Comprehensive Study Notes on Integrated Shelter Models and the Nova Scotia Housing Crisis
Overview of The Bridge Integrated Shelter Services
Definition and Identity: The Bridge is described as a "one of a kind model in Nova Scotia." It is a health care services integrated shelter model.
Location and Capacity: The facility operates within a hotel setting in Dartmouth and supports approximately adults daily.
Target Population: The facility is strictly adults-only (no children). It serves individuals who specifically benefit from on-site health and support services.
Referral Model: Unlike traditional shelters in the Halifax Regional Municipality (HRM) that often operate on a "first come, first serve" basis, The Bridge uses a unique service referral model. It works with community partners to identify clients who are a "best match" for the specific services provided on-site.
Strategic Partnerships and Administration
Administrative Oversight: Adsum for Women and Children (Adsum) oversees the shelter administration side of the program. Riley Boroff, as the Shelter Director, ensures operations align with strategic visions.
Health Care Partners: Nova Scotia Health and various partners oversee the medical and wellness aspects. Key contributors include:
Nova Scotia Health: General oversight of healthcare services.
Occupational Therapists and Social Workers: Providers for holistic care.
Patient Wellness Navigators: Act as health case managers.
VON (Victorian Order of Nurses): Operates the on-site nursing clinic.
Northwood: Provides continuing care support.
Mosh (Mobile Outreach Street Health): Facilitates nurse practitioner hours for patients without access to a prescriber.
Workforce: The integrated team consists of nearly employees across all partnering organizations.
Concept Origin and Startup History
Ideation: The idea of using a hotel setting was influenced by the COVID-19 pandemic, where moving individuals out of communal spaces was necessary to prevent the spread of illness. The province approached Sherry Lecker (Executive Director of Adsum) in late February or March of .
Comparative Models: The model was based on similar health-integrated hotel shelters in Toronto. Key Adsum leaders (Sherry Lecker, Riley Boroff, and JC) visited Toronto in March to study three different sites, focusing on healthcare integration, harm reduction, and service access.
Transition and Timeline:
Research phase: Extremely short; Boroff noted they were still working their original jobs during research (referring to it as a "side quest mission").
Launch: Adsum took over the space on .
Initial Scale: The facility began with only staff members supporting clients who were already in the building under a previous provider's mixed-use model (where the hotel was still open to the public).
Advantages of Hotel Setting: Provides privacy, security, and dignity compared to communal shelters with cots or half-walls. It allows for autonomous space, which is critical for wellness.
State of the Halifax Housing Market
Market Deterioration: Boroff reports that the housing crisis has continued to worsen since she began working in the community in .
Demand vs. Response: While more service providers have entered the sector, the demand for housing continues to outpace the response. There is a critical lack of "housing stock."
The Design of the Crisis: Boroff suggests the current housing system is practically "designed to continue to increase homelessness."
Core Operating Principles: Housing First and Harm Reduction
Housing First:
Definition: Every person has an inherent right to housing. Access to housing should not be constrained by parameters, restrictions, or conditions.
Implementation: The Bridge prioritizes individuals often labeled as "higher acuity" (though Boroff dislikes the term), including those with comorbidities, mental health concerns, substance use issues, or histories with the justice or foster care systems.
Harm Reduction:
Practical Application: Because clients have private rooms and bathrooms, they can use substances on-site safely. They have access to safe supplies, Naloxone, and staff support without being judged or stigmatized.
Psychological Framework: It is a mindset of acceptance, reducing the harm of the work itself, and meeting folks with "curiosity" rather than assumptions.
Flexibility/Autonomy: The Bridge does not implement a curfew. Traditional shelters often revoke beds if a client is not back by midnight; The Bridge allows clients to come and go freely or stay away for a night (with notice) to preserve dignity.
Housing as a Human Right
Legal Context: Canada passed the National Housing Strategy Act in , which recognizes the right to adequate housing as a core component of federal strategy. There is a Federal Housing Advocate tasked with ensuring this is enacted in practice.
Organizational Role: At the ground level, Adsum weaves this right into their services, especially when making difficult decisions about residency.
Government Responsibility: While Boroff identifies a "sincere appetite" at the provincial level to address housing, she maintains that current efforts fall short globally and locally, as many still lack access to adequate housing.
Aging Populations and Specialized Supports
The "Aging" Crisis: There is an increasing trend of seniors experiencing homelessness. Traditional shelters are often physically inaccessible (e.g., stairs).
Accessibility at The Bridge: The facility includes elevators, mobility equipment storage, and the ability to accommodate hospital beds.
Clinical Interventions: A clinical lead and healthcare partners assess for age-related conditions like Alzheimer’s or dementia to determine if higher levels of intervention are needed.
Community Gaps: While organizations like North End Community Health Center and specific HRM case managers focus on seniors (+), many seniors still end up sleeping in cars or outdoors.
Transitioning out of Shelters: Gaps and Barriers
The "Single Adult" Gap: There is a severe shortage of affordable housing for single adults aged to . Public housing often has higher vacancies for seniors (+), and youth programs end at . This leads to individuals spending multiple years in the shelter system.
Post-Shelter Supports:
Housing Support Workers: Help clients transition to independent living to combat the social isolation that often follows leaving a supported communal environment.
Eviction Prevention: Community funding for rental arrears is available through Shelter Nova Scotia, Welcome Housing, and Adsum for Women and Children.
Legal Loopholes: Boroff identifies "fixed-term leases" as a massive loophole for landlords. They provide no security for tenants at the end of the term, as there is no guarantee of renewal. Boroff notes that housing is currently treated as a "commodity" or an "asset" rather than a home.
Future Visions and Potential Changes
Utopian Goal: The total eradication of the shelter sector in favor of permanent housing.
Shelter Standards: Boroff advocates for provincial shelter standards (similar to those in Toronto) to ensure:
Food Security: Guaranteed access to three square meals a day.
Dignity for Marginalized Groups: Standardized safety and dignity for transgender and gender-diverse community members.
Harm Reduction Standards: Moving away from "institutional" or "colonial" practices such as bag checks and pocket emptying, which mimic carceral settings.
Lease Reform: Ideally, the eradication of fixed-term leases, though Boroff acknowledges this is difficult within a "neoliberal capitalism" setting where private property rights are prioritized over the right to stay in a home.