H.O.M.E Program Results
An evaluation of the first year of H.O.M.E Program implementation from January 11, 2021 to January 10, 2022 was conducted to:
- Determine the reach of the program and opportunities to optimize reach;
- Assess the impacts of using a collaborative, multi-disciplinary, mobile outreach model on access to primary care and wraparound services;
- Understand the experiences of clients accessing the program; and
- Identify lessons learned from implementing the program, including successes, challenges, and opportunities for improvement or change.
Results represent data gathered from a database of services provided, a survey and focus group completed by program team members, site partners, and service partners, and a survey completed by clients who received support from the H.O.M.E Program. A snapshot of the results is presented below.
Between January 11, 2021 and January 10, 2022, through the H.O.M.E Program…
- 1,059 unique clients accessed medical and wraparound care services
- 71% of clients accessed care 1 time and 29% accessed care 2+ times
- 1,175 non-essential emergency room visits were potentially prevented
- 780 chronic illness care visits were conducted
- 498 visits were focused on mental health care
- 182 visits were conducted to provide infectious disease care
- 84 individuals without a care provider were rostered to primary care
- 64 prenatal care visits were provided
- 18 emergency medical interventions were given
- 12 overdose responses were conducted
Client feedback survey respondents reported…
- 100% find it easier to access care because of the H.O.M.E Program
- 100% feel comfortable accessing the H.O.M.E Program
- 95% are using harm reduction strategies more often because of the H.O.M.E Program
- 92% would recommend the H.O.M.E Program to others
- 84% were treated with respect by H.O.M.E Program staff
- 72% have experienced improved well-being because of the H.O.M.E Program
The 4 most common changes clients experienced because of the H.O.M.E Program are…
- Better access to care and positive care experiences
- Receiving wound care
- Improved health and well-being
- Increased sense of safety
When collaborative partners were asked how the H.O.M.E Program impacted them…
- 95% reported the coordination of services for highly marginalized individuals in London has improved
- 94% have a deepened relationship with other service providers implementing the program
- 88% feel better able to support highly marginalized individuals in London
- 82% said communication between service providers supporting highly marginalized individuals in London has improved
- 76% reported partners are working differently to support highly marginalized individuals in London
For more information, please see the H.O.M.E Program Year 1 Evaluation Report.
Stories of Impact
The stories below demonstrate the impact the H.O.M.E Program has had on individuals accessing the program. Please note that names have been changed to maintain anonymity.
Anna Received Immediate Care to Address Life-Threatening Injuries
While accompanying two clients to the mobile clinic, members of the H.O.M.E Program outreach team spotted Anna standing on a traffic island and stumbling into traffic. When the outreach workers approached Anna, she appeared groggy, had blood coming from her head, and kept telling them she just wanted to rest. The outreach workers spoke with Anna and told her about the services available from the H.O.M.E Program mobile clinic and encouraged Anna to get her head wound assessed. Anna agreed and was supported by the outreach workers to the mobile clinic. When Anna arrived on the mobile clinic, medical staff completed a full assessment. They found Anna had sustained life-threatening injuries and that there was spinal fluid leaking from her nose. EMS was called immediately to take Anna to the hospital. The medical team continued to support Anna until EMS arrived and explained the situation to them. Anna was taken to the hospital and members of the H.O.M.E Program team followed up to ensure she received the care she needed.
Gabe Was Supported to Return to the Hospital and Provided With Follow-Up Care
Gabe was in the hospital after being assaulted and receiving multiple stab wounds to his leg and lower back and fractures to his face. He was experiencing difficulty lifting his foot (foot drop) and had damage to his eye. Gabe needed multiple surgeries, but felt he was not receiving sufficient care for the opiate withdrawal he was experiencing, and he left the hospital against medical advice before all of his surgeries were finished. Gabe returned to the street where the H.O.M.E Program connected with him, and he was open to seeking medical support from the mobile clinic. After reviewing Gabe’s charts and procedures from the hospital, the medical team determined he was at high risk if he remained on the street. The medical and outreach teams advocated for Gabe to stay at an emergency shelter in order to receive proper care. Further, they helped Gabe to return to the hospital for further care by creating an emergency safer supply plan to prevent Gabe from experiencing opiate withdrawal while in the hospital. With the support of the H.O.M.E Program, Gabe was able to access adequate shelter for the duration of his recovery, was provided with follow-up care three days a week, and was supported to attend follow-up medical appointments at the hospital. As a result, Gabe did not miss any of his appointments and healed in approximately six weeks.
Steph and Darien Received Support to Access Housing, Wound Care, and Wraparound Services
Steph and Darien were experiencing homelessness and were camping in a field with several other people. One day, an accident with a lighter led to a large tent fire, leaving Steph and Darien with burn wounds and no belongings. Steph and Darien attended the hospital to get their wounds checked. At the hospital, Steph’s wounds were treated, but Darien was asked to remain overnight in the hospital for ongoing care. Due to COVID-19 policies, Steph was unable to stay with Darien and visiting was limited. Darien felt nervous leaving Steph alone on the street and in the elements, as they had lost their tent. As a result, Darien left the hospital against medical advice to make sure Steph was safe that night.
Members of the H.O.M.E Program outreach team encountered Steph and Darien the next day, learned what had happened, and encouraged them to attend the mobile clinic for medical care. After assessing Darien’s wounds, the medical team discussed with Darien and the outreach team how serious his wounds were and that if he wasn’t treated and able to access hygienic living conditions where he could receive aftercare, he could die. Together, the medical and outreach teams worked with Darien to determine what would help him feel most comfortable to stay in the hospital. Program staff secured a spot for Steph to stay in a shelter for women while Darien was in the hospital so that he didn’t have to worry about her safety. The program team also provided support for Steph and Darien to remain in contact during Darien’s hospital stay. Further, the outreach team worked with the City to secure a safe, clean space for Darien and Steph to stay once Darien was discharged from the hospital. Steph and Darien were very thankful for the care they received from the H.O.M.E Program team, are comfortable in their new unit, and have continued receiving wraparound supports from the H.O.M.E Program and partner agencies.