Edmonton emergency department patients who lack housing will soon get a chance to find a home following their hospital stay.
“No one should leave emergency without a place to go and a roof over their head,” says Louis Francescutti, professor in the School of Public Health, ER physician and lead on the Bridge Healing project now known as Asamina Kochi, which means “try again” in Cree.
People experiencing houselessness make more than 26,000 visits to Alberta emergency departments each year, according to Francescutti. Those patients are treated for medical issues ranging from diabetes complications to wound care, but are then discharged back to the street or a homeless shelter without having their underlying needs addressed. Many wind up returning to hospital repeatedly.
Improving lives, reducing health-care costs
The pilot project aims to break that cycle. Before discharge from the Royal Alexandra Hospital, patients will be offered temporary housing at a new building in the Glenwood neighbourhood run by Jasper Place Wellness Centre. They can stay for up to four months, access wraparound services like mental health and employment counselling, and connect to permanent supportive housing.
“It's going to not only improve the lives of these individuals, it's going to save the health-care system an enormous amount of money,” Francescutti says.
The program will be delivered for $68 a day, compared with costs of up to $1,000 a day to care for a patient in hospital, Francescutti notes.
“I actually don't know of any other program that's ever existed to solve this need,” says Taylor Soroka, vice-president of strategy and engagement for the Jasper Place Wellness Centre, which offers housing, medical care, food security programs and employment to people in west Edmonton.
“This program is specifically for individuals who are heavy users of the emergency room that are often not using other community services, so it's about opening that door and diverting them back into the community through housing.”
A community of partners
A broad community partnership of post-secondary students, volunteers, health-care and housing staff, government and private donors came together to make the bridge healing plan a reality. The idea was born in a graduate student classroom at the University of Alberta three years ago. At first the focus was on building tiny homes, but that was eventually rejected as being too expensive and isolating.
The plan has since received endorsements from the Alberta Medical Association’s section of Emergency Medicine and the Edmonton Police Service. The City of Edmonton approved $290,000 in May to fund operations at one building for one year.
Other supporters include Lions Club International, Edmonton Oilers Community Foundation, University Hospital Foundation and Royal Alexandra Hospital Foundation and many private donors.
Students from the Northern Alberta Institute of Technology developed a marketing plan for Asamina Kochi and an app for use by emergency department staff to book rooms for their patients. Fundraising continues to open a second building in a more central neighbourhood.
The donated time of volunteers has also been key, worth $350,000 so far, Francescutti estimates. Joan McCollum, a retired project manager, has personally spent 600 hours on the project. McCollum says she hopes to see the bridge healing model eventually adopted across the province.
“This model is scalable to any community, any location, any place in the world, really,” McCollum says. “We'll be gathering data to determine the effectiveness of the program and areas that can be improved, but we feel very confident that this is going to succeed because we've had such strong support from the community and from the volunteers.
“It’s going to blossom into something much, much bigger.”
They hope to receive the first clients by September. The 12-room net-zero building has self-contained, wheelchair-accessible suites, each with its own fridge, induction cooktop, shower, toilet and a Murphy bed. The facility will operate using the Eden Alternative philosophy of care, which allows clients to support each other.
Offering help at a critical moment
Francescutti says a visit to the ER is often a sign that someone living rough is ready to make a change in their lives.
“When someone who's experiencing homelessness ends up in the emergency department, that's a crisis, because they've had to leave whatever limited possessions they have somewhere, they've had to cross the security guards and go through the triage process and wait. That's when they're reaching out telling us, ‘I really need help.’ So that's where we have to meet them,” he says.
Each person’s program will be tailored to their individual needs. Francescutti, who recently co-edited a special issue of the International Journal of Environmental Research and Public Health on homelessness and public health, hopes some clients may end up using their street skills to help others navigate through the system.
“What we're really trying to achieve is that everybody who comes through this program has a sense of self-esteem and dignity, that they're being served in a way that they feel respected, that they have a sense of belonging and that they’re able to contribute to society in a meaningful way,” says McCollum.
Francescutti says this is just the kind of community partnership the university should be leading.
“There's enough brainpower and ingenuity and wherewithal within a university environment, from undergrads, grads, professors and staff, that the Government of Alberta should be asking on a regular basis for universities to solve complex societal problems like this one.”