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Lessons from Medicine Hat’s first-in-Canada Functional Zero homelessness

Jaime Rogers, manager of Homelessness & Housing at Medicine Hat’s Community Housing Society, spoke over the phone with about what it takes to tackle homelessness
Homeless person begs for a home (Chanin Wardkhian-Moment-Getty Images)
A homeless person begs for housing. Housing First is principle that every other problem is easier to solve if a person is safely and permanently housed - the reverse is also true

Jaime Rogers, manager of Homelessness & Housing at Medicine Hat’s Community Housing Society, spoke over the phone with about what it takes to tackle homelessness.

By 2015, Medicine Hat’s strategies to reduce homelessness had guaranteed that no one slept rough, or in a shelter, for more than 10 days before that person had access to safe, stable shelter – and the supports needed to ensure it.

At that time, there was no Canada-wide accepted definition of what an end to homelessness looked like. The adoption of the standards proposed by the Canadian Alliance to End Homelessness (CAEH)’s Built for Zero – Canada (BFZ-C) campaign raised the bar – so Medicine Hat did it again.

Functional Zero means that three or fewer individuals were experiencing chronic homelessness for three consecutive months. The CAEH confirms that Medicine Hat is the first community in Canada to get there.

In June 2021, Tim Richter, president and CEO of the CAEH, said, “Medicine Hat’s groundbreaking work has resulted in a historic moment for all of Canada. Once again, this determined and focused community is showing the rest of us not only that it’s possible to end homelessness, but also how it’s done. Medicine Hat was at the forefront of many of the strategies that are now embedded in Canada’s federal Reaching Home program including Housing First, data-driven decision making, effective and inclusive local leadership, and developing a coordinated local homeless system.”

What it means to be driven by data

The system that Medicine Hat has set up, led by the Medicine Hat Community Housing Society (MHCHS), is aware of every person in the city who is homeless – or even at risk of homelessness – in almost real time.

“Since 2013, we’ve had a daily list from our shelter providers,” said Jaime Rogers, manager of homelessness and housing at MHCHS. “Not just with the number of people facing homelessness, but their names – with consent, of course.”

Informed consent to have their names on a list is a key part of the system. “With that,” Rogers said, “we cross-reference for people… we have a coordinated access system, where the components of our system talk to one another. And with that, we do have a kind of master list.”

Every community-based organization (CBO) in Medicine Hat is part of that coordinated access system. The government services also participate. “If the police happen upon someone, they know to call. Even the hospital – the hospital knows to call for discharge, so we can do the work for that individual before they’re released or discharged,” Rogers explained.

The causes of homelessness are complex, so the solutions have to be too. CBOs coordinate depending on an individual’s situation. If they’re fleeing abuse; if they’re working, but something has happened where they can’t afford their rent or mortgage; if they have a substance abuse disorder; if they’re a minor who has run away or been kicked out: each situation requires different resources and support specialists.

Homeless Management Information Systems (HMIS) are local information technology systems specifically designed for coordinated access in a community. They protect confidentiality, track program attendance, and allow providers to send those in need exactly where they need to go. Only the necessary information reaches each provider, ensuring the privacy of those in the system.

A growing number of Canadian communities are using such tools. The Homeless Individuals and Families Information System (HIFIS) is a federally-supported tool currently on its fourth iteration.

Two-pronged approach – an ounce of prevention is worth a pound of cure

“When we looked at efforts to end homelessness back in 2007, 2008, we ran an Affordable Housing Task Force,” Rogers said, “and what they found was that people that were working were losing their housing because of job loss, and utility rates going up, and banking rates going up, etc.”

Rogers said that that first task force found that ending homelessness was easier on the upstream side than on the downstream. In other words, helping people keep their housing is both easier and less expensive than helping them afterward.

Once a person is homeless, everything else becomes harder. Concerns of nutrition, hygiene, physical safety, dangerous weather events, crime, addiction, and joblessness all follow. This is why Housing First is a vital principle.

The HMIS that Medicine Hat uses, therefore, doesn’t just account for people who have become homeless – it also accounts for people who are at risk of homelessness.

“We do a lot of work with housing loss prevention, where we would prefer, and people would prefer, to stay in their homes and not have to enter into that state of homelessness,” Rogers said. “Whether that’s applying for income support benefits or COVID benefits or just getting them back on the path to stability, whatever that looks like. We have workers to help with that. It makes far better sense than having them come through an entire homeless-serving system for something that can be supported with mild intervention.”

Housing First – removing compliance standards

“It has been a continual effort to get community on board, to get systems and government on board,” Rogers confirmed. “There have been a lot of challenges.”

Rogers said that Medicine Hat needed to undergo a “complete paradigm shift in terms of meeting people where they’re at. We’re a non-compliance program. We don’t have pre-conditions of housing, people don’t need to stop doing things to be worthy of a home.”

A great deal of work has gone into combating stigma and discrimination – and changing or eliminating policies that perpetuate stigma and discrimination. “How we deal with an opioid crisis is very different than how we deal with those experiencing homelessness. But I think it’s really easy for people to roll it into one,” Rogers added.

She said that they don’t care about anything else an individual is going through before they have housing. Whatever that person’s situation, social supports will be more effective once they are housed.

Rogers said that the people of Medicine Hat have been tremendously supportive. She added that while the help of provincial and federal resources has made a major difference, at a fundamental level, change is community-driven. Local leaders, people experiencing homelessness, and the community itself have to continue to choose to engage in the hard work of community-based delivery.

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