© 2013 Canadian Homelessness Research Network

ISBN 978-1-55014-637-0

Gaetz, Stephen; Scott, Fiona; & Gulliver, Tanya (Eds.), Housing First in Canada: Supporting Communities to End Homelessness. Toronto: Canadian Homelessness Research Network Press.

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This book is protected under a Creative Commons license that allows you to share, copy, distribute, and transmit the work for non-commercial purposes, provided you attribute it to the original source.

The editors wish to acknowledge the work of Sarah Jean Harrison and KC Santo who provided excellent copy-editing services. We would also like to thank the key informants who contributed to the development of each case study: Tim Richter, Katrina Milaney & Alina Turner (Calgary – Calgary Homeless Foundation), Kim Wirth/Katie Davies (Infinity Project), Brad Crewson (Victoria), Amanda DiFalco (Hamilton), John Sharpe & Timothy Ross (Fredericton), Amelia Ridgway (Vancouver), Wally Czech (Lethbridge) and Susan McGee & Alex Abboud (Edmonton).

The Canadian Homelessness Research Network (CHRN) acknowledges with thanks the financial support of the Government of Canada’s Homelessness Partnering Strategy (Employment and Social Development Canada) and the Social Sciences and Humanities Research Council of Canada. The analysis and interpretations contained in the chapters are those of individual contributors and do not necessarily represent the views of the financial contributors of the CHRN. The views expressed in this book are those of the Canadian Homelessness Research Network and do not necessarily reflect the views of the Government of Canada.

Transitions to Home

Hamilton ONTARIO

Fiona Scott

Key Messages

• The case study explains how the program was built based on the success of a pilot program in Hamilton ‘Hostels to Homes’ that housed 80 people.

• Profiles unique partnerships developed with police services resulting in coordination with the EMS Social Navigator who works closely with the Transitions to Home (T2H) program to identify individuals with high needs.

• The program is currently undergoing a cost-benefit analysis to determine the program’s return on investment. Results will be available in the spring of 2014.

Hamilton, like most major Canadian cities, has struggled with the growing problem of homelessness since the 1990s. The first response was to develop emergency services, including shelters and day programs. As the City moved forward to develop a more strategic response to homelessness, there was growing consensus that relying on emergency shelters was not only an ineffective response to the needs of people experiencing homelessness, but also seemed to have little impact on the broader problem of homelessness in the community.

A city of just over 500,000, Hamilton is the fourth largest city in the Province of Ontario, yet it struggles with almost the same rate of people experiencing homelessness as the largest city in Canada.

In the 1990s and into the past decade, Hamilton had a rapid increase in its homeless population. Between 1995 and 2004, the number of people needing emergency shelter almost doubled (City of Hamilton, 2007b). The number of families seeking emergency shelter also increased dramatically from 5 in 1998 to 378 in the year 2000 (HRSDC, 2007).

Following a planning process that culminated in the report, The Blueprint for Emergency Shelter Services, Hamilton committed to developing and implementing a Housing First strategy. Building upon a successful pilot project, Hostels to Homes (H2H), a new Housing First program Transitions to Home (T2H) was developed.

The Transitions to Home program implements two unique aspects of service not shared by all Housing First programs. Firstly, relationships with police services were developed, including a connection to the EMS Social Navigator who works closely with T2H staff to identify individuals who are street involved with high needs, and could be excellent candidates for the program. Secondly, the T2H program separates the roles of case manager and housing support worker, providing clarity and transparency of service; this important distinction fosters empowerment and trust for people accessing the program.

The results of T2H to date have proven extremely positive; 74% of people remained housed after 6 months and, of those 74%, 90% remained housing after 12 months.

This case study presents an analysis of the Transitions to Home Housing First program. As a review of a specific program model, we focus on the underlying principles of the program, the process of building support for the initiative, planning and implementation challenges, and evidence of success. The case study concludes with a consideration of key learnings from this Housing First program.

GETTING STARTED: FRAMING THE ISSUE

In the early 2000s, a few years prior to the development of Hamilton’s new strategy to address homelessness, there was talk in the community about the pressure on the emergency shelter system. The shelters were operating on a per diem funding model, which is counter-productive given that funding is therefore dependent on having people in the beds. Hamilton needed a different way of doing business in order to accomplish their goal of eliminating homelessness. Not only were the facts revealing (i.e. the current system was undeniably unsustainable), but keeping people in shelter beds was not what people wanted for the citizens of Hamilton.

As is the case in other communities across Canada, the rise in homelessness throughout the 1990s led to efforts to develop effective responses to the problem. In 2004, the City of Hamilton published its first housing strategy. Keys to the Home: A Housing Strategy for Hamilton outlined four effective solutions for reducing homelessness in the future:

1) There is no one ‘quick fix’ or ‘silver bullet’ to address the housing needs of the citizens of this community. A balance and range of responses are required from many organizations that recognize the context of the local housing market and the complexities and linkages of housing needs;

2) Partnership must be the modus operandi;

3) Housing is not a ‘cost’; it is an investment that will allow people to lead more independent and fulfilling lives now and in the future. It is the building block for stable healthy communities and families, and enhances access to educational and employment opportunities for society’s most vulnerable members; and,

4) Housing is a catalyst for economic growth (City of Hamilton, 2004).

In 2006-2007, The City of Hamilton and the Social Planning and Research Council of Hamilton conducted research on homelessness throughout city to inform their strategic planning process. The report, entitled On Any Given Night, highlighted the problem of people experiencing chronic homelessness who face many barriers obtaining and maintaining housing and, as a result, cycle through the emergency shelter system (City of Hamilton, 2007a).

The report concluded that while an emergency response was important, and would remain necessary, in the end emergency shelters cannot be considered a solution. While shelters provide a place to sleep for a night, they are not able to adequately provide other services many people require in order to access and maintain housing. There were enough beds in Hamilton’s emergency shelter system, but the number of people who needed the service was not decreasing, and too many people were unable to make the transition from shelter to housing because of complications unaddressed and under-serviced in supporting housing stabilization and positive landlord-tenant relations.

The City recognized the need to provide more than emergency shelter to its citizens experiencing low-income vulnerabilities – they needed a more effective way of helping people move into long-term affordable housing. This required a plan and strategy, focusing on case management and supports.

DEVELOPING A PLAN TO ADDRESS HOMELESSNESS

The City gathered representatives from government, social service agencies, advocacy groups, City staff and those with lived experiences of homelessness for a series of community consultations, including a Homelessness Summit in 2006, focus groups and individual interviews to provide input into the plan. Representatives from these sectors were also part of the two advisory committees established to provide input to the Plan’s development. These consultations and advisory groups formed the basis for the plan.

It was clear the status quo was not the solution. Changes were needed in the delivery of programs and services if the goals of the plan were to be achieved.

The importance of collaboration between people and agencies was also a recurring theme from these consultations. It was recognized that everyone needed to work together to develop new partnerships and mobilize resources. A Community Check-in was held on September 12, 2006, to review a draft of the Plan.

The Plan

In 2007, Everyone Has a Home: A Strategic Plan to Address Homelessness was launched. The desire for Hamilton to be “a community where everyone has a home” was to be achieved by focusing on what the community wants for its citizens, rather than reacting to people’s immediate circumstances. The system planning framework is designed to:

• Engage the entire community in addressing homelessness.

• Provide a continuum of supportive housing that help residents achieve their potential.

• Provide supports that help residents obtain and maintain housing.

• Help citizens secure adequate income.

• Illustrate how to make use of community resources efficiently and effectively (City of Hamilton, 2007a).

The Evolution of Housing First in Hamilton

From 2007 – 2009 the H2H program was piloted. A collaborative effort, funded by the province, the program aimed to help move people dependent upon the shelter system as long-term housing into more permanent, affordable, and sustainable housing. The program included an Integrated Mobile Case Management Team (IMCMT) that provided enhanced case management, 24/7 mobile supports, help accessing sustainable housing options and referrals to appropriate employment supports and linkages to community-based services (City of Hamilton, 2007).

The H2H model, similar to a Housing First approach, had already been successful supporting people with histories of chronic homelessness move into more permanent housing. That program stemmed from “the realization that almost 25% of people using emergency shelters were spending more than 42-days a year in emergency shelter beds” (City of Hamilton, 2009a). The pilot program helped 80 individuals find and sustain safe affordable housing. Stakeholders had been skeptical, but once they learned the housing retention rates were over 80% one year after discharge, they were on board.

Despite its success and a desire to keep the program running, funding for the pilot was coming to an end. At the time, the City of Hamilton was undergoing a review of its emergency shelter services. The report, entitled Homelessness Blueprint for Emergency Shelter Services, sought to develop a sustainable system to better support people experiencing homelessness as they move to permanent housing. The report recommended that partners would “collaborate in the development of an integrated network of emergency shelters that work towards achieving the vision and goals of the Blueprint and support compliance with the Emergency Shelter Standards” (City of Hamilton, 2009a).

Agencies working in the homelessness sector, including all emergency shelters, came together to devise a system to work collectively. As a result, the T2H program was developed and would be led by Wesley Urban Ministries.

THE TRANSITIONS TO HOME PROGRAM MODEL

T2H works with men experiencing long term shelter use and homelessness in order to help them acquire and maintain safe, affordable and long term housing in the community (Supporting our Sisters supports women experiencing homelessness). The program operates under five ‘program anchors’ that align with the core principles outlined in A Framework for Housing First (Gaetz, 2013:11). These program anchors demonstrate the program’s fidelity to the Housing First model:

1. Long term shelter users and people living on the streets move into housing directly from streets and shelters without a requirement of mental health or substance abuse treatment prior to participation in the program. The immediacy of moving to a housing unit is based upon the availability of financial supports, housing units and each individual participant’s needs.

2. Transitions to Home provides ongoing case management supports without a time limit. T2H participants must commit to receiving case management supports through a mutually developed case plan with a Case Manager.

3. Transitions to Home uses a harm reduction approach to addictions. Clients do not need to be abstinent in order to access services, but are instead supported in reducing the harm associated with their addiction.

4. Residents have leases and tenant protections under the law. Transitions to Home works primarily with private market landlords to identify permanent housing for the programs’ participants.

5. Once housed, continued tenancy is not conditional upon participation in services. In addition, in circumstances where tenancies deteriorate to the point of eviction, T2H will help participants find another housing unit and offer continued supports.

Core Supports

Mobile Intensive Case Management –PLUS

A mobile Intensive Case Management (ICM) team provides direct supports to help people reliant upon the shelter system as long-term housing achieve successful tenancy in affordable private apartments. In addition, vulnerable people living on the street receive help finding affordable apartments and creating successful tenancies.

The team is composed of 15 Intensive Case Managers, one addictions worker, one Therapeutic Recreation Therapist, one housing worker, one supervisor and one manager. There is also part of a nurse’s time at the Wesley Centre that is allocated to assisting T2H participants. There are also three Social Workers who provide support to clients but not directly affiliated with the T2H program.

The caseload size is on average 18-20 active clients per case manager. Case Managers also have a number of clients in ‘maintenance’, which essentially means that these clients are not receiving ongoing ‘active’ case management supports but may reconnect with T2H should they have an issue relating to housing.

The PLUS component consists of a team of 5 clinicians who provide supportive trauma-informed therapy, addictions counselling, and therapeutic recreation to program participants. Case managers and clinicians also connect program participants to primary health care services through the accessible drop-in Shelter Health Integration network.

Follow up Support – Housing Support Workers

Transitions to Home currently helps over 250 people formerly accessing shelter services and people living on the street to maintain successful tenancies throughout the City of Hamilton. Housing Support Workers are able to quickly intervene when issues arise between landlord and tenants, negotiating and mediating the relationship as a strategy for eviction prevention. Housing Support Workers focus on supporting the tenancy by remaining impartial, while Intensive Case Managers are advocates and counsellors for the individuals accessing the T2H program.

Recreation

Transitions to Home also operates community wide recreation programs for people experiencing homelessness as a means of facilitating a connection to the program and providing healthy recreation time. The Hamilton Homeless Baseball League, Bowling League and other events are provided with the help of program participants.

Recruitment

Clients are recruited mainly through Hamilton’s emergency men’s shelters and also through the Hamilton Police Services Social Navigator (more details on page 10). Case management staff spend 2-4 hours a week in every emergency shelter in order to recruit clients. Referrals to T2H are made on a first come, first served basis.

How the Program Works

The program closely aligns with the At Home/Chez Soi model of Housing First. They have also adopted the Ontario Ministry of Health guidelines for Intensive Case Management. Everyone on the active caseload is seen a minimum of once per week, and individuals are visited at their home at least once per month.

T2H currently works with approximately 250 individuals, 170 of which receive ICM. Another 75 receive ‘maintenance care,’ having developed a successful tenancy and deciding they no longer need the weekly support. These individuals receive a visit every 3 months for a one-year period, at which time they receive yearly contact. The program is flexible and clients can reactivate support at any time. There are also no defined time limits on ICM.

Other than support received from social assistance (approximately 55% of clients are on Ontario Works, and approximately 45% receive financial aid from the Ontario Disability Support Program), the majority of clients do not receive rental supplements from T2H. The City of Hamilton provides approximately 90 housing allowances through the Investments in Affordable Housing program to T2H.

Affordable Housing in Hamilton

The housing situation in Hamilton is relatively better than it is in cities like Toronto – there is a fairly healthy vacancy rate of 3.5% compared to Toronto’s 1.7% – although the quality of housing stock is still an issue (State of Homelessness in Canada). The challenge is less about housing availability and more about identifying and recruiting landlords willing to work with a Housing Support Worker if issues arise. Similar to the At Home/Chez Soi and Pathways to Homes Housing First programs, T2H decided to separate the housing management role from that of case management, thus allowing the case manager to focus on the provision of supports, while the housing support worker is free to focus on property management and landlord liaison. People who experience low-income vulnerabilities are often stigmatized as irresponsible and violent. Housing Support Workers spend a considerable amount of time destigmatizing potential tenants to recruit landlords and explaining the benefits of the T2H programs to landlords, tenants and the community as a whole.

MOVING FORWARD: PLANNING

Those involved in setting up Transitions to Home identified the following key issues as having an impact on planning:

Changing the Current System

In order for this program to be successful, there had to be willingness from the agencies serving people experiencing homelessness. Difficult conversations amongst the groups involved ensued. Eventually it was decided the Wesley Centre, which had more shelter beds than needed, would close the shelter and take over the Integrated Mobile Case Management Team, becoming a Housing First model program.

Setting up the Program

In order to address a broad range of questions, establishing the program involved a considerable amount of planning and input. Where were clients going to be housed? How many staff were required? What was the right client to case manager ratio? What did case management look like? How many times would clients be seen per week? Staff looked to experts who had successfully implemented Housing First, including Sam Tsemberis from Pathways in New York. Case management standards were drawn from existing provincial guidelines.

Since the H2H program was coming to an end, the T2H team had the added complication of dealing with participants who needed to be discharged from the program. Clients were offered the opportunity to participate in the Transitions to Home program.

Human Resources

Those who were already working in the housing system in Hamilton, who believed in a new approach to homelessness (including the Housing First model) and who had compassion, empathy, and patience, were sought to develop and implement the program. This also helped to keep the collaborative spirit behind what was being created.

The Importance of Landlord Relationships

The program uses scattered site housing, and as such, relationships with private market landlords and other housing providers are a critical component to its success. A Housing Support Worker acts as a mediator between landlords, tenants, and case managers and builds relationships with landlords, in order to effectively deal with problems as they arise. The Housing Support Worker also supports the tenants and empowers them with tools to solve their own housing issues.

Consumer Input in Program Development and Implementation

Homeless-serving staff in Hamilton recognized in order for programs to be effective, they needed to meet the needs of the people they are designed to serve. Consultations with people who have experienced homelessness were crucial to the development of Hamilton’s plan to address the issue.

Initial Investment/Funding

Funding has been and continues to be the biggest challenge to implementing and sustaining Housing First in Hamilton. The program is funded through the Homelessness Partnering Strategy (HPS) and the Community Homelessness Prevention Initiative (CPHI). T2H also receives some municipal funding from the City of Hamilton. Ensuring ongoing funding for the program in a context of shifting government priorities is a continual concern.

MAKING IT HAPPEN: IMPLEMENTATION

Hamilton is a relatively small community and homeless-serving agencies are inter-connected. The agencies, including the City of Hamilton and all of the community partners, sit at a number of different systems planning tables to address the issues of housing and homelessness, including the Hamilton Emergency Shelter Integration and Coordination Committee and the Housing and Homelessness Planning Group.

Transitions to Home was developed by the Hamilton Emergency Shelter Services Integration and Coordination Committee (HESICC). HESICC is a partnership between the City of Hamilton, Good Shepherd Centres, Hamilton Housing Help Centre, Mission Services, Salvation Army and Wesley Urban Ministries. Wesley Urban Ministries administers the program and acts as the employer for staff in the Transitions to Home program. These agencies have met since 2007 and continue to meet to discuss what has been successful and what remains in need of improvement.

All of the City’s project charters, terms of reference and the Blueprint for Emergency Shelters report highlight the need for agencies to work together. This philosophy is shared by the people working in the homelessness sector in Hamilton; the only way to make a significant impact is to work together and leverage one another’s strengths.

Hamilton’s collaborative nature towards services for vulnerable people created a culture of willingness to partner. City and agency staff connected with other sectors, told them what they were trying to accomplish, how they shared similar clients and highlighted the potential benefits and ways they could work together. There was recognition that no one agency or service can be all things to all people.

Key Partnerships That Enable the Success of Housing First in Hamilton

Everyone has a role to play in addressing homelessness. Hamilton’s plan clearly indicates collaborations between organizations, agencies and sectors are key to addressing the range of issues faced by people experiencing homelessness. The homelessness sector is intentional about developing relationships with police, health and mental health sectors, as well as organizations that administer financial assistance.

Hamilton Police Service

Staff from Hamilton Police Service attend monthly shelter standards meeting, where the focus is on operational issues in the emergency shelter system. At these meetings, the police provide information on trends they are seeing within Hamilton, specifically the downtown core. Police are familiar with many of the people accessing emergency services and try to develop relationships to facilitate a good resolution for public space in the downtown core. Police and T2H work together to tackle issues that arise and require police presence.

Ontario Disability Support Program (ODSP)

The ODSP branch in Hamilton has a manager representative who takes part in the monthly shelter standards meetings. Their role is to provide insight into new processes and legislation that may directly affect people accessing the emergency shelters and in the T2H program, and answer ODSP-related questions from shelter managers/T2H case managers.

Hamilton EMS Social Navigator

The Hamilton Police Service developed this unique staff position to manage a caseload of high-needs individuals who are living unsheltered or precariously housed and who have high contact with police, EMS and emergency services. EMS staff attend Hamilton’s bi-weekly shelter case conferences, where challenges with specific clients are discussed. Through these case conferences the Social Navigator is able to discuss specific clients’ needs. The Social Navigator works alongside shelter/T2H staff to develop case planning and referrals for these clients. The Social Navigator is able to build relationships with individuals on the street, which builds the foundation for relationships with the T2H program.

The Good Shepherd HOMES Program

HOMES is a housing and support services program for people experiencing homelessness and living with mental illness. Program staff provide consultation to other agencies working with clients with mental health challenges and are also a necessary partner in providing housing for clients.

Monitoring and Data Collection

The T2H program uses the Client Outcome Tracking System (COTS) to collect data. The database was chosen through an RFP process and deemed most useful for the case managers working with, and collecting information about, clients. The City monitors and measures indicators from both the emergency sector and the T2H program. With emergency services, for example, they monitor the reduction in number of nights people stay in shelters and shelter usage in general. With T2H, they monitor housing placements and housing retention rates.

Questions of Sustainability

The best argument for the sustainability of a Housing First approach in Hamilton is that the Transitions to Home program is cheaper than the per diem approach under which emergency services currently operate. The impetus for Hostels to Homes and Transitions to Home was not due to funding pressures, but rather the community’s commitment to ensure people accessing the shelter services are equipped to move from the emergency system to more sustainable and permanent forms of housing. Part of the purpose for the Blueprint for Emergency Shelter Services report was to help find solutions to both long term shelter stays and financial pressures (City of Hamilton, 2009a). The per diem rates encourage occupancy, thus the objective was counter-intuitive to the funding model.

With the recent changes to provincial homelessness funding, City staff are currently leading an assessment with the Community Homelessness Prevention Initiative (CHPI). This involves reviewing provincial funding opportunities, the City’s core homeless services and what is needed to sustain the successes they have experienced with their current system, all in order to make future funding recommendations for CHPI funded programs, including emergency shelters.

The city’s strategic plan is comprehensive and as such requires additional resources beyond operational funding to support data collection, planning and community development.

Costs

Transitions to Home is funded through federal-provincial-municipal contributions. The City of Hamilton has committed a portion of their housing allowance (funded through the Provincial Investment in Affordable Housing for Ontario Program) to T2H. The T2H program leverages from their agencies fundraising contributions and other supports/services in the community. Overall, T2H costs $911,537 per year – not including the Housing Allowances or all of the clinical supports – or approximately $3700 per person annually.

EVIDENCE OF EFFECTIVENESS

Transitions to Home collects data on the housing outcomes of participants in the program via the Client Outcome Tracking System (COTS). The most recent data collected from the Transitions to Home program (from January 1, 2012 – December 31, 2012 inclusive) showed that:

• 74% of clients remained housed after 6 months.

Of those 74%:

• 90% remained housed after 12 months.

T2H was recently awarded a federal research grant in order to conduct a cost-benefit analysis of the program. The results of the research project with McMaster University will help identify the cost-effectiveness of the program in order to demonstrate to funders the return on investment and effectiveness of the T2H program in ending homelessness in Hamilton. A final report is expected in March 2014.

KEY LEARNINGS

As with other Housing First programs, there are key learnings that can help support communities in planning and implementing Housing First.

1. Appropriate (affordable, suitable and safe) housing is essential for a Housing First approach to work in any community.

Without places for people to live, the program will not be effective. In the next 20 years Hamilton is projected to grow by approximately 26%. The City’s Urban Official Plan identified that Hamilton needs to create 629 new rental units each year to meet this demand (City of Hamilton, 2009).

2. The homelessness and housing systems need to work in a collaborative manner.

In order to provide housing to individuals experiencing homelessness, relationships between organizations providing emergency services, as well as those providing housing, are important. Many issues are created as a result of the complexities within these systems rather than due to the complex situations of individuals. Community partners and stakeholders in housing and homelessness need to work together to ensure sustainable housing.

Given the need to create sustainability within the emergency shelter system, Hamilton chose to close a shelter, thus creating more revenue for the remaining services. This only worked, however, if occupancy remained reasonably low which meant that T2H was a critical part to support people leaving the shelter.

Hamilton’s Housing and Homelessness Action Plan outlines how the city will effectively address homelessness and housing over a ten year period. The plan covers the housing continuum, including homelessness prevention and services, emergency shelters, transitional and supportive housing, rent-geared-to-income housing, market rental housing and affordable homeownership. A Housing and Homelessness Planning Group, co-sponsored by the City of Hamilton and the Affordable Housing Flagship and comprised of more than 20 representatives from the housing and homelessness sectors, works together to achieve the vision that “everyone has a home” (City of Hamilton, 2007c).

3. Do not give up on people.

Everyone has the right to a home. Many people have not had the appropriate life experiences or access to supports that would give them the skills to manage their own home, so sometimes they make mistakes. Additionally they have often lived through traumatic events, addictions, mental illness and physical health problems, further complicated by, and complicating, their housing-related struggles. For the most part, programs place unrealistic conditions on people to stay in the program or remain housed. Realistically, many people will need support for a long time. If it does not work out the first, second, or even third time, it is important not to abandon that person.

4. Housing First is not the only answer.

People have various risk and protective factors related to housing security; some will have no experience of managing a home and will need regular support, while others will be fully capable of taking care of paying bills and cleaning, yet may need assistance with accessing health services, finding a job, and/or integrating into the community. Any Housing First program needs to be responsive in the range of supports it provides. The program does not have to deliver all those supports directly, but should leverage resources found in the community.

5. Landlord relationships are just as important as relationships with program participants.

There will be issues with tenancies. Empower the tenants and work closely with the landlords. In Hamilton, they have learned keeping these roles separate helps maintain the trust built between the tenant and their case manager. There is a separate staff person who acts as a landlord liaison to deal with any issues that arise.

REFERENCES

City of Hamilton. (2004). Keys to the Home: A Housing Strategy for Hamilton. Retrieved from http://www.hamilton.ca/Common/Search%20Results?txt0=0%7ckeys%20to%20the%20home%7c0&s=COH

City of Hamilton. (2007a). On Any Given Night. Retrieved from http://www.hamilton.ca/NR/rdonlyres/A85A4701-C327-459D-A66E-19D81CFA6A99/0/OnAnyGivenNight2007.pdf

City of Hamilton. (2007b). Information Report. Retrieved from http://www.hamilton.ca/NR/rdonlyres/7EB6F5E3-C25D-452B-AA4B-1E5BB337D45F/0/Oct22Item54ECS08047INFOREPORTHostelstoHomesUpdate.pdf

City of Hamilton. (2007c). Everyone Has a Home: A Strategic Plan to Address Homelessness. Retrieved from http://www.hamilton.ca/Common/Search%20Results?txt0=0%7ceveryone%20has%20a%20home%7c0&s=COH

City of Hamilton. (2009a). Blueprint for Emergency Shelter Services. Retrieved from http://www.wesleyurbanministries.com/cmfiles/Blueprint%20for%20Emergency%20Shelter%20Services%20-%20Council%20Report.pdf

City of Hamilton. (2009b). Urban Hamilton Official Plan. Retrieved from http://www.hamilton.ca/CityDepartments/PlanningEcDev/Divisions/StrategicServicesSpecialProjects/Policy+Planning/HamiltonNewOfficialPlan/Council+Adopted+Urban+Hamilton+Official+Plan.htm

Gaetz, S. (2013). A Framework for Housing First. Canadian Homelessness Research Network.

Gaetz, S., Donaldson, J., Richter, T. & Gulliver, T. (2013): The State of Homelessness in Canada 2013. Toronto: Canadian Homelessness Research Network Press.

Human Resources and Skills Development Canada. (2007). Community Plan 2007-2009. Retrieved from http://www.hamilton.ca/HealthandSocialServices/SocialServices/Homelessness/