A collaborative effort is making strides towards providing vital primary health care services to those at risk of or experiencing homelessness in Windsor, Ont. The collaboration includes the City of Windsor, Hotel Dieu Grace Healthcare, the Canadian Mental Health Association – Windsor Essex Branch and the Schulich School of Medicine & Dentistry.
The Shelter Health Initiative, an independent working group under the Windsor Essex Ontario Health Team (WEOHT), is providing essential same-day episodic medical care to the city’s homeless population and their efforts are now being bolstered by the participation of two family medicine residents from Schulich Medicine & Dentistry’s Windsor Campus – Dr. Jala Rizq and Dr. Julia Petta.
“This initiative aims to provide trauma-informed and person-centred care that is both accessible and appropriate for those at risk of or experiencing homelessness. It is also a unique learning opportunity for medical students and residents interested in understanding and addressing the impact of social determinants of health on their patients,” said Dr. Jennifer Bondy, adjunct professor, department of family medicine at Schulich Medicine & Dentistry’s Windsor Campus.
Homelessness continues to challenge municipalities across Canada. Although people experiencing homelessness represent a small fraction of the region’s population, this vulnerable group confronts significant threats to their health and well-being. The Shelter Health model addresses a gap in the community by improving health, social stability and quality of life for residents living on the street and in area shelters.
“We have seen people experiencing homelessness are more likely than their housed counterparts to be admitted to hospital for complex medical conditions and far more likely to visit the emergency department. By providing same-day primary care at shelters and drop-in centres, we are hoping to increase access to outpatient care in a setting conducive to these individuals. We also aim to reduce expensive emergency room visits for people with non-emergent needs,” said Bondy, who is the principal preceptor of the Shelter Health & Social Medicine Family Medicine residency at the Windsor Campus.
The Shelter Health Initiative currently delivers health care at three locations in the city: Welcome Centre Shelter for Women and Families, the Salvation Army – Centre of Hope and the Homelessness and Housing Help Hub (H4). All of the sites are digitally connected with all of the hospitals in the Windsor-Essex region through an Electronic Health Record.
Currently, two local family physicians and one nurse practitioner support the initiative with up to 12 hours of work per week across the three locations. Significantly expanding the scope and capacity of the program, family medicine residents have joined the program at H4 as part of Bondy’s team.
During the one-month rotation at the Shelter Health Initiative, the residents will spend time in a variety of clinical settings working alongside other health professionals and social services providers. The residents will be looking after primary care patients with diverse needs, will perform common office procedures and provide wellness and preventive care across life cycle.
“The Shelter Health elective provides an exceptional inter-professional health education learning opportunity for our trainees. We are proud of the resident trainees who recognize the importance of this work and choose to enhance their learning experience through this initiative,” said Dr. Larry Jacobs, associate dean of the Windsor Campus.
“Our dedication to delivering accessible health care and supporting such initiatives is not just an educational strategy, but also a testament to the School’s impact and responsibility in providing quality health care in the region.”
According to the data provided by the city, in 2022-2023, the H4 location alone recorded 100 unique visits by those experiencing homelessness or living in shelters. The involvement of medical trainees also plays a crucial role in securing the Alternative Funding Plan (AFP), a funding source for Shelter Health that will allow more family physicians, psychiatrists, palliative care physicians and other specialists to work within this system.
“The City of Windsor fully supports this initiative by facilitating connections with the appropriate healthcare, post-secondary and emergency shelter operators to improve the health, social stability and quality of life for our neighbours experiencing homelessness,” said Andrew Daher, commissioner of human & health services, City of Windsor.