Community Homes for Opportunity

Evaluation

The Homes for Special Care (HSC) program was established in 1964 in Ontario, Canada as part of the deinstitutionalization of mental health services. The program provides supportive housing for adults living with serious mental illnesses. Tenants of HSC group homes are provided with 24-hour staff support including assistance with meals, activities of daily living, and medication management. The HSC group homes are privately owned and funded by the government.

The Ministry of Health is in the process of revising the HSC program to better meet the needs of tenants. The HSC program is being replaced with a new program, called Community Homes for Opportunity (CHO), which strives to achieve best practices for supportive housing. The CHO program aims to help tenants to:

  1. maintain safe and affordable housing;
  2. have more control of their housing and supports;
  3. become better integrated into their communities;
  4. improve or stabilize their physical and mental health; and
  5. be active in their own goal-setting and wellness planning.

In 2017, the Ministry of Health began a phased rollout of the CHO program in parts of South Western Ontario. Lawson Health Research Institute is evaluating the rollout. The evaluation will explore:

  • potential impacts of the new CHO program;
  • issues with the rollout process; and
  • recommendations for extending the CHO program to other regions.

Methods

Lawson Health Research Institute is evaluating the phased rollout of the Community Homes for Opportunity (CHO) program in Ontario, Canada. The evaluation uses a longitudinal, mixed-methods, repeated-measures design.

Individual interviews are being conducted with a random sample of CHO tenants. Surveys used during the interviews will measure outcomes related to quality of life, community integration, housing stability, and health and social service use.

Focus group discussions are being conducted at multiple timepoints with key stakeholders to identify issues, solutions, and recommendations for improvement. Key stakeholders include CHO tenants, CHO homeowners and home staff, representatives from the Ministry of Health, and representatives from community agencies involved with implementing the CHO program.

A comparison (matched control) group is being generated from the databases housed at the Institutes of Clinical Evaluative Sciences. Health data from CHO tenants will be compared to data from the control group. Analyses will determine if the CHO program has led to decreases in the use of healthcare services, such as visits to emergency rooms.

Phase 1:

In 2017, the CHO program was rolled out to 28 homes serving 368 residents. Lawson's research team has conducted three sets of interviews with 116 tenants. The team has also conducted focus groups with 343 participants across three timepoints approximately 4 months apart. The research team is now conducting a fourth round of follow-up interviews with CHO tenants.

Phase 2:

In 2020, the CHO program was rolled out to an additional 21 homes serving 323 residents. Individual interviews will be conducted at three timepoints with up to 120 tenants. Due to COVID-19 restrictions, focus groups have temporarily been replaced with virtual discussions.

Implications

The evaluation of the Community Homes for Opportunity (CHO) program being conducted by Lawson Health Research Institute will assess whether the CHO program is helping tenants to improve their housing stability, community integration, health, and quality of life.

Outcome data and stakeholder feedback will be used to generate specific recommendations for improving the program.

A best practices guide is being developed to inform the roll-out of the CHO program to other HSC homes across the province.

Principal Investigator

Cheryl Forchuk, RN PhD
Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery,
Parkwood Institute Research
Lawson Health Research Institute
P: (519) 685-8500, ext. 77034
E: cforchuk@uwo.ca

Project Contacts

Phase 1:

Bryanna Lucyk
Research Coordinator
Lawson Health Research Institute
P: (519) 685-8500, ext. 77097
E: bryanna.lucyk@lhsc.on.ca

Phase 2:

Lewis Mahon
Research Assistant
Lawson Health Research Institute
P: (519) 685-8500, ext. 75719
E: lewis.mahon@sjhc.london.on.ca