 9-5 No Health Card

Registered clients

London

InterCommunity

Health Centre

No services to

homeless individuals

Huron and

Highbury

Walk-In Clinics Various Health Card


OV

ER

DO

SE

Emergency/Urgent

care Acute medical

treatment

Admission for med

care only

Outpatient referral

Victoria Hospital

University Hospital

St Joseph’s HC

24/7

24/7

8-4

No Restrictions

Emergency Medical

Services

Acute med treatment City wide mobile 24/7 All

London Police Safety management

Transportation of

aggressive/ reluctant

clients

City wide mobile 24/7 All


APPENDIX B: 9

ORGANIZATION SERVICES LOCATION HOURS ELIGIBILITY F

IRS

T A

ID

Centre of Hope

FHT Assessment

Prescriptions

Treatments

Medical care

281 Wellington Rd. M-F, 8-4

W, 5-8

Rostered clients

Health Card

Emergency

Medical Services

24/7 No Health Card

London Health

Sciences Centre Emergency

Admission to

medicine

CCTC

Sepsis treatment

Victoria Hospital

University

Hospital

24/7 Health card

preferred

Salvation Army

Centre of Hope

All staff are First Aid

and CPR trained

281 Wellington Rd. 24/7 Maybe required

Salvation Army

Operation

Mobilizing Hope

(street RV)

Minor wound care

Counseling

Referral to other

services

Nursing assessment

Vitamins

London Coffee

House

Across from Ark

Aid on Dundas St.

Thurs,

7:30-

8:30 pm

Thurs,

8:30-

9:30 pm

Drop in

No Health Card


AD

DIC

TIO

N T

RE

AT

ME

NT

Addiction Services

Thames Valley Heartspace for women,

mothers

Freshstart (employment

barriers)

Substance abuse

counseling

CAReS

200 Queens Ave

Suite 260 M-T,

8:30-8

W-F,

0:30-

16:30

Self referral

No Health Card

Some restrictions

with hours

Centre of Hope Non medical withdrawal

assessment

281Wellington

Rd.

24/7 Self referral

Male and female

16 years of age

No HC needed


APPENDIX B: 10


AD

DIC

TIO

N T

RE

AT

ME

NT

C

ON

TIN

UE

D

Centre of Hope

FHT Withdrawal meds and

assessment

Addiction counseling

Harm reduction

281 Wellington

Rd. M-F,

8-4

W, 5-8

Rostered patients

Shelter patients

Counterpoint

Harm Reduction

Needle Syringe

Needle syringe program

Outreach-exchange

186 King St.

City wide

M-F,

9-5

M-F,

11-6

Self referral

Dr. Sadex Methadone

Suboxone

Oxford/

Wharncliffe

Health Card

No referral

London Drug

Treatment Court

Intensive rehabilitation London Court

House

Tu, 12-3 Must be court

referred

Methadone

Clinic

Methadone maintenance

program 502 Oxford St

528 Dundas St

Middlesex-

London Health

Unit

Needle Exchange Program 50 King St M-Th,

8:30-7 Drop-in

No health card

Quintin Warner

House

Residential treatment Queens/Maitland 24/7 Fit admission

criteria

Referral including

self

Supported

Housing for

Addictions

(WOTCH/ADSTV)

Housing for persons

struggling with substance

abuse

39 Tecumseh 24/7 Must be referred by

ADSTV

Turning Point Residential treatment

programs for male and

female

Mornington Ave

Wharncliffe

24/7 Fit admission criteria

Westover

Treatment Centre

Aftercare and family

groups

Dundas/

Waterloo

Tu-W,

PM

Graduates of

residential

treatment

Youth Action

Centre

Needle exchange Dundas St. M-S, 3-7 Under 25 years old


APPENDIX B: 11


ME

NT

AL

H

EA

LT

H S

UP

PO

RT

/C

OU

NS

EL

LIN

G/

TR

EA

TM

EN

T

Canadian Mental

Health

Association

Advocacy

Counseling

Support

Referrals

Court House,

London

M-F, 9-5 18+ incurred criminal

charges, Axis I

No health card

Centre of Hope Full service 281

Wellington M-F, 8-4

W, 5-8

Rostered clients

Health card

Elgin Middlesex

Detention Centre Trauma crisis

Social workers

711 Exeter M-F Selected inmates

John Howard

Society Trauma Counseling

Anger management

Mental health

counseling services

Healthcare referrals

601 Queens

Ave M-F, 8:30-

4:30

Closed F, 3

Closed 12-1

Youth support 16-24

Homeless or at risk

Persons/families

involved/at risk in

crime/justice

London

InterCommunity

Health Centre

Social workers 659 Dundas

St.

9-5 M-F

Adults

Regional Support

Associates

London Office

Mental

health/counseling

Behaviour

management

Psychiatric support

633

Colborne St. M-F, 8:30-

4:30

After hours

available

Adults with

intellectual disabilities

Referral from

Developmental

Services Ontario- SW

St. Leonard’s

Community

Services

Social workers

Main office

405 Dundas

Adults

SLCCS clients only

Western Area

Youth services Short term crisis

support

Referral to youth

Mental health

assessments

Community

based-will

travel to

client

714 York St

M-F, days

Flexible

evenings

Youth 13-18

Referral needed from

crisis and intake team

Western Ontario

Therapeutic

Community

Hostel

Mental health support

Case management

Housing

Family med

Psychiatrist

Clinic support

534

Queens

My Sister’s

Place

8:30-4:30 Referred


APPENDIX B: 12


WO

UN

D A

BC

ES

S C

AR

E

Centre of Hope

FHT Prescriptions

Assessment

Medical care

Follow-up

281 Wellington St. M-F, 9-4

W, 5-8

Rostered patients

Health Card

London

InterCommunity

Health Centre

Prescriptions

Assessment

Medical care

Follow-up

659 Dundas St. M-F, 9-5

Th,

10:30 -5

Rostered clients

London Heath

Sciences Centre Prescriptions

Assessment

Referrals

Emergency

Medicine

Outpatient care

University

Hospital

Victoria Hospital

24/7

Specific

days

Health Card

preferred

Referrals

St. Elizabeth

Community Care

Access Centre

(CCAC)

Prescriptions

Homeless specific

Assessment

Referral

CMHP MSL

457 York St

10-11AM No referrals

No health card

St. Joseph’s

Urgent Care Prescriptions

Assessment

Referral

St. Joseph’s HC Referral


FO

OT

C

AR

E

Centre of Hope FHT Foot care clinic 281

Wellington

Thurs 8-4 Rostered clients

Health Card

London

InterCommunity

Health Centre

Advanced foot care 659

Dundas St. M-F, 9-5

No Th AM

Reigstered clients

(some first aid)

Mission Services

CMHP

Foot care volunteers 457 York

St.

Announced 16 and above

Western Ontario

Therapeutic

Community Hostel

Footcare

Diabetes support and

screening


APPENDIX B: 13


CO

MM

ON

A

CU

TE

C

ON

DIT

ION

S

Centre of Hope FHT Common acute

condition assessment

Wellington Rd M-F 8-4

W 5-8

Rostered clients

Elgin-Middlesex

Detention Centre

Common acute


711 Exeter 7-12 Women and men

in custody

No Health Card

London Health

Sciences Centre

Emergency (Social

work, referrals and

payment of meds)

Victoria

Hospital

University

Hospital

24/7` Health card

preferred

London

InterCommunity

Health Centre

Common acute

condition

assessment

Doctor/NP/RN

Minor first aid

659 Dundas St

Men’s Mission

York St

M-F

No Th AM

Adults

No Health Card

Middlesex-London

Health Unit

Common acute

condition assessment Wellington Rd.

450 Clarke

42 Stanley St

Hill St

M-F

Dependent

on shelter

Half day

per week

Women and

children

No Health Card

No referrals

At shelter

St. Elizabeth CCAC Emergency 456 York 10-11AM Drop-in

Urgent Care St Joseph’s HC 8-4 M-F Health card

preferred

Walk-In clinics London Health Card

Western Ontario

Therapeutic

Community Hostel

Common acute


534 Queens

MSP M-F, 8:30-

4:30

M-F 10-3

Referred and non

referred


APPENDIX B: 14


BA

SIC

H

EA

LT

H A

DV

ICE

Centre of Hope

Family Health

Team

Full service medical

care

NP/Doctors/

Nurses/Social Workers

Specialist physician

referrals

281 Wellington Rd. M-F, 8-4

W, 5-8

Rostered

patients

Health Card

Emergency/Urgent

Care Acute medical

Treatment/ Counselling

Outpatient referral

Victoria Hospital

University

Hospital

St. Joseph’s HC

24/7

24/7

8-4

No restrictions

London Public

Library (MLHU, St

Joseph’s, LHSC,

LHS providers)

Health info programs,

Q& A

Books, pamphlets

In person experts

251 Dundas and 15

other locations 9-9 F-T

9-6 F

9-5 Sat

All

Middlesex-

London Health

Unit

Ask a nurse

Pre/postnatal

Communicable Disease

Acute illness

referrals

Rothelome

WCH

101 Wellington

2nd Stage (450

Clarke St)

Zhaawanong

M -W, PM

Th, AM

F, AM

Residents of

shelter

Middlesex-

London Health

Unit

Phone/in-person

advice through Family

Health Services

Communicable

diseases

Sexual health services

Bed bugs and

environmental health

50 King St.

Health connection

phone # 519 850

2280

CD 519 663

5317 ext 2330

Bed bugs- 519

663 5317 ext?

SHS 663 5446

Health

Connection

8:30-4:30

CD 24/7

Bed bugs

24/7

Self, no

referrals

No Health

Card,

No fee

Drop-in

St. Leonard’s

Community

Services

Family services

Food issues

405 Dundas St. Clients

Telehealth Phone advice From any phone 24/7

Western Ontario

Therapeutic

Community

Hostel

Nutrition, diabetes

support

534 Queens Ave

also MSP

M-F 8:30-

4:30

Referrals and

non referrals


APPENDIX B: 15


PR

E/

PO

ST

N

AT

AL

&

P

RE

GN

AN

CY

ADSTV Heartspace Addiction Treatment

High risk infant

Development worker

Parenting supports

260-200 Queens M-F,

8:30-4:30 Self referral

Facilitated

referrals

0-6 Children

Centre of Hope

FTH

Pre/postnatal care 281 Wellington

St M-F 8-4

W 5-8

Rostered patients

Women in shelter

Emergency/Urgent

Care Acute medical

treatment

Referral for

outpatient OB,

Womens Health

Victoria

Hospital

University

Hospital

St Joseph’s HC

24/7

24/7

8-4

All

London’s Crisis

Pregnancy Centre Support services to

pregnant women and

couples

Referrals

261 Piccadilly

St

London

InterCommunity

Health Centre

MD/NP/RN 659 Dundas St. M-F 8-4

W 5-8

Rostered clients

Middlesex-London

Health Unit

Pre/postnatal

education

WCH M, 1-3

W, 1-3

Shelter residents

No health card

Middlesex-London

Health Unit

Pre/post natal outreach Salvation Army

Centre of Hope On call

M-F,

8-4

Women in shelter

No fee

No health Card

Middlesex-London

Health Unit

PHN Roth home 42

Stanley St

54 Riverview

Besthesda

Th 9-12

M, 3-4

W, 9:30

-10:30

Women in shelter

No fee

No health card

Smart Start For

Babies Prenatal classes

Nutrition advice

Bus tickets

Food vouchers

Dundas OEXC

MLHU- 50 King

Tu, 6-8

W, 6-8

Registration less than

20 weeks gestation

Thames Valley

Midwives Pre/post natal care

Midwives

Travel

WCH

Facilitated by My

Sister’s Place

Women’s Health

Care-LWSC

Prenatal care

Prenatal care

TA

Baseline/

Wellington Rd.

M-F Health Card

No referrals


APPENDIX B: 16


SE

XU

AL

H

EA

LT

H

Centre of Hope (FHT) Full services related

to sexual health

281 Wellington

St M-F, 8-4

W, 5-8

Rostered clients

Health card

Elgin Middlesex

Detention Centre Sexual Health

Harm reduction

(LMHU) provide

services

711 Exeter Rd M,1:30-3 Women

Emergency/

Urgent Care Emergency

STI testing and

treatment

Education

Victoria

Hospital

University

Hospital

St. Joseph’s HC

24/7

24/7

M-F, 8-4

Card preferred

All welcomed

London

InterCommunity

Health Centre

Options

(anonymous testing) 659 Dundas St.

Outreach

9-5 Some

Middlesex London

Health Unit

Sex health groups

clinics WCH

450 Clarke

101 Wellington

Scheduled No Health card

No Referrals

Middlesex London

Health Unit, The

Clinic

STI testing/treatment

Birth control

50 King St.

F, 8:30-

10:30

M,W, 5-7

Any age

No OHIP

No referrals

Middlesex-London

Health Unit, Sexual

Health Promotion

Student support

Health promotion

On site at

facility

EMDC

Western,

Fanshawe

CAS, Families

First LFCC

M-F PM

Weekends

No health card

No referrals

Western Ontario

Therapeutic

Community Hostel

Sex worker support

Counseling

My Sister’s Place M-F, 10-3 Walk in


APPENDIX B: 17


DE

RM

AT

OL

OG

Y/

SK

IN

C

AR

E

St. Elizabeth

CCAC

Mission services

MOU

Cellulitis/Wound care Various

457 York

CMHP

7-? Clinic

hours

10-11

daily

No card

No referrals

Health Card is

mandatory for

CCAC to assist

Western Ontario

Therapeutic

Community

Hostel

Foot care 534 Queens

My Sister’s Place

140 Langarth

Referrals

Salvation Army

Family Health

Team

London

InterCommunity

Health Centre

Doctor/NP 281 Wellington

659 Dundas St.

9-5 Must be

registered

patient

COH will see

shelter patients

Middlesex-

London Health

Unit

NP clinics Sherwood Forest

Mall

550 Hamilton Rd

Northbrae

South Lon

119 Jalna Blvd

Emergency/

Urgent care Acute medical

treatment

Follow up

CCACA referral

Outpatient referral

Burns

Cellulitis Clinic

University

Hospital

Victoria Hospital

St Joseph’s HC

24/7

24/7

8-4

No restrictions


APPENDIX B: 18


DE

NT

AL

C

AR

E

Docs Basic 184 Horton None

Middlesex-London

Health Unit

Basic care 50 King St. 8:30-

4:30 Clients under 18

Healthy Smiles Ontario

Private dental office Any Anywhere Discretionary benefits

OW

St Joseph’s Dental

Clinic

Dental Mt Hope

346 Platt’s Lane

ODSP

OW

UWO Dental

Emergency

Emergency LHSC 24/7 None


APPENDIX B: 19

ITEM 6: CURRENT AND MISSING SERVICES, SEPTEMBER 28, 2011

Who are the organizations providing health services/programs to

individuals and families experiencing homelessness?

ORGANIZATION SERVICES

Addiction Services of Thames Valley WOTCH- MSP

Centre of Hope Family Health Team

ASH-TV

HS

S.A Program

Freshstart

CAReS Bethesda Centre

Pre/postnatal care

Public health nurse

Counsellor- Family court Community Care Access Centre (CCAC) Home Care/St. Elizabeth

Centre of Hope Family Health Team (FHT)

Addiction Services

Volunteer Chiropractic Services

Shelter

Withdrawal Management

Drug Stores

Elgin Middlesex Detention Centre (EMDC) Health department housing

Health care Health Zone Nurse Practitioner

Clinics at 3 sites

Outreach clinics opening soon

o MSP

o Glen Carin

o WCH

Intercommunity Health

John Gordon Home

London Family Clinic

London Health Sciences Centre (LHSC) Emergency Rooms

St. Joseph’s Health Centre

Obstetrics clinic


APPENDIX B: 20


London Public Library Middlesex-London Health Unit (MLHU)

Western Ontario Therapeutic Community Hostel (WOTCH)

Canadian Mental Health Association (CMHA)

Men’s Mission

Methadone Clinic

Middlesex-London Health Unit – London

(LMHU) Family Health

Dental

Sexual Health

Infectious disease

Vaccines

Healthy Babies Healthy Children (HBHC)

Nurse Practitioners

Clinic

Free Sexually Transmitted Infection medication

Needle exchange

Sexually Transmitted Infection testing and referrals Mission Services of London Quinton Warner House

Addiction services My Sister’s Place Diabetes and foot care

Smoking cessation

Sexual health

Primary care (soon through Nurse Practitioner)

Men’s health through MLHU on site

Needle exchange Regional HIV/AIDS Connection Counterpoint Harm Education

Regional Support Associates - London Supporting adults with intellectual disabilities

Mental health/behaviour management

Psychiatric support

Primary care/medical management Salvation Army: Operation Mobilizing

Hope Nurse at London Coffee House across from Ark Aid

Wound care

Counseling

Vitamins

Referral to other resources St. Leonard's Community Services Facilitates residents to get initial medications at

emergency rooms Streetscape Provide ADAT


APPENDIX B: 21

What organizations are missing?


Western Ontario Therapeutic Community

Hostel (WOTCH) Psychiatry

Family doctor

Diabetes clinic

Foot clinic

Hoarding groups and consultation

Women’s Community House Shelters

Outreach

Help line

Addictions support counselor

Mental health counselors through CHMA

Public health nurse

Sexual health

Nurse practitioner

CHMA: Access team Infectious Disease Care (St. Joseph’s HC)

Dale Brown Injury Service LHSC Women's Health

Dental Outreach London Crisis Pregnancy Centre

Dental Outreach Community Services Methadone clinics

Emergency Response Services

(EMS, Fire, Police)

Pharmacies

First Nation Services RMHC

Health Zone (Nurse Practitioners) Youth Access Centre Addiction services


APPENDIX B: 22

ITEM 7: SUCCESSES AND CHALLENGES, SEPTEMBER 28, 2011

SUCCESSES RESPONSES

Ability to make appropriate referrals for treatment 2

Ability to help clients complete follow-up 1

Ability to provide bus tickets to clients for appointments 1

Building one-to-one relationships 2

CAReS 1

Changes are emerging in patients (diet is better) 1

Community collaborations and partnerships 8

Diagnosis and treatment of complex mental health issues 1

Diversity and team approaches when working with clients 2

Drop-ins for medications such as Plan B 1

Exiting relationships (need to build)*

Focus on health care for the homeless population 1

Free drop-in clinics 1

Free sexual health services and medications (EG: STI testing) 1

Good quality health care by agencies 1

Graduation from ASH-TV 1

Great partnerships exist*

Housing support 1

Implementation of plans or resources 2

Inclusion of outreach workers/support network 3

Increase "open door" approach 2

Increase awareness about needs and services 3

Increase collaboration among services 1

Increase in support funding (e.g ODSP) 1

Increased numbers of individuals served/getting referrals 1

LDTC 1

Less "silo-ing" 1

London CAReS collaborative (EG: NEP partnerships at MSP)*

Mental health focus (LHINS)

MSP 1

Network of services 4

New housing (transitional for homeless addicted: ASH) 2

No health card required for STI clinic 1

Opportunities for students at UWO*

People are excited about changes 1

People who discover recovery 1

Portable services 1

Providing correct information 1

Range/Diversity in this Region is Amazing*

Reducing discharge from psychiatric ward to homeless shelters 1

Research UWO-focused/common data*

Services more portable than in past*

Social work 1

Speaking engagements where experts answer questions 1

Successful withdrawal of individual 1

This summit itself (Reassuring to see a multidisciplinary) 1

Variety of health services/ support and resources 11

Willingness to discuss this difficult topic*


APPENDIX B: 23

CHALLENGES RESPONSES

Ability attend scheduled appointments 2

Ability to focus on health when daily housing is a struggle 1

Adherence 1

Affordable housing 4

Attitudes of staff (tend to give up easily and easily frustrated) 1

Consent required from agencies also working with clients 1

Continuity of care vs. confidentiality 1

Continuity of relationships in care 1

Criteria not meeting all needs 1

Dual diagnosis (some services won't support if there are dual present) 2

Effectiveness of services? 2

Emergency long waits*

Expectations; criticism of the addict. System 1

Feedback, perspective of lived experience*

Fees for referrals when there is no family doctor 1

Follow up (Cannot contact individual) 7

Funding sustainability* 9

Health coverage 2

Historical perspective sometimes missing (to assess growth/success)*

Identification of who is homeless, addicted/identification in general 2

Immediate services for "crisis" 1

Inability to access med clearance from pregnant women 1

Inability to access medical support (EG medications, wound care and support) 3

Inconvenient of hours 2

Increased illness or disease (EG: brain injury and Hepatitis C) 2

Integration with other determination of health 1

Lack of awareness of services 6

Lack of communication within supports being accessed/among agencies 5

Lack of medical history*

Lack of physicians 2

Lack of primary care providers who will treat without health card 1

Limited services for new clients 1

Limited time for treatment 1

Literacy (paperwork, forms to fill-out) 2

Little flexibility with legal system (advocacy can be difficult) 1

Managing the expectation of providers in the systems 1

Measurement of outcomes 1

Mobilizing similar services 1

Navigating through the system 1

Need for more portable services 1

Need more outreach services 1

No shows*

Not enough long term support 1

Number of homeless experiencing mental health issues (diagnosed or not) 1

Obtaining referrals in timely manner 4

Ongoing health care 1

Orientation of provider*

Outreach shelter on site work more immediate in shelter care 1


APPENDIX B: 24

CHALLENGES CONTINUED RESPONSES

Patient funded system (working with it)*

Perception of need: Provider v. client 2

Physical space (too small) 1

Physician lack knowledge about where to send homeless people for care 1

Post client negative experiences 1

Pre/post pregnancy onsite rather than at agency 1

Relationship quality, continuity with provider*

Right treatment, time, place, hours*

Safe housing for 18 under 1

Services only cover individual until their 18th birthday (such as dental) 4

Stigma surrounding homeless 2

Strict policies (EG: One "no show" and client is discharged) 1

The limits in length of shelter say 1

The relationship of non-medical models and medical models 1

Thinking creatively 1

Time and staffing 2

Time commitments elsewhere (no crossover with them day-to-day) 1

Transportation problems/accessibility 7

Treat all humans with respect and grace/making them feel comfortable 4

Trying new ways to deliver service 1

Waitlists/wait time for treatment or resources 6

Weighing consumer responses equitably 1

Working through resistance to change with clients 1

Youth focused services (adult-youth dynamic)*

* denotes response expressed during the large group session


APPENDIX C NOVEMBER 11, 2011

OVERVIEW OF NOVEMBER 11, 2011 WITH INDIVIDUALS EXPERIENCING HOMELESSNESS ...... 1

ITEM 1: NOVEMBER 11, 2011 AGENDA ..................................................................................... 2

ITEM 2: SERVICES USED .............................................................................................................. 3

ITEM 3: IDENTIFIED SUCCESSES AND AREAS OF IMPROVEMENT .............................................. 7


APPENDIX C: 1

OVERVIEW OF NOVEMBER 11, 2011 WITH INDIVIDUALS EXPERIENCING

HOMELESSNESS

The November 11th full day session with individuals experiencing homelessness was held at CitiPlaza, London

so that access would be easier if participants were using public transportation. The agenda was developed in

consultation with two individuals with prior experience of homelessness who provided some very helpful

suggestions. For example, it was determined that it was best to have “peers encouraging peers.” For this

reason, three members of the Regional HIV/AIDS Connection Harm Reduction Services were stationed at

CitiPlaza entrances to provide a “peer to peer” welcome and to give directions to the storefront location. A

nourishing meal was available all day long and enjoyed by 99 individuals with lived experiences of

homelessness.

It was decided that there would be no formal presentations and that those caregivers and service providers

who have worked with individuals and families experiencing homelessness would best explain the purpose and

obtain the information. Twelve small group facilitators were prepared in advance and during the day

masterfully created a safe and open space for individuals to share their experiences. Staff from Regional

HIV/AIDS Connection, Western Ontario Therapeutic Community Hostel (WOTCH), Middlesex London Health

Unit (MLHU) and London Intercommunity Health Centre (LIHC) served as facilitators and guided individual and

small group discussions using a common set of questions.

Discussion Questions:

1. What services have you used?

2. How would you describe your experience?

What worked well for you?

What didn’t work for you?

What would make it better or easier for you?

3. How did the different services that you used seem to work together?

What worked well?

4. How could the movement (transfer) from one service to another be improved for you?

This session was characterized as respectful, calm and focused as a multitude of individuals and small groups

shared their experiences and reflected on the questions posed by facilitators. Highlights of the conversations

were posted on wall charts for all to see. A summary of the input is provided and the common challenges and

successes that could be readily distilled are noted below:

Key Service Successes Identified by Individuals

with Lived Experience of Homelessness

Key Challenges Identified by Individuals with

Lived Experience of Homelessness:

Many services were identified More financial support/subsidy to assist with housing

Service providers were frequently felt to be

respectful

Concern about the stigma and discrimination attached

to having a history of being a drug user

Not surprisingly, participants responded favorably to sharing a meal and being given space to talk about their

personal experiences with interested facilitators. Special thanks are extended to all facilitators and members

of the Peer Program at the Regional HIV/AIDS Connection for their support which led to a smooth and well

organized and well attended session.


APPENDIX C: 2

ITEM 1: NOVEMBER 11, 2011 AGENDA


APPENDIX C: 3

ITEM 2: SERVICES USED

The following charts contain data that is largely unedited so as to preserve the integrity of the commentary.

SERVICE USED COMMENTS

Atlousa Good program, lack of funding

Provides lunch

Blood labs on Central

Canadian Mental Health

Association

Centre of Hope Food bank

Centre Point Great, friendly staff

Childrens Aid Society Good place to go if pregnant

Give up

Change their visitation policy.

Chiropractor Staff is nice

First come first serve

Accommodating

Coffeehouse

Community clothing centers Lacks clothing for bigger people

Dental for adults $20 cleaning

Family Health Tem Nurses are very nice

Food bank/Meal programs

Hospitals Takes too long

Urgent care: provided good treatment for one week

Sometimes there is too much judgment and discrimination

among the homeless and those who are suffering from

addiction. Assumed that those who are addicted are just

seeking out more pills however in actuality they are seeking

help or in real pain

Good, helpful people

Improve hours of operation

Accessibility

Be less restrictive


APPENDIX C: 4


Intercommunity Service

Practical services. Great

”Dr. Harris is welcoming and great”

Library Have addiction counselor there

Safe injection site

Good overall

Not enough help finding stuff

London Cares Helpful

Basic needs

Good service

London Crisis Centre

London Health Sciences Centre

Emergency Was treated nicely

London Housing

London InterCommunity Health

Centre (LIHC)

Men’s Mission Not too bad

Good food

Good people

Agreeable staff

Dirty

Too many shooters

Jim Henderssen and Megan Vander are always happy with

people and services

From one male: lived there, a good place to live when he was

homeless

Methadone Clinics “Should not be able to just cut you off”

Middlesex-London Health Unit

(MLHU) “Had to watch what was being said”

Doesn’t want to say anything bad or they won’t help you

“Excellent”

Mission Resource Centre Meals and a cot

Puts you on your feet quickly

Better answers rather than just kicking people out into the

street


APPENDIX C: 5


My Sister’s Place More health needs are met

Laundry

Food

Good programs

“Donna is very good” (foot lady from WOTCH)

“The best”

Needle exchange Good experience

Ontario Disability Support

Program

Ontario Works

OTHER We need better services for the drug users and Listerine

drinkers

The kids shooting drugs on the streets are a danger to the

public, they need a place to go

Why did they shut down the drop ins. We need more places

for street people to go not less and longer hours on

weekends.

Health care services are well coordinated

More recovery homes for street addicts

Number of food providers such as the SAcOH, Mission, and

Daily Bread

Some services did not really help.

o Made excuses for poor health.

o Did not believe individual was ill, but found out she

was ill, suffering in pain, in/out of hospitals all her

life.

o Diagnosed with osteoarthritis after being in a lot of

pain.

Doctors found it in every bone, originally from

pelvic bone and then it transferred throughout

individual's body.

Paramedics “Worked well”

Charge of 45 dollars for a ride

Pharmacies According to one female: they are always nice to her

Explains things clearly

United Way Pharmacy treats everyone well and waived fees

(sometimes)


APPENDIX C: 6


Police Have a hard time being believed by the police when making

a complaint

Quinten Warner House They are awesome

Regional HIV/AIDS Connection

(RHAC) Awesome

Non judgmental

Thorough

Really care

SACoh They treat individuals with respect

They do a great job

Salvation Army Good experiences overall

People are kind, courteous, treat patients well

Never had a problem in 6 years”

“Homeless this year for the first time and stayed at the Sally”

St Leonard’s “We will support your drug habit”

St. Paul’s

Stratford Free sex clinic

More around London, cleaner

"Staff doesn’t know how things are ran and everyone has an

opinion"

Streetscape

Turning Point Good staff

Really care

Walk-in clinics From one male: use the walk ins because he doesn’t have a

GP

Different doctor you don’t always have the same one

Never had a doctor since he was married

Western Ontario Therapeutic

Community Hostel Friendly

“Management people don’t know the policies”

YOSWA

Youth Action Community Good service

Nice staff

Zhaawanong Shelter


APPENDIX C: 7

“Staff is friendly,

resourceful and

respectful, and

services are easily

accessible.”

ITEM 3: IDENTIFIED SUCCESSES AND AREAS OF IMPROVEMENT

What is working?

(The following data is largely unedited so as to preserve the integrity of the commentary.)

Very fast service

Within walking distance

From an older lady: “my experience has been very good”

o Therapy was needed for a full year after being blown over by the wind

o Treated with respect and dignity by the staff

Overall, it’s okay

Staff is friendly, resourceful, and respectful and services are easily accessible.

Good overall

Youth services are really good

OW was more easily accessible

My Sister's Place meets basic needs and has been good

o Clients are respected, feelings and privacy- don’t have to put up with rowdy behaviour

o Good information (educational health)

o No appointments needed or required.

o Talk to a nurse, really friendly

Most are working fine just need to fine up a few things

A lot of service staffs are welcoming most of the time

The shelters treat people nicely and with dignity, they are also supportive

Great health care at the hospitals

Greater access like Peer Day event where common needs are met

The services that have been acquired were very good. Staff was very friendly and helpful.

I know where to go (LIHC) to get medical supplies. Was told by a staff at the walk in clinic that he

needed to buy medical supplies, but due to lack of $ this was difficult. LIHC supplied the medical

necessities.

Access to services, very supportive, assisting with forms

Happy to access walk-ins

Supportive of client issues

Investing time in client

Compassionate and thorough

Client followed up with clients

Personable


APPENDIX C: 8

“Constant

presumptions by health

care workers that I

don’t know anything

about my health.”

What is not working? How can it be improved?

Wish there are places that didn’t require health card in order to use services

“Too many children”

I want to know why I am getting less money through ODSP

Not enough shelter for women

Single abused fathers need a place for them and their kids to go

Want support person for legal matters, medical appointments,

dental surgery, transportation, extra medical prescriptions

Getting extra medical prescriptions

Getting extra clothing for winter and summer

Paying rent

if in medical distress or incarcerated, cannot work or unable to get

ODSP/ OW forms in on time.

Funding for a scooter

Funding for school supplies for grand children

Funding for family deaths/ transportation etc

Funding for new beds because of bed bugs

Funding to move women into new apartments (packers and movers needed)

“Highly paid health care people. Ridiculous wages. Why?”

Judgmental and untrusting paramedics

o “Paramedics called the cops and made assumptions about my health status. They wouldn’t believe

me.”

“Constant presumptions by health care workers that I don’t know anything about my health”

GP won’t listen to me because she thinks my judgment is impaired due to mental health issues.

Dr. won’t release a quantity of prescriptions so I can’t get out of town because of suicide

I don’t often get fair treatment because health care providers have a view point that I don’t need the help

because I am a service user and a service provider (peer worker)

o “What are you doing here?”

We need a paid social planning council staffed with people who have lived experience.

o It should be inclusive and broad in scope

o Fundamental question being always asked: “What kind of community do we want?”

I am a “wounded healer” but health care professionals do not grant me the same respect or value as they

do with their colleagues

We need 24/7 safe drop-ins with a supervised injection site

“Where do folks go to be safe if they are zoned?”

Split the detox from SACoh

More places like Coffeehouse on Dundas which are out of the core

Judgmental healthcare providers who are unwilling to accept people as they are

Portland Hotel Society in London

Ask more “what do you need” not “what you should do.”

Don’t like that the police are providing the health care services. If police are going to be the health care

providers they need to have a higher level of training, have higher regard for the vulnerable people, and

be more sympathetic


APPENDIX C: 9

More access within a community for diabetes support, psychiatric services

Help people apply for health card

Interpreters

Social workers

Dieticians,

“HIV on-site”

Pay to stay policy at some shelters

Walk-in clinics unwilling to prescribe medications that individual has been using for a long time

Nurses cannot give prescriptions without doctors

Family doctor or psychiatrist would be easier to go to

“Hate the police”

Need more doctors

Need more visual art to raise awareness

Incorporate art therapy

Limited supply at food banks (30 days)

o No meat

o Not enough food

o Too much hoop jumping

“Treated poorly” at Ontario Works

o Unrealistic

o “Just horrible”

o Not interested in clients circumstances

Salvation Army provides good services, however, too quick and impersonal

Coffeehouse is not wheelchair accessible

Have hangout places for people who don’t have homes

Put the money in the important places

Forced to stop using drugs and judged by society

Need more mental health support

More stuff for kids

Need more education for parents

Doctors talk down to you when you have abscesses and other injection drug issues

Doctors don’t listen to you when you talk about pain because you are an addict

Waiting in the emergency room until they are pill sick and end up leaving

I won’t tell the doc about any drug use because of stigma of how other people have been treated

Hospitals have a stigma about homeless people

Housing is difficult to get into because process of references

Lack of services for adults

Food programs doesn’t provide enough

Finding a doctor is like “entertainment in community”

Fair chance housing

Better services could make quality of service/life easier

Have more affordable housing


APPENDIX C: 10

“Recognize the

coordination

need.”

Stigma about intravenous drug users

Obtaining a health card is a difficult process

Lack of resources for the homeless

Too many unrealistic rules and regulations

“Native shelters?”

No doctors, no access to medicine

No access to phone

Legal system is too slow

My Sister’s Place doesn’t work for health reasons

o Workers get really busy and forget to help one on one

o Cleanliness is most important

o Only serve homeless people

Didn’t feel safe as a woman

Change the actual delivery of services

Just get a “smile” on their faces will relax people

Show people that they are just people not just a number for more services

Explanation of why you have to wait for medical appointment

OW needs more money

Need transportation to get to appointments

Medical operations

Can shelters prescribe medication?

o Are shelters giving medications to clients on time

“People using these organizations, why the things are they way they are?”

“Why send clients from Toronto/elsewhere to go to the methadone clinic? Who is paying?”

Housing is difficult because some landlords will not rent to people who are new to the area, especially

immigrants.

Assistance and resources for recent immigrants seeking employment

Recognize the coordination need

“We need more places where people can have shelter and food”

“Despite having a roof over their heads, people also need clothes and other necessities”

Ongoing support is needed after people have found a home.

Organizations need to regularly meet as a group to examine what is working and what are the gaps

Need to keep busy in order to feel like a part of something beyond current struggles.

Denied family doctor at InterCommunity because of an open file at walk-in clinic

Need family doctor to get on ODSP

No information on how to get a family doctor

Wait times are just too long for family doctor

Refuse to access Centre of Hope because clients and staff “too much drama”

Police are not helpful, understanding, or supportive

Enough care is offered, but not enough communication between agencies or staff at agency

More screening or intake needed


APPENDIX C: 11

At Salvation Army there are clients from different backgrounds who cannot relate to each other and cause

fights.

o Doesn’t work for any clients

Not all staff follow proper protocol

Inconsistent service

Clients not treated with dignity or respect

StreetScape needs longer hours

Nothing for homeless to get shelter for the day

Centre of Hope has “dirty residents”

Need more help with finding a place to live

More “stuff” for youth in crisis

Food Banks do not have enough food choices, healthy options and variety.

Looking for a GP is very difficult

Services are far and transportation is an issue

Need subsidized bus passes

Everyone dumps their feelings , and people don’t have time to listen

Treatment by the police is not good

Lack of respect for client concern with addiction

Very unfriendly

Need a baseline assessment

Reduce stigma

Adequate pain management for clients

Reassess client needs on individual basis

Don’t clusters us into groups; each individual is unique

Identify gaps in services

Wait times

Ability to access interpreters, for some staff it is important to be more sensitive for new comers when

English is not their first language.

Increasing support during transition from new country

Appreciation of different languages.

Male doctors need to be more accepting of different cultures and open to explain therapies and

importance of identifying each individual’s uniqueness

Time to invest in each individual

Respect client concerns

Make medication more accessible

Cost can be a barrier to needed medications

Hospitals only help working people.

Treat you better according to your address

Hospitals need to take people seriously, when going to the hospital.

Don’t just send them away when they are talking “suicide”

Health care is adequate in this city

health services & homelessness - abe oudshoorn · health services & homelessness final...

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