CCBR became involved in evaluating a number of pilot programs in Waterloo Region that took a unique approach to supporting people experiencing housing issues ranging from homelessness to insecure housing. The Persistent Homelessness programs was a series of pilot programs aimed to address and prevent persistent homelessness in the Region of Waterloo, and to aid people to find and maintain housing. The pilot programs were as follows:

The Reference Group is composed of representatives from each of the pilot programs. It serves to keep a unified vision for all of the programs, to share information and resources, and to work together to solve problems as they arise. We are also conducting an evaluation of this linkage process. At all pilot sites, workers are recording all interactions with people involved in the program. The Reference group is also participating in an evaluation process of their own group and process.

Downtown Street Outreach- Street outreach is a service that is offered by a variety of agencies throughout the region. Through this process, the region partially funded The Working Centre in hiring three outreach workers for Kitchener-Waterloo and one for Cambridge. The purpose of the Street Outreach program is to engage with people in the urban centres of Cambridge, Kitchener, and Waterloo who are street involved. Outreach workers seek to develop relationships, build trust, meet immediate needs, and ultimately connect street involved people with the supports and services of their choosing that may assist in maintaining and/or improve their health and/or quality of life. In addition, as relationships progress, program participants are supported in engaging with the community to develop more relationships, build capacity for support and services, and develop mutual engagement between the person and the community.

Streets to Housing Stability is designed to provide an intensive support relationship for approximately ten people who are experiencing persistent homelessness. Support is provided by one worker at The Working Centre who works with men, and another worker at YWCA- Mary's Place, who works with women. The goal is to assist people in becoming housing-ready and in finding housing, and then to continue supporting them in maintaining housing.

Shelters to Housing Stability is similar to the Streets program, but people involved in this program are episodically homeless and have medium support needs, so the support provided is less intensive. As a result, it is expected that each worker would be able to support approximately ten people. This program has two sites in Kitchener (YWCA- Mary's Place and Charles Street Men's Hostel) and one in Cambridge (The Cambridge Shelter), and works with both women and men who are generally staying at the local shelters. The goal is to assist them in finding housing and to continue a supportive relationship with them to maintain that housing.

"WIT" (Whatever It Takes) is designed to work at a slightly different level than the Streets and Shelters pilot programs. The purpose of this program is to bring together service providers and participants experiencing persistent homelessness to develop and implement a plan that will solve the systems-level barriers to housing. The goal is to create stabilized services for up to 10 participants over a period of time that will create conditions for success in securing and maintaining housing and to help to facilitate the transition from crisis services to more stabilized services. This pilot program involves collaboration with primary front-line agencies who are addressing homelessness and related issues such as using emergency services in developing criteria that would aid in selecting people experiencing homelessness who have had long histories of shelter or street activities, and who may be ready (i.e. "housing ready") to participate in working towards housing stability. In addition, an underlying objective is to gather information of a systems nature that will create an inventory of policies and practices that act as systemic barriers for people experiencing homelessness to participate and have equal access.

Two new programs, Hospitality House and At-Home Outreach Worker were added to the Persistent Homelessness program spectrum under the Aging at Home Strategy (AAH) of the Ontario Ministry of Health and Long-Term Care with funds available through the Aging At Home Strategy (AAH) of the Waterloo Wellington Local Health Integrated Network (WW-LHIN).The strategy aims to support seniors and those who are prematurely aged in their desire to live independently in a safe home of their choice. The AAH funding will be allocated through The Working Centre (program lead) from October 2008 to March 2011. The Working Centre has identified the need for housing with support for people experiencing persistent homelessness as a priority action item.

The purpose is to assist those who are prematurely aged, homeless or are at risk of homelessness and are experiencing debilitating health issues to live as independently as possible, for as long as possible. Hospitality House provides a six-bed non-medical residence that supports medical and life stabilization for the target population. Participants are individuals who have been diagnosed as being between acute and palliative, who do not qualify for current long-term care facilities and for others (complex issues needing short term stabilization) who do not have secure/safe housing. The At-Home Outreach Worker provides at home support for those who are at risk of homelessness and offers coordination with the participant and CCAC to have appropriate medical needs met within the context of their own home or an alternate location. Typically, these complex needs are shaped by addictions, mental health, physical disabilities/illness, and/or cognitive disabilities (e.g., developmental, head injury, Fetal Alcohol Spectrum Disorder, etc.).

In addition to the Persistent Homelessness programs, CCBR was also recently involved in evaluating the "Peer Health Workers Pilot Project", a support service for people experiencing homelessness through the Kitchener Downtown Community Health Centre (KDCHC). Through this project, people with lived experiences of homelessness were employed to address health issues among people experiencing homelessness. The duties of the PHWs were to establish rapport with people experiencing homelessness, listen to their concerns, and provide information referral and system navigation support regarding health, emergency, and related services.

The goals of this project were to improve the health and well-being of people experiencing homelessness, increase their access to health and related community resources, and reduce the isolation of people experiencing homelessness. It also aimed to increase the skills and confidence of Peer Health Workers (PHWs), to share information, make referrals, and provide feedback regarding programs and services, and to develop a better understanding of the needs and barriers faced by people experiencing homelessness in order to develop better practices and supports, and to increase the participation of peers in community action and service planning.

PHWs collected data after each weekly shift detailing their interactions. A key informant interview and focus groups were conducted with PHWs and people experiencing homelessness. The results of this evaluation found that PHWs have a unique knowledge base of social services and how to access them; PHWs are able to provide unique emotional support because they have 'been there'; people experiencing homelessness trust PHWs and the information they receive, people experiencing homelessness are comfortable approaching PHWs with issues; and, people said they are being connected with and referred to services by PHWs.