Frequently asked questions

London is facing a dire health and homelessness crisis. There has been a dramatic increase in the volume and complexity of health and housing needs.

Throughout 2022, Londoners from all sectors and backgrounds said loud and clear that something needed to change, to save lives, to better deliver healthcare and housing, and to address the whole of community impacts of this crisis.

In all, more than 200 leaders from all backgrounds and areas of expertise, representing more than 70 local organizations, came together over three summits in November and December 2022, and January 2023, with a pledge to do things differently. The summits were convened collaboratively by the City of London, CMHA Thames Valley Addiction & Mental Health Services, London Health Sciences Centre, London Police Service, Middlesex London Health Unit, Middlesex-London Paramedic Service, and St. Joseph’s Healthcare London.

This call for change led to the development of London’s Whole of Community System Response. This is a critical and transformative plan for London that has been developed to respond urgently to our health and homelessness crisis.

The system response will support the entire community – those who are most marginalized, those working in the system, and those trying to provide support, including businesses and community members who also experience the impacts of this crisis.

The Whole of Community System Response document can be read online.

Currently we do not have one comprehensive system with a focus on working together, across the whole community, to support people in moving indoors to highly supportive homes. 

This kind of response to homelessness is believed to be unique in Ontario – embedding health care and two foundational elements: Hubs and Housing. 

Hubs are designed to support the most marginalized Londoners, approximately 600 individuals with the most complex needs who are often completely unsheltered. 

Hubs are not traditional shelters; they are 24/7 safe spaces that include transitional beds and a range of services and supports that operate as an entry way into the housing system. 

The system is also designed to be easier to access, with just one phone number that anyone can call – from loved ones and caregivers to business owners – to refer individuals with the most complex health and homelessness challenges to these supports. This central access point through one phone number does not currently exist.

The Health & Homelessness Fund for Change is administered by London Community Foundation, powered by the generosity of London’s business and community leaders and enabled by a transformative gift by a London family who wishes to remain anonymous but who has pledged $25 million to seed the fund, with an additional $5 million in matching dollars to encourage others to give. A volunteer fundraising committee is working with the anonymous donor and LCF to raise the matching funds, which will grow the Fund to a total of $35 million.

The Fund for Change will be a critical part of making the first three to five Hubs a reality through funding for capital and other emerging needs.

More information about the Fund for Change is available at movementforchange.ca

Creating additional high-support housing units will require deliberate collaboration between the City, for-profit and not-for-profit developers and landowners, and the federal and provincial governments.

The goal is 100 high-support housing units by the end of 2023 and 600 over 3 years.

Implementation is already underway, with 44 high-support housing units approved by Council in May, which will open in October 2023.

In addition to highly supportive housing, there are a number of other initiatives underway at the City to address the supply of housing overall.  This includes the Housing Supply Action plan to meet the pledge of 47000 homes in 10 years (the provincial target for London.)

The Health & Homeless Summits were convened collaboratively by City of London, CMHA Thames Valley Addiction & Mental Health Services, London Health Sciences Centre, London Police Service, Middlesex London Health Unit, Middlesex-London Paramedic Service, and St. Joseph’s Healthcare London.

In all more than 200 individual leaders from all backgrounds and areas of expertise, representing more than 70 local organizations, came together over three summits in November and December 2022 and January 2023, with a pledge to do things differently.

The proposed system response was authored collectively by all summit participants, using insights collected in all three community sessions, and enhanced based on the real-time and post-event feedback opportunities offered to all participants.

Ultimately, the proposed system aims to support the whole community – those who are most marginalized, those working in the system, and those trying to provide support, including businesses and community members who also experience the impacts of this crisis.

Crisis situations necessitate action, especially when lives are at stake. People in our community are dying, businesses are closing, and neighbourhoods are being impacted.

The vast majority of people living on our streets are Londoners who are experiencing a crisis of health and homelessness because of a complex number of circumstances.

When individuals do arrive from other communities, there is a process, managed through the City’s Coordinated Access system, that can help them make a plan to return home and be connected to services there.

Evaluation is being built with in-kind support from the Centre for Research on Health Equity and Inclusion (CRHESI) at Western University, which has a strong reputation in community-based research and evaluation. 

While this detailed evaluation is developed, early ways that will indicate success are fewer deaths on our streets, fewer encampments, and more people successfully housed.

Hubs are a network of multiple, purpose-designed locations offering comprehensive services to help the most marginalized unhoused Londoners move safely indoors, stabilize, access supports and become sustainably housed. 

Every interaction at a Hub is an active and intentional effort to enable an individual’s next steps toward highly supportive housing.

Each Hub serves 25-35 people and is population specific and the plan is to start with three to five Hubs initially. 

Hubs should have a feeling of community, with drop-in supports open 24/7 where anyone can walk in the front door, access immediate basic needs and stabilization support, and be connected to services and the next steps to housing. The focus is always on enabling next steps.

The common core service functions of a Hub are to provide: 

• 24/7 safe places
• Basic needs (food, shower, laundry, rest)
• Community engagement
• Housing access support
• Income supports
• Integrated care planning
• Justice system services
• Medical stabilization beds
• Quick access and intentional connections to acute and primary care
• Respite beds
• Transitional beds
• Translation and interpretation
• Transportation

Hubs are designed to support the approximately 600 Londoners with the most complex needs, referred to as “high acuity”, who are often completely unsheltered and predominantly living outside of the shelter system. Proportionately these individuals can have high levels of interactions with police, emergency services and the healthcare system.

Hubs are not for everyone experiencing homelessness, and other programs and supports will continue to help other Londoners experiencing homelessness.

Priority populations for the first three to five Hubs are: 

• Couples and families 
• Indigenous individuals
• Medically complex individuals 
• Women and female-identifying individuals
• Youth (16-25)

Hubs can service one or more of these priority populations in addition to the general population of people in need, or may service one population exclusively, depending on the unique needs of people.

This model is simpler, and expected to be more effective and efficient, for:

• Individuals accessing services
• First responders
• Businesses
• Family, friends and caregivers

It supports the sector and partners to work collaboratively and deliver services in a different, more accessible and effective way with a clear identifiable purpose and central locations vs. multiple single purpose locations.

Hubs are not safe injection sites. Their purpose is to move people into the supportive housing continuum. 

Some people living unsheltered use drugs but not all do, and research shows that mental health and substance use worsen the longer people are homeless.

Critical to the success of bringing people safely inside is reducing as many barriers as possible, which means meeting them where they are at with a low barrier approach. But, this does not mean “no rules”.

Hubs will provide care and support based on evidence-based practices – this includes harm reduction practices like distributing new equipment and referrals to addiction treatment.

A low barrier and harm reduction-informed approach recognizes that some people will use substances and so practices must exist to ensure this happens in the safest possible way.

We will connect community members with the exhaustive array of evidence-based supports and interventions to support individuals in achieving safety and improved quality of life.

Hubs are designed to support the most marginalized Londoners with the most complex needs. Hubs are not for everyone experiencing homelessness. 

Hubs do not stand alone, but are part of the larger system response that includes many existing programs and services that will work in partnership to support an individual on their path to housing.

Existing agencies will also continue to work with individuals of all levels of acuity to help ensure a comprehensive end-to-end system for all of those experiencing homelessness in London.

Hubs are a transition point between living outdoors and living in highly supportive housing. Hubs help bring people safely indoors to stabilize them as a critical and necessary first step. Hubs will assist people with the most complex needs who are often completely unsheltered and not accessing existing services and supports, including traditional shelters.

Highly supportive housing can be permanent housing and for some individuals this is required. Other individuals may move to other models of housing as their needs are less complex.

Individuals will be able to access a Hub through one phone number to call and through multiple referral doors. This was an intentional and important outcome of the Health & Homelessness Summits that was heard loud and clear, that there is a need to shift how people can access these critical services. 

Connections to Hubs may come through self-referral or the individual dropping into a Hub, or referrals through outreach workers, family/caregivers, police, EMS, hospitals, or business/community. Access is streamlined and connected.

London City Council approved the first Hubs on October 5, 2023, marking a significant leap forward in addressing the health and homelessness crisis. The approval of the first Hubs marks the next step in the implementation of the Health and Homelessness Whole of Community Response and a new, system-wide approach to ending homelessness in our city. 

The Hubs are as follows:

1. Atlohsa Family Healing Services Hub: This Hub, aimed at supporting Indigenous individuals, will be located at 550 Wellington Road. Scheduled to open in December 2023, it will provide wrap-around services for 10 respite beds and 18 transitional rooms.
2. Youth Opportunities Unlimited (Y.O.U.) Hub: Geared towards assisting youth in need, this Hub will be situated on two sites: the first, at 800 Commissioners Road East, will offer services for 6 respite beds and 9 transitional rooms. The second site will provide accessible primary care and will open at Joan’s Place downtown once completed. YOU anticipates helping up to 60 youth annually, leaning on a wide range of services including shelter, life skills development, and a gamut of housing supports based on the individual needs of each participant.

Canadian Mental Health Association (CMHA) and CMHA Thames Valley had also been selected to provide a Hub serving women and female-identifying individuals at a multi-site Hub. The proposal included two sites (705 Fanshawe Park Road West and 556 Dundas Street), which were evaluated and awarded as a single bid submission under the formal public procurement process. On November 6, 2023, CMHA Thames Valley announced that it was no longer able to proceed with its Hub proposal due to circumstances beyond its control.

Before locations were selected, a location criteria was drafted by the City, and public engagement about this criteria took place in June 2023. With this feedback from residents, a wide variety of potential Hub location criteria has been considered, with additional input from sector experts, business, development and community members including those with lived experience of homelessness.  

All of this perspective was considered in the following final location criteria which was endorsed by Council in July 2023.

Hubs should be located near:

• Arterial roads
• Transit routes 

Hubs should not be located in close proximity to:

• Elementary schools 
• Splash pads and wading pools 
• Not directly adjacent to licensed child care centres
• Not in parks or directly park adjacent 
• Not within residential neighbourhood interior

Other considerations that have been endorsed by Council for the first five hubs are that:

• Hubs should be established within areas that have existing Emergency Care Establishment zoning 
• Hubs should be located in existing buildings, via partnerships with property owners (versus new builds)
• Hubs should represent net new beds, or an addition to capacity, not the repurposing of existing facilities 
• Hubs should be located outside of the Old East Village and not on Dundas Place or Richmond Row (contingent on zoning, available properties, physical space requirements and ability to deliver functions and standards effectively)
• Hub locations should ensure their properties are well kept and that cleanliness and safety are prioritized
• Proactive and ongoing neighbourhood engagement should also be a priority for Hubs, and include neighbourhood communication and engagement

The estimated operating cost of each hub is up to approximately $2.7M, for: 25-35 beds, operating 24/7 with six staff on-site during the day and evening, and five staff overnight. 

The City has budget to fund the first two Hubs and additional operating dollars are being sought from other levels of government for the next three. 

All partner services and supports (from healthcare to income support services) are in-kind, largely Ontario Health funding and other municipal funding such as Ontario Works and there is an opportunity for shared services and back office supports.

The estimated capital cost is a maximum of $2M per Hub for renovations and property alterations. The Fund for Change is intended to support these costs.

Advocacy efforts are well underway at both the provincial and federal level and the plan has been met with positive responses at both levels of government. 

There are many potential avenues of government funding being actively explored from several different ministries. 

The City already has funds in its budget to operate the first two Hubs.

Each Hub will be operated by a Lead Agency, selected by the City through a procurement process.

The City will enter into a purchase of service contract with Lead Agencies for operations of a Hub.

Capital funders, including the Fund for Change, will enter into grant agreements for capital allocations.

Ownership of the property may depend, and could be owned by the:

• Lead agency
• Property co-lead
• Property owner

Lead Agencies will be responsible for:

• Defining and coordinating full operating model
• Community engagement
• Property management
• Operating 24/7 safe space
• Basic needs
• Integrated care planning
• Respite beds
• Transitional beds
• Transportation

Partner Agencies will support:

• Medical stabilization beds
• Access to acute and primary care (including physical health, mental health and substance use treatment)
• Housing access support
• Income support
• Justice system services
• Translation & interpretation

Following Council endorsement of the Hubs Implementation plan in July, City staff are undertaking several steps including a procurement process to help identify lead agencies and the proposed locations for the first five hubs.

Proposals from agencies and community partners are to address:

• Location and size of the Hub
• Priority population to be served
• Services provided 
• Partner agencies where known

It’s important to note that each Lead Agency selected will be committed to actively participating in community and neighbourhood development efforts and contributing to community education, and awareness.

Request for proposals began on August 4, 2023, and closed on September 5, 2023.e.

A report was then prepared by the City about health and homelessness and the procurement process to identify lead agencies to operate Hubs. The report can be reviewed online.

The report was discussed at a Special Meeting of the Strategic Priorities and Policy Committee on September 25, 2023. The recommendations of the report were approved at the committee meeting and will next be considered at a Council meeting on October 5, 2023.

Following community engagement this summer, a request for proposals for Lead Agencies to operate Hubs began on August 4, 2023, and closed on September 5, 2023.

A report was then prepared by the City about health and homelessness and the procurement process to identify lead agencies to operate Hubs. The report can be reviewed online.

The report was discussed at a Special Meeting of the Strategic Priorities and Policy Committee on September 25, 2023. The recommendations of the report were approved at the committee meeting and will next be considered at a Council meeting on October 5, 2023.

The first Hubs are expected to begin to be operational by the end of 2023.

All Hubs will have consistent standards of care that set out expectations and practices for service delivery, as prescribed in the Hubs Implementation Plan that was approved by Council in July 2023.  This includes standards of practice for programming inside and outside the hubs.

All individuals working in Hubs will have consistent training, including crisis de-escalation training.

Hubs will proactively engage with surrounding neighbourhoods and provide ongoing opportunities for neighbours to provide feedback.

Lead Agencies will be responsible for supporting community development and engagement in the immediate area surrounding Hubs.

A community engagement process was undertaken in June to collect feedback from Londoners about Hubs, which was incorporated into the Hubs Implementation Plan endorsed by Council in July.

This City is committed to ongoing community engagement, and public engagement sessions continued in late August and early September collecting comments from Londoners. Comments also continue to be collected online through the City’s Get Involved engagement website. 

Residents are encouraged to comment at getinvolved.london.ca

Residents can also subscribe for email updates at movementforchange.ca

Specific input continues to be sought from various sectors and individual groups, including those with lived and living experience, business, developers and the sector workforce.

A public awareness campaign also began in late August, providing information and education to the community about the system and includes the opportunity to sign up for regular updates by email. 

Additional engagement opportunities will be available as the Whole of Community System Response continues to be implemented. 

As locations for Hubs are determined, Lead Agencies will continue to proactively engage with surrounding neighbourhoods and provide ongoing opportunities for neighbours to provide feedback.