Supportive Housing

CRNCC Symposium October 15 2007CRNCC Symposium October 15 2007

About Vancouver Coastal HealthAbout Vancouver Coastal Health

One of Canada’s largest H lth A th itiHealth AuthoritiesAnnual Budget of $2.1 billi

Insert Map of Region

billionMore than 1 million peoplepeople27,000 staffLong history of working in partnership to deliver Supported HousingSupported Housing

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Determinants of Health ApproachDeterminants of Health Approach

Focuses on factors that influence HealthIncomeEducationHousingHealth ServicesEarly Childhood Development Biological

Early Intervention/Prevention

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Two Models of Supported HousingTwo Models of Supported Housing

Supportive Services to Peoplein their Homes – ARQ Model of Home Support

Housing with Supports for people with disabilities and brain injuriesdisabilities and brain injuries

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Why Home Support?Why Home Support?

ALC

AL, Supported Housing

Home support, meals, transportation, social

supports

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Vancouver SeniorsVancouver Seniors

Population 597,68225% below low income cut-off12% over 6551% English speaking30% or over 22 000 Vancouver residents over30% or over 22,000 Vancouver residents over 65 live alone

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Home Support Clients

Total long term clients5,335 community dwelling39% with mild to severe cognitive gimpairment81% receiving home support42% supported at home while meeting high to very high needs Maple score

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Range & Location of Services g

Individual Homes / Apartments Supportive Living Residentialp

Individual homes

Clustered Supports –

Housing with People with

Assisted Living

Complex Care

Apartments or Neighborhood

Disabilities

Clustered Home Support with additional

services

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1. ARQ Model and Cluster Care

“Accountability, Responsiveness & Quality for Cli t ”Clients”

3 j l t f h3 major elements of change:Clustering & block fundingQuality Performance Management indicatorsPerformance based fundingg

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How Clustering WorksHow Clustering Works

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Example of Population Clustering DensityExample of Population Clustering Density

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Block Funding of ClustersBlock Funding of Clusters

Stable base funding for HS providersStab e base u d g o S p o de sIncludes short term and discharges from hospital pEfficiencies achievedReinvestment of “savings” into otherReinvestment of savings into other support services such as meal programs

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Quality Performance IndicatorsQuality Performance Indicators

VC Quality indicators are: Availability/AccessibilityContinuity of Care ySkill CompetenciesClient and Clinician satisfaction feedbackClient and Clinician satisfaction feedbackCHW Staff well-being Efficiency

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How Performance Funding WorksHow Performance Funding Works

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2 Supported Housing for Adults with Disabilities2. Supported Housing for Adults with Disabilities

Another Model

Two Key QuestionsTwo Key QuestionsIs it Health’s Business? If so, how do you get started?

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Needs of People with Disabilities in CanadaNeeds of People with Disabilities in Canada

According to “In Unison” report (1997) and “Advancing the Inclusion of Persons withAdvancing the Inclusion of Persons with Disabilities” reports (2004, 2005, 2006)

Accessibility and Disability SupportsL i Skill d E l tLearning, Skills and EmploymentIncome SupportsHealth and Well-Being

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Disability Supports ApproachDisability Supports ApproachCommunity ConsultationPlanning based on need rather than diagnosisSpecialized “Housing for People with Disabilities”Complex Rehabilitation Supports

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Values and PrinciplesValues and Principles

A range of choices

Integration and participation in the community

“Nothing about me without me”Nothing about me without me

Most “facilitative” and least “restrictive”

D i t i i i d dDesign to maximize independence

Support rehabilitation and transition

Funding based on individual requirements

System collaboration and continuitySystem collaboration and continuity

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Housing and HealthHousing and Health

Government Programsg

Partner with Non-Profit Providers

Independent Living BC funding

Created 32 units - within 2 years

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Supported Housing Cost ComponentsSupported Housing Cost Components

R t Rent Health Care Rent Rent

Subsidy and Supports

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The Models

Client Support RequirementsRequirements

Access to 24 hr support24 hr support

RequiredHousing with Self-Directed Physical

C

Housing with Physical Care

and PsychosocialCare

Night staffing

and Psychosocial Supports

g gDay Time

Individualized Staffed Housing

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Next StepsNext Steps

EvaluateLearn from clients, particularly those with “before and after experience”Measure stability of housing and healthLearn from Mental Health Individual Confidence/Satisfaction with Housing and Support Model

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