Planning Tasks

Task 1: Convening a stakeholder coalition & setting up a planning group

In order to develop an effective and sustainable program, it is essential to work with key stakeholders across sectors to develop a program that can best meet community needs. In jurisdictions where housing/homelessness and mental health/support services are separated, it is essential to bring stakeholders from both housing and mental health groups together.

Stakeholder coalitions will vary by context, and may differ if groups are developing a program from existing resources or creating a new program. While the goal is to develop as comprehensive a stakeholder coalition as possible, groups can include as many contributors as is feasible, based on their community context.

In addition to the groups mentioned above, several other stakeholders that planners may wish to include are:

• Local leaders and advocates
• Health authorities with a focus on policy/planning regarding mental health, or issues relevant to the target population
• ACT or ICM teams that will provide mental health services and/or other support services
• Consumer organizations and People with Lived Experience (PWLE)
• Police and criminal justice stakeholders
• Education and employment sector stakeholders
• Potential funders, including municipal, regional, and provincial governments, community entities, Community Advisory Boards (CABS) for the Homelessness Partnering Strategy (HPS), and private foundations
• Income assistance stakeholders
• Business community members
• Members of resident/neighborhood associations
• Community members from the target population (for instance, members of Aboriginal and ethno-cultural communities, youth, domestic violence survivors, etc.).

Importantly, people with lived experience of homelessness (and mental illness, depending on the target population) can help groups to ensure that the planned program is person-centred and that it responds to the key challenges faced by the target population. Also, people with lived experience can speak to key challenges faced by the community. Additionally, consider contacting and bringing in groups experienced in planning and implementing a Housing First program for support.

At this stage, it is also important to communicate and connect with the community to develop support for the program and its participants, including the business community and landlord and residential associations. Try to gain the support of these groups early, and communicate how Housing First is part of the solution. By identifying Housing First “champions” in your community, including political figures or other individuals with experience and credibility, programs can begin to establish positive relationships with community members.

It is essential to work with key stakeholders across sectors to develop a program that can best meet community needs.

When preparing for implementation, it is advisable to set up a planning group to help drive the exploration and implementation process. Before developing specific solutions, the planning group can increase awareness about the problem, and mobilize interest amongst potential stakeholders about Housing First as a solution.

Task 2: Mobilizing readiness through social marketing framing your message

Creating readiness for change requires a social marketing strategy for gaining support of a critical mass of key stakeholders, and for addressing the concerns of potential skeptics.

The key to social marketing is to consider the perspectives of the various audiences, and to develop some key messages that frame Housing First in a way that brings them on side as part of the community coalition.

The key to social marketing is to consider the perspectives of the various audiences, and to develop some key messages that frame Housing First in a way that brings them on side as part of the community coalition. For instance, bringing funders and business people into the coalition means being able to make the case for Housing First on the basis of economic or cost-effectiveness. Bringing members of the housing advocacy community into the coalition means emphasizing that Housing First is to be considered in the context of broader concerns about housing affordability and the right to housing. Bringing existing supportive housing and homelessness agencies (e.g., shelters) into the coalition means being able to articulate a role for them in the context of an overall homelessness-serving system of care guided by Housing First principles. Finally, bringing the local community into the coalition means being able to emphasize how the underlying principles of the model can be modified to address the needs of a particular context.

Bringing these groups and the wider community together also means being able to anticipate and address specific misconceptions. Common misconceptions about Housing First are that it ignores the needs of women and families (the model can be modified for various subpopulations), that it involves “free housing for drug users” (housing first is not “housing only”, and requires participating in home visits and carrying out the responsibilities of “being a good tenant”), and that it is inappropriate for people or groups that might prefer supportive or congregate housing. Housing First is not necessarily “scattered-site”, but is focused on the choices of individuals. While the majority of homeless people tend to choose their own apartment, Housing First still meets the needs of others who choose other options.

Task 3: Developing a program model

When developing the program model, start by considering and evaluating existing problems or gaps in the current housing and service system for individuals experiencing homelessness, and for your target population specifically. Consider existing programs in relation to the key components and guiding philosophy of the Housing First model.

Key components of the Housing First model include:

1. the provision of consumer chosen housing, which is provided through housing subsidies;
2. the provision of clinical supports, such as ICM and ACT, which are separate from housing;
3. support services, including supports to foster community integration, vocational assistance, and independent living skills; and
4. the participation of people with lived experience.

It is important to meet with a diverse group of stakeholders across different sectors to identify key issues. It is particularly important to engage stakeholders who might be resistant to Housing First to understand their perspectives and to address their concerns. One concern in particular is that Housing First will replace rather than build on existing services. By identifying existing gaps, groups can think about how a Housing First program can be complementary to existing services, in the context of an overall system of care for addressing homelessness. Another concern is that the Housing First model may not be appropriate to the local context, and the needs of particular sectors of the community. By communicating the key components of the Housing First model as principles that are adaptable to local need, this concern can be addressed. For instance, the clinical aspects of the model can and should be delivered in a way that is adapted to ethno-racial populations and to specific needs of Aboriginal people.

Click here for an overview of program components eligible for HPS funding.

Click here for a resource exploring how to take a systems approach in Housing First planning and evaluation.

Task 4: Choosing host agencies

A key step in the planning process is identifying host agencies for the program that will provide clinical/support and housing services. It is important to consider pros and cons of a particular host agency at an early stage. Depending on the community, some groups may choose a single host agency, while others may decide to use a multi-agency model. Criteria to consider include familiarity with the recovery philosophy, experience with the Housing First model, the flexibility of the agency to innovate and make changes, and willingness to use creative approaches that are not currently being employed. Another criterion is familiarity and comfort supporting people with complex needs, including complex mental health, addictions and other health conditions. Housing and mental health agencies sometimes have competing perspectives and worldviews. It is important for the host agency to be seen as a trusted ally by all partners. Additionally, the housing component should be considered in terms of the capability of a host agency to engage the landlord community, particularly in locations with low vacancy rates. Some existing housing placement agencies may have other clientele (e.g., seniors, people with disabilities) and because of a need to preserve landlord relationships may be resistant to taking a risk placing Housing First clients in decent housing.

Watch this video to learn more about Pathways Philadelphia and its innovative collaboration with Thomas Jefferson University Hospital.

Task 5: Securing funding

A central planning task is securing funding for a Housing First program. Funding mechanisms vary widely by context and province. Potential funders include:

• Municipal, regional, and provincial governments;
• Community entities for the Homelessness Partnering Strategy (HPS);
• Community Advisory Boards (CABS) for (HPS) (which play an advisory role helping community entities to make decisions on HPS funds);
• Private foundations

Stakeholders can start by understanding how funding operates in their particular context, including all the various streams of funding relevant to housing and services related to the components of the Housing First model. In certain jurisdictions (e.g., Ontario), the city or municipality plays a key funder role in the housing sphere, while in most others the primary responsibility for housing is at the provincial level, and the city primarily plays a planning and regulatory role. Funding from the services side of the equation will generally come from health ministries (or regional authorities) as well as ministries that address income assistance, vocational training and post-secondary education. Consider reaching out to funded Housing First programs in other areas to learn about how funding was secured, including any strategies that may apply to your context. In all cases, potential funding (and human resources) should be considered from multiple sources from the health, housing and social development spheres, which will need to be brought together and coordinated.

Additional Resources

• Collective Impact (pdf)
• Channeling Change: Making Collective Impact Work (pdf)
• Embracing Emergency: How Collective Impact Addresses Complexity (pdf)
• Understanding the Value of Backbone Organizations in Collective Impact (pdf)

Task 6: Hiring staff

Next, a key task is setting up a housing team and a support services team. It is important to hire staff committed to the values and vision of Housing First, particularly regarding the notion of housing as a human right, commitment to a recovery philosophy, and support for consumer choice and the involvement of people with lived experience. In the planning stage and before hiring, it is important to develop a profile of the skills and values that staff should possess, either initially or through training. The profiles should be specific to the various roles within the clinical team, as well as to housing staff. Thus, carefully consider fit when hiring staff, and plan to train staff in Housing First principles and recovery-oriented services at an early stage, keeping in mind that recovery-oriented values are difficult to train for and should be sought as part of recruitment and hiring.

It is also important to develop a protocol for housing and service teams to work cohesively, as well as an accountability structure.

Click here to read several job descriptions used by sites involved in the At Home/Chez Soi project.

Task 7: Developing housing protocols

There is a lot to think through logistically about the housing process. The development of protocols is important for creating clear and action-oriented guidelines in the procurement of housing, interim housing, moving and storage, unit transfers, and evictions. Protocols should assign responsibility to specific staff members and help to ensure accountability to the Housing First model.

Click here to read the housing protocols from the Toronto At Home site.

Task 8: Involving people with lived experience

It is crucial to engage the voices of multiple people with lived experience of homelessness at an early stage of the program planning process. People with lived experience should participate in all stages of planning in an ongoing and meaningful way. Some programs develop plans for employing people with lived experience in the program, such as on clinical service teams, which can be very helpful in terms of engaging participants. For example, there must be a peer support worker on an ACT team. Additionally, programs should develop plans for engaging people with lived experience in quality assurance and evaluation processes. When employing people with lived experience, job descriptions should have clearly defined tasks and roles to avoid tokenism. Stakeholders also suggest having a supervisor (in some cases, another peer) for peer support workers, who can assist them in navigating the role.

Doug is one of the 127 service providers working with the “At Home” project. He coordinates work for the 100 residents of a community housing initiative. (NFB)

In addition to employing people with lived experience in the program, several stakeholders suggested creating new communities of consumers. Stakeholders suggested developing opportunities for participants to connect with and support one another. For example, a group of peer support workers developed an advisory group, which was organized, led, and sustained by Housing First participants. It was initiated as a vehicle to help participants bring forth and discuss issues and resolutions. Another idea from stakeholders was to create a peer ombudsperson. This ombudsperson is available to participants if they have any concerns about the services being provided.

Other stakeholders suggested conducting focus groups with participants during the planning stages to solicit feedback about the direction of the planning process. In the Vancouver site, for example, focus groups with people with lived experience resulted in the development of a consumer reference group, along with other subcommittees and expanded roles for people with lived experience in the program. As a person with lived experience in Toronto explained, “We speak from lived experience, we attend subcommittees, so I am always giving personal examples of what it was like when I was living it so that I can give recommendations of the services that need to be provided for people that are now receiving housing .” Programs interested in a focus group approach should provide honoraria so that participants are paid for their work.

Within the Toronto site, a governance structure was established for people with lived experience- the People with Lived Experience Caucus. Within the People with Lived Experience Caucus, a full time peer organizer was hired to moderate the caucus, provide leadership, and offer support. Members received an honorarium and participated in a number of reference groups that addressed key issues of interest to the group.

Click here to access the People with Lived Experience caucus document.

When developing a Caucus or reference groups for people with lived experience, several stakeholders emphasized the importance of training. Participants should receive guidance “in how to participate in committees and how the [program] is structured…[to foster] more comfort and confidence so they feel free to speak and share their knowledge1.” It is also helpful to hold a training workshop to educate team members on peer involvement, to help to facilitate the transition of peers onto the team and to reflect on the need for sensitivity regarding power imbalances. Involvement of people with lived experience should be frequent and ongoing. People with lived experience have suggested that it is helpful to include peers as part of the planning team and as contributors to all planning meetings from the beginning, and to ensure that peers and service teams are in constant contact with one another, as this will make peer involvement more meaningful. Peers provide important insight on current resources for the target population, including the challenges of accessing these resources, and other challenges to address during the planning process.

Click here to access a document about stigma, discrimination, and planning for
peer involvement written by people with lived experience.

Once, Laszlo worried he would disappear in Vancouver’s Downtown Eastside. These days, he’s making sure his voice is heard. (NFB)

Task 9: Connecting with landlords

It is critical to develop relationships with landlords at an early stage of the process. There are two strategies to consider for this task:

1. Finding the right housing agency is important.
   A housing agency with existing relationships with landlords in the community will be in a good position to engage landlords in Housing First.
2. If this capacity does not exist or needs to expand engaging landlords and property managers is crucial.
   An important framing to landlords and property management companies is that participation in a Housing First program gives them guaranteed rent accompanied by clinical services for participants. To this end it is important to target building owners or managers at property companies as opposed to site staff.

Potential landlords are likely to be unfamiliar with Housing First. Consider developing a user-friendly brochure that describes Housing First, and your program in particular. Another strategy is to engage a pool of landlords at a community meeting where agency-staff give a presentation on Housing First. Municipal landlord associations might be good access points for this strategy. Some communities have brought in individuals who can articulate the business model aspect of the program.

When speaking with landlords, it is important to emphasize that a skilled and responsive team will be connected with program participants. Explain that team members will meet with the participant on a weekly basis and respond to any issues that might arise. As relationships are established with potential landlords, work collaboratively to develop strategies for eviction prevention. Additionally, consider planning special events (e.g., monthly or bimonthly lunches) specifically for landlords to promote communication and knowledge exchange, and to continue strengthening relationships. Finally, information sharing with landlords is an important planning task. The creation of a monthly newsletter is a great way to share information with landlords in addition to regular informal “stop ins” by members of the housing team.

The NFB videos below show the importance of forming relationships with landlords.

Task 10:Developing an evaluation plan

It is important to evaluate your Housing First program for several reasons. First, this information is important to funders and may be a critical component of sustaining your program. Second, evaluation data are useful to the program itself, as it allows stakeholders to identify what is working well and what is working less well. Additionally, evaluation provides a way for programs to assess fidelity to the Housing First Model.

When developing an evaluation plan, start by deciding on whether to use an internal team (within the program) or external evaluation team (outside consultants). During the planning stage, the evaluation team should work collaboratively with stakeholders to develop a logic model, determine what to track and measure and at what intervals, and discuss a system for data collection, including the development of a database.

Follow this link to access the Evaluation Module, which provides in depth information about evaluating your Housing First program.