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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
2
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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