London s Community Plan

Transcription

1 London s Community Plan Regarding Street Level Women at Risk Executive Summary June 2015

2 Prepared by the Centre for Organizational Effectiveness Inc. and the City of London, Neighbourhood Children and Fire Services, Homeless Prevention CITATION INFORMATION City of London, Neighbourhood Children and Fire Services, Homeless Prevention London s Community Plan, London Ontario (2015) Retrieved from: Neighbourhood Children and Fire Services, Homeless Prevention, 151 Dundas Street, 3rd Floor, PO Box 5045, London ON, N6A 4L6

3 A cknowledgements The Community Plan for Street Level Women at Risk 1 was developed through a collaborative, consultative process. We are grateful to the City of London, Neighbourhood Children and Fire Services particularly the Homeless Prevention Team and Jan Richardson, for the guidance and support provided during the consultation process to develop the Community Plan Regarding Street Level Women at Risk. The leadership of the London Police Service Persons at Risk Program and Sergeant Lorna Bruce s dedication to street level women at risk and to this project cannot go without mention. We are deeply grateful to the 33 women with lived experience who shared their stories, wisdom and insights. These women breathed life into the Community Plan and the Model of Service. A special thank you to all the service providers, local researchers and community leaders who participated in one-on-one or group interviews: Abe Oudshoorn, Western University Alexis Chaddwich, Youth Opportunities Unlimited Andre McKenzie, London and Middlesex Housing Corporation Angela Minielly, London Health Sciences Centre Anthoula Doumkou, London InterCommunity Health Centre April Quinn, Western Area Youth Services Ashley Cochrane, London Health Sciences Centre Ashley Griffin, City of London,Ontario Works Ashley Liltevreaux, London Health Sciences Centre Aura Burditt, The Salvation Army Correctional & Justice Services Bob Newman, City of London, Ontario Works Brandon Agnew, London CAReS Brandy Dobbs, Women s Community House Brenda Hall, Western Area Youth Services Brenda Malott, Children s Aid Society London & Middlesex Brian Lester, Regional HIV/AIDS Connection Carole Lambkin, The Salvation Army Centre of Hope Withdrawal Management Cass Wender, CMHA Middlesex/My Sisters Place Chanda Kennedy, At Lohsa Native Family Healing Services Charlene Lazenby, Unity Project for Relief of Homelessness Cheryl Smith, City of London,, Community Partnerships & Funding Cheryl Patience, City of London, Ontario Works Claire McKenzie, London Health Sciences Centre Cyndy Ballantyne, City of London, Ontario Works Dave Morris, Children s Aid Society London & Middlesex Deanie McClinchy, Children s Aid Society London & Middlesex Derek Muir, Western Area Youth Services Dr. Anne Bodkin, London InterCommunity Health Centre Dr. Christopher Mackie, Middlesex-London Health Unit Dr. Sharon Koivu, Palliative Care, London Health Sciences Centre Eleanor Weekmark, City of London, Ontario Works Elizabeth Hall, Freedom Fighters Gordon Russell, Mission Services of London Grant Martin, London CAReS Heather Wharam, London Abused Women s Centre Heather Davidson, London Health Sciences Centre Heather Lokko, Middlesex-London Health Unit Heather Lumley, St. Leonard s Community Services of London & Region Henry Eastabrook, London InterCommunity Health Centre Jane McGregor, Sexual Assault Centre of London Jennifer McIntosh, Children s Aid Society London & Middlesex Jesse Huntus, Regional HIV/AIDS Connection Jodi Hall, Fanshawe College John Griffith, Goodwill Industries Judy Miller, London Abused Women s Centre Karen Burton, Regional HIV/AIDS Connection Kate Cowan, United Way London & Middlesex Kate Wiggins, Women s Community House Kelly Miller, London Health Sciences Centre Kelly Wright, Regional HIV/AIDS Connection Keri Wheatley, Regional HIV/AIDS Connection Leanna Zeyl, London InterCommunity Health Centre Linda Cunningham, John Howard Society Linda Sibley, Addiction Services of Thames Valley Louise Pitre, Family Services Thames Valley Lynn Lamb, The Salvation Army Centre of Hope Lynne Livingstone, City of London, Neighbourhood, Children & Fire Services Martha Connoy, Mission Services of London Mary O Sullivan, Elgin Middlesex Detention Centre Megan Walker, London Abused Women s Centre Megan Yates, London Health Sciences Centre Michelle Hines, The Salvation Army Centre of Hope Michelle Hurtubise, London InterCommunity Health Centre Mike Cretkovich, Children s Aid Society London & Middlesex Mirella Bryant, Youth Opportunities Unlimited Nancy Powers, The Salvation Army Centre of Hope Natalie Spruce (Student Placement), Nokee Kwe Neena Gupta, Children s Aid Society London & Middlesex 1 Street Level Women at Risk ~ women involved in street level, transactional, survival sex work

4 Nick Scrivo, Regional HIV/AIDS Connection Pam Hill, Addiction Services of Thames Valley Patty Swartman, City of London, Ontario Works Peter Rozeluk, Mission Services of London Rebecca Jesney, London Health Sciences Centre Regina Bell, Children s Aid Society London & Middlesex Richard MacDonagh, Regional HIV/AIDS Connection Robyn Carsey, London Health Sciences Centre Sandra Oakes, London Health Sciences Centre Saundra-Lynn Coulter, London Abused Women s Centre Sandy Bannister, City of London, Ontario Works Sarrah Boyd, London Health Sciences Centre Sgt. Lorna Bruce, London Police Service Sheena Ewen,, London Health Sciences Centre Sheryl Manzara, City of London, Ontario Works Sonja Burke, Regional HIV/AIDS Connection Stacey Thibodeau, The Salvation Army Centre of Hope Sue Slomer, London Health Sciences Centre Susan Macphail, CMHA Middlesex/My Sisters Place Taylor Rae Starrett, SafeSpace Tina Lightfoot, City of London, Ontario Works Tina Riccobon, City of London, Ontario Works Treena Orchard, Western University We are also grateful to those who participated in the conceptual model review sessions and provided much needed feedback to refine the Model as well as the Women with Lived Experience Advisory Council: Advisory Council - Women with Lived Experience Abe Oudshoorn, Western University Amy Lobb, London and Middlesex Housing Corporation Anthoula Doumkou, London InterCommunity Health Centre Ashley Fisher, John Howard Society Ashley Fisher, St. Joseph s Health Care London Aura Burditt, The Salvation Army Correctional & Justice Services Brandon Agnew, London CAReS Brandy Dobbs, Women s Community House Brian Lester, Regional HIV/AIDS Connection Bruce Rankin, John Gordon Home Cass Wender, CMHA Middlesex/My Sisters Place Chuck Lazenby, Unity Project for Relief of Homelessness Dr. Anne Bodkin, London InterCommunity Health Centre Eleanor Weedmark, City of London Ontario Works Grant Martin, London CAReS Heather Lumley, St. Leonard s Community Services of London & Region Heather Wharam, London Abused Women s Centre Holly Weaver, SafeSpace Jaclyn Seeler, United Way London & Middlesex Jan Richardson, City of London, Homeless Prevention Jane McGregor, Sexual Assault Centre of London Janet Tufts, United Way London & Middlesex Jodi Hall, Fanshawe College Karen Jenkins, Fanshawe College - School of Nursing Kate Wiggins, Women s Community House Linda Sibley, Addiction Services of Thames Valley Louise Pitre, Family Services Thames Valley Lynne Livingstone, City of London, Neighbourhood, Children & Fire Services Martha Connoy, Mission Services of London Mary O Sullivan, Elgin Middlesex Detention Centre Mbaka Wadham, Regional HIV/AIDS Connection Megan Walker, London Abused Women s Centre Michelle Hines, The Salvation Army Centre of Hope Michelle McIntyre, Children s Aid Society London & Middlesex Mirella Bryant, Youth Opportunities Unlimited Nancy Powers, The Salvation Army Centre of Hope Natasha Falle, London Abused Women s Centre Nici Hamilton, London and Middlesex Housing Corporation Pam Hill, Addiction Services of Thames Valley Peter Rozeluk, Mission Services of London Pina Sauro, City of London, Ontario Works Regina Bell, Children s Aid Society London & Middlesex Rhonda Brittan, Middlesex London Health Unit Saundra-Lynn Coulter, London Abused Women s Centre Sgt. Lorna Bruce, London Police Service Shaundra Law, St. Joseph s Health Care London Sheena Ewen, London Health Sciences Centre Stacey Clarke, London and Middlesex Housing Corporation Susan Hocking, London InterCommunity Health Centre Susan Macphail, CMHA Middlesex/My Sisters Place Taghrid Hussain, John Howard Society Treena Orchard, Western University Yvonne Rimbault, John Gordon Home Finally to the team members of the Centre for Organizational Effectiveness, the consulting firm that facilitated the consultation process: Amy Fox, Research Associate Anne-Marie Sánchez, Research & Development Associate Carolyne Dee, Graphic Designer Danielle Carr, Small Group Facilitator Elizabeth Zimmer, Project Assistant Linda Lustins, Small Group Facilitator Louise Vandenbosch, Small Group Facilitator Maria Sánchez-Keane, Principal Consultant Shawna Lewkowitz, Small Group Facilitator Shirley Mitchell, Administrative Assistant Susan Ralyea, Small Group Facilitator Tracey Lipp, Small Group Facilitator

5 E xecutive Summary Why a Community Plan Regarding Street Level Women at Risk? In 2010, the City of London Council and the London Homeless Coalition approved the Community Plan on Homelessness and in 2013 the London Homeless Prevention System Implementation Plan (System) was introduced. The System focuses on applying a Housing First philosophy and approach to address, reduce, and prevent homelessness in London. One key area of focus is to develop a community plan regarding street involved sex workers. In 2014, an extensive community consultation was undertaken including meeting with women with lived experience, service organizations working within multiple systems, conducting an international literature review and reviewing housing models in other communities that serve street involved sex workers. The consultation demonstrated a need to focus on women who are involved in street level sex work and/or trading sex for food, drugs or a place to stay. The Community Plan (Community Plan) will focus on addressing the housing, exit strategies, health and well-being outcomes of women. The Community Plan is grounded in the lived experience of street-involved women, and feedback from our city s service providers who work with street level women at risk as well as evidence informed practices collected through an international literature review. A Housing First approach is the underlying approach of the plan and focuses on improving housing, exit strategies, health and well-being outcomes. A Housing First approach shifts the priority to move individuals and families quickly into a home with the supports needed to support their stability. This approach is in contrast to other models which expect individuals and families to first address the issues that led to their homelessness such as addiction, trauma, and mental illness before they are housed. This evidence-based philosophy has proven that health and well-being improves by quickly housing and stabilizing individuals and families who are in a housing crisis or who are experiencing homelessness. What did we hear from women with lived experience and how is this linked with the experience of service providers, other communities and the literature? As a key guiding principle of the consultation process for the development of the Community Plan 1 the consultation process began by interviewing women with lived experience which included current and former street 1 Street Level Women at Risk ~ women involved in street level, transactional, survival sex work 1

6 involved sex workers. The key themes that emerged from these interviews were echoed in the interviews with service providers and were confirmed in the literature 2. Addiction: The most common theme discussed by almost every woman interviewed was the role that substance use and addiction played in their initial and ongoing involvement in survival sex work. Women noted that their introduction to drugs was often by male family members (brothers, fathers) or male significant others. A common observation from the women who were interviewed was that sex work was often directly related to their addiction. As one former sex worker explained, the only time she would resort to sex work was when she was excessively using drugs and could not afford her next hit. Additionally, many women interviewed had complex histories of abuse and trauma which often led to substance use as a way to self-medicate, self-sooth and numb out. Many women attributed addiction to leading them to their involvement in survival sex work. Housing: Women interviewed agreed that the ability to find stable housing was key to becoming healthier and making smart choices. They suggested that the ability to have their own space and a place to call their own was important in terms of stability, dignity and independence. However, most women did note that they would still require significant supports (e.g., someone you can call ) when they first get off the streets. Many women expressed concern that their housing was often dependent on their significant others which repeatedly left them in vulnerable situations. When women shared positive experiences about landlords or housing, it was because the landlords were patient and respectful with the women and believed in them. Based on the interviews, a continuum of housing options is needed to meet the needs of women as not all women want or need the same type of housing. Some of the women interviewed wanted to be away from old neighbourhoods which reminded them of old ways of living; some women expressed the desire to live in a single unit away from the downtown core, or affordable housing in neighbourhoods, so that they would not run into enablers. Still others discussed the importance of living with women in similar situations so they could provide each other with support, while others mentioned not wanting to live with anyone because it often leads to infighting, mistrust, and conflict. In contrast, other women expressed the need for shared accommodation with a private room versus having their own apartment, as that would be an overwhelming responsibility. A few wished for the opportunity to leave the London area completely. Children: Of the women interviewed who were mothers, the impact of having their children in the care of child welfare was traumatic. Women frequently shared how difficult it was for them to lose their children and how this often led to a downward spiral leading to more frequent and intense use of substances. The determination, resiliency and motivation to stay clean and aim to change their current situation was tied to the goal of regaining custody of their children. 2 The terms: Street involved sex worker, street based sex work(er), survival sex and transactional sex are used interchangeably throughout the report to respect the fact that varied terminology is used in current research. All terms refer to trading sex to originating at a street level for food, drugs, favours or money to survive. 2

7 Many women cited being overwhelmed and not knowing the appropriate steps to regain custody of their children. It was also noted that caseworkers do not seem to be prepared for, or familiar with, working with those impacted by addiction and active substance use. Women identified this often creates an added layer of misunderstanding and tension between the mother and caseworker. The women who shared their experiences with child welfare want the process to be less adversarial and more inclusive of the mothers who genuinely want their children back. Safety: Most women related their level of safety to housing and many expressed that likely only stable housing would assist them in feeling safe. Women often felt unsafe on the streets, as much as they did in shelters where there is little supervision and the constant threat of conflict and predators. Several women also suggested that the feeling of safety would increase with stable income. The lack of safety related to survival sex work was constantly on their mind and evident as they shared stories of being beaten, violated, raped and held against their will. Most women interviewed shared their stories of abuse related to their street level sex work. Additionally, while many women and even service providers assess safety from a housing and lifestyle perspective, many women talked about safety from a perspective of trust and acceptance. Women lamented often never truly feeling accepted and consequently never feeling safe among circles of friends or within their living conditions with significant others or family. Supports: Many women noted that it was when they were able to truly connect with a support worker who believed in them and whom they could trust that things started to come together in a positive way. Women stressed the importance of peer support and ideally one support worker who could advocate for them and connect them with a variety of resources such as counselling or workshops on how to achieve employment. Women also emphasized the importance of having this support worker available immediately as they leave jail, as those first few days are often when they get back to old habits such as use of substances and reconnecting with negative influencers. How does the Community Plan Address the Issues Named by Women? The title of the Community Plan was created by an advisory group of former street involved sex workers, the sub-title Hard to Stop, Harder to Stay Stopped is a direct quote from a woman with lived experience who summarized her experience in those words and also reflect succinctly what other women shared. The Community Plan was developed based on the experience of women with lived experience and supported by research, a review of other models and the experience, and expertise of local service providers and builds upon London s many community assets. 3

8 During interviews with service providers, many expressed a commitment to shift the way their resources were used to align with the Community Plan. The City of London is committed to realigning resources to support the implementation. Service providers and local researchers reviewed the Model over a three-session consultation in November and December An advisory group of women with lived experience also reviewed the Model. Feedback from participants informed the final version of the Community Plan. The Model for the Community Plan has been endorsed by 22 service organizations in the community. These organizations have also committed to the implementation of the model outlined in the Community Plan. The Community Plan is meant to strengthen what is already taking place in London and to design a collaborative, integrated Housing First response to improve the housing, exit strategies, health and well-being outcomes of street based sex workers. Overview: The Community Plan is an important component of the London Homeless Prevention System, and as such, is driven by the same vision and guiding principles. The core purpose and guiding principles that are specific to this Community Plan were developed based on what women with lived experience articulated as essential elements required to provide them with the supports they need. Vision The City of London s Homeless Prevention System is a coordinated and integrated individual and family centred housing stability approach that is outcome focused and designed to address, reduce and prevent homelessness in London. Core Purpose of the Community Plan Grounded in London s Homeless Prevention System, the Community Plan Regarding Street Level Women at Risk is aimed at supporting housing stability, sustainable exit strategies, and long term health, wellbeing and community belonging for women involved in survival sex work. The Model is framed in a service collaboration providing rapid response, housing with intensive in-home support, and a system of supports focused on long term community integration and belonging. 4

9 Guiding Principles Guiding Principles Homeless Prevention System Housing with Support Homelessness is a Solvable Problem Individual and Family Centred and Inclusive Partnership Based London Driven Neighbourhood Based Harm Reduction Fiscally Responsible Outcome Focused Guiding Principles: Community Plan Safety: Factors, people, systems and other interactions to assist each woman to be out of danger and feel secure are considered and addressed Housing First: From the well-being of her home, each woman is provided with a variety of supports to meet her needs Active Engagement: Understanding the gravity of illness and death of women, and the impact of losing their children, we work from a place of urgency and assertiveness to support each woman in reaching her goals As Long as it Takes: We work toward continuous progress, focusing on long-term safety, health and well-being Housing with Support: We actively work toward each woman achieving housing stability Women and Family Centred: The unique strengths and needs of each woman and her family will be respected, and solutions will be customized to her experience and situation in her community of choice Relational Based: Strong relationships and trust ground our interactions with each woman Strength Based: We draw upon the personal resilience, experiences, resources, motivation and hope of each woman as we work toward viable, long-lasting solutions Trauma Informed: A deep understanding of the impact of trauma and violence in the lives of women and their families informs our work as we realize that the effect of trauma is pervasive and broad and touches many life domains Respect: Each woman and her family are always treated with dignity Organizational Practices: We adapt our practices to respond effectively to address the housing and health outcomes of each woman Joint Agreements: We create concrete memorandums of understanding with participating agencies with clear roles and responsibilities so that they function as an effective system Women s Experience Leads the Way: Women with lived experience are an active part of the process at every step of the way Community Education, Readiness and Support: We work toward involving Londoners in creating safe and accepting communities Harm Reduction: Practices encompass a continuum of interventions including prevention, education and minimizing risk of harm Fiscally Responsible: Resources are used in effective, accountable ways Sustainable Outcome Focused: Results are measured, reported and form the basis of change based on the Guiding Principles Developmental Evaluation: Learnings are captured and inform the continuous improvement of the Model 5

10 The Community Plan contains a variety of elements that together create a comprehensive, collaborative and integrated strategy to address the many challenges facing street level women at risk. All elements of the Model identified in this Community Plan are essential components that support the successful achievement of the desired outcomes. A Housing First philosophy, providing a permanent home with supports, is at the heart of the Community Plan. London s Homeless Prevention System Governance & Peer Support Health, Well-Being, Collaboration and Belonging Capacity Building Rapid Response Housing with Intensive In-Home Support Policy Change System Design HEALTH JUSTICE EDUCATION CHILD WELFARE EMPLOYMENT SOCIAL SERVICES COMMUNITY Resources & Neighbourhood Belonging A Housing First approach is recognized as the combination of attainable permanent housing based on the choice of the women and integrated supports and services anchored in intensive in-home supports. The Model provides a continuum of integrated supports focused on permanent housing with in-home supports. 6

11 Brief description of the Model elements: Element Housing with Intensive In-Home Support through the Systems Integration Team Intensive Support through Systems Integration Team Ongoing & Regular Communication Rapid Response Team Health, Well-Being & Belonging Team Governance & Collaboration Peer Support Capacity Building through Competency Training & Coaching for Organizations Policy Change System Design Neighbourhood Belonging Service Delivery Elements Brief Overview Assist women in attaining and retaining housing including those who continue to work in the sex trade and those who are seeking exit strategies. Provide intensive and ongoing service coordination, direction, coaching and support to the women by maintaining frequent, in-home contact and working with other service providers who are supporting her. Support is based on need and is available seven days a week, 24 hours a day. Meet weekly, via a one-hour conference call, to identify steps and assign roles and review action plans to address high-risk situations for street involved sex workers who are not housed, not safely housed or recently housed. Immediately assist and provide warm transfers for street involved sex workers whose housing, health, and physical safety are at risk, to emergency and community services and refer to the System Integration Team. The team works regular hours, after-hours and weekends. Develop a strong support system for the participant and her family, with a focus on community integration and belonging and including in her team peers, natural supports, volunteers and professionals. System-Level Supporting Elements Provide effective leadership and accountability for all aspects of the Community Plan and work collaboratively to reach intended outcomes. Embed the voice and experience of street involved sex workers throughout the Community Plan, including the service delivery, governance and supporting elements. Deliver comprehensive training and coaching based on the core competencies of working with street involved sex workers to increase the capacity of organizations. Review, enhance and/or develop policy, at the system and organizational levels. Collectively work to achieve system change to ensure that barriers, prejudice and biases related to street level women at risk are removed. Foster neighbourhood engagement and dialogue that focuses on the safety and health of communities and all residents, including the women themselves. The service delivery component of the Model is comprised of three interactive, interdisciplinary, multi-agency teams: The Systems Integration Team, the Rapid Response Team and the Health, Well-Being and Belonging Team coordinated through a collaborative governance structure. 7

12 Systems Integration Team Rapid Response Team Health, Well-Being, and Belonging Team While the Model may appear static and linear on paper, it is clear from the women with lived experience consulted, the literature, and service providers, that life for street involved sex workers is dynamic, varied, and shifts regularly. The Community Plan is meant to be an active system that provides a coordinated and active commitment to street based sex workers. A brief overview of these three components follow: The Systems Integration Team While there are many service providers who work with street level women at risk, there is no systematic approach for service providers to regularly communicate and collaborate to support women. This issue was made clear by both women with lived experience and the service providers who were interviewed. Additionally, there is no systematic way to rapidly house women and provide intensive in-home case management. Purpose: The purpose of the System Integration Team is to rapidly assist street involved women at risk in securing housing and providing ongoing intensive and integrated in-home support available as needed, and to assist with responding to a crisis seven days a week 24 hrs a day through cooperative case management and weekly case conferences. This Systems Integration Team is meant to enhance the way service providers currently work and build on the many assets already established within the London community. The Systems Integration Team will have dedicated Housing Finders and Intensive In-home Case Managers who will work toward housing street level women at risk rapidly. The goal 8

13 is to provide a variety of housing options for individuals referred to the team based on their interest, choice of neighbourhoods and need. The streamlined response includes key service providers meeting on a weekly basis to focus on Housing First solutions that can be implemented within 24 to 48 hours in order to provide focused and continuous support to street level sex workers. The in-home case managers are based on existing community resources committed to working with those newly housed and augmented with available funding particularly to support the Housing Finders in securing attainable housing. Models of the weekly case conference meetings in other communities such as Calgary, Alberta and Prince Albert, Saskatchewan have proven very effective in identifying individuals most at risk and addressing their unique needs. The Intensive In-Home Case Workers focus on linking individuals with the right community support to address issues such as mental health, addiction recovery and trauma, and coach around basic life skills (e.g., shopping, cooking, cleaning, banking, financial planning, forging new friendships, using public transportation and social norming, being a good neighbour and tenant) and organizing meaningful daily activity opportunities (e.g., using the public library and belonging centres). As one woman stated, I needed to relearn how to live a regular life again. The Rapid Response Team It was evident from the interviews with women with lived experience that there are individuals in London who do not seek service with any service providers in the community and do not actively seek help or support even when it is urgently needed. The Rapid Response Team provides the ongoing street level intelligence, gathering much needed information related to the safety of women who are street involved in London. The team builds trust with street involved women and seizes opportunities to provide warm transfers for immediate and often urgent services. The team actively works to provide options to address the housing, health and safety of street involved sex workers. Purpose: The Rapid Response Team is an interdisciplinary, multi-agency team whose integrated focus is to identify, actively refer and provide warm transfers for women at risk to resources that will meet immediate health, safety and housing needs. The Team is available 24 hours, seven days a week. This team will actively support individuals through a Housing First lens by connecting them to the Systems Integration Team and other necessary supports. The Rapid Response Team enhances the well-established London Police Service Persons at Risk Program. 9

14 The Rapid Response Team is an essential component of the Community Plan; however, on its own the team will not effectively meet the needs of women identified. While this team is a required element of the Community Plan, it must link with the Systems Integration Team to ensure that women referred are rapidly housed and receive the supports they need in the comfort of their own homes. The Health, Well-Being and Belonging Team As articulated in the subtitle of the Community Plan: Hard to Stop, Harder to Stay Stopped, ongoing support for women to successfully meet their life goals is essential. The Community Plan addresses this challenge with the Health, Well-Being and Belonging Team. This approach is further confirmed by the literature, the interviews conducted with other communities who use a Housing First approach and the experience of local organizations. The supports needed vary from woman to woman, particularly as they progress in meeting their life goals. Purpose: The Health, Well-Being and Belonging Team is created and led by each woman, and supported by a facilitator. Wraparound principles and processes are recommended for this team. These include formal and natural supports, use a strengths-based approach, consider all life domains and focus on the life goals of the woman and her family. This team will not generally come together in the early days of housing with supports. Once the woman is more settled, the creation of her Health, Well-Being and Belonging Team supports her as she integrates and anchors herself in her community of choice. Many former sex workers who were interviewed discussed this process as being long and lonely. Over time, formal supports should play less of a role as a woman creates her natural community and develops a sense of belonging. How will we know we have been successful? Two primary outcomes guide the efforts and form the basis for the indicators of success of the London Homeless Prevention System: Individuals and families experiencing homelessness obtain and retain housing Individuals and families at risk of homelessness remain housed Once fully operational, the Community Plan will focus on these outcomes: Decrease the number of women experiencing cyclical, chronic homelessness Earlier identification of new women becoming street involved through a housing stability intervention Increase the number of women who are living in their home Increase the number of women exiting survival sex work Increase the number of women who are raising their children in a safe environment with appropriate supports 10

15 Increase the number of women actively engaged in their addiction treatment plan Increase the number of women who are safer Increase the number of women who have met or are working toward meeting realistic life goals Improve physical and mental health outcomes Improve the well-being of street level women at risk Increase the number of informal, natural supports to improve women s social network and sense of belonging Achieve a high level of satisfaction with service providers that street level women at risk will encounter What are the next steps? There are 22 service organizations in the city that have already made a commitment to the implementation of the Community Plan. An advisory council of women with lived experience have also committed to being involved in supporting the implementation. There is a great need for everyone to work collaboratively, in an integrated way, and an expressed commitment to more effectively improve the housing, health and well-being of women involved in street based sex work. Street level women at risk have shared their experience in the hope of creating change in our community. Make my place my own close to my community [woman with lived experience] A nice house, like a retreat setting, away from the downtown community. [woman with lived experience] If I can just have a home, not just a place and just a few good people in my life, then I know I can make it. [woman with lived experience] 11

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