Program
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Community Homes for Opportunity (CHO) Program Description
Purpose:
CHO is a supportive housing program for people with mental health and addictions. The program is intended to assist participants by providing appropriate housing and support services to achieve and maintain stability in a home that is safe and affordable. The recovery-based program offers opportunities for participants to enhance the quality of their daily living, their personal growth and development and improve life skills through participation in a variety of activities and programs. CHO provides housing, meals and support services in a home setting for people with serious mental illness and addiction who require 24-hour supportive care.
CHO Site Locations:
London – 5 homes, 8 bed homes, most rooms are single
Strathroy – 2 homes, 1 in town has 8 single bedrooms, 1 rural home with 40 beds, 25 single, and non-CHO tenants accepted
Exeter – 33 beds, 23 CHO, 8 single bedrooms and non-CHO tenants accepted
Parkhill –15 CHO beds, 9 single bedrooms
Merlin –10 CHO beds all single
Port Bruce - 40 bed home, 30 CHO beds, 21 single bedrooms, shared rooms, non-CHO tenants accepted
St. Thomas -7 homes, 9-43 beds, single and shared rooms, non-CHO tenants accepted
Philosophy/Vision Statement:
“Every person has the right to quality, safe and affordable housing and support services to enable them to live as independently as possible and flourish in a community setting. We believe a supportive environment in our homes will enhance individual quality of life, skills, dignity and sense of worth. We value the uniqueness of each resident and adhere to the principles of Psychosocial Rehabilitation.”
Program Outcomes:
1. Participants physical and mental health is improved/stabilized
2. Participants achieve and maintain housing stability. Housing is safe and affordable
3. Participants have greater independence and control of their housing and supports
4. Participation and Integration into the community is facilitated
5. Participants improve life skills
6. Participants have appropriate housing and support services
7. Homes and services align with the values, principles and practice of the recovery model
The goal is to support participant’s recovery potential and quality of life by encouraging increased responsibility for themselves with the objective of moving on to a more independent living setting for some participants.
Support/Treatment Modality:
The CHO Program supports a psycho-social recovery-based approach and provides access to support services both in the CHO home and in the community, which will aim to improve and or stabilize peoples’ physical and mental health, foster independence, and enhance participation and integration into the community. Staff provide supports and interventions using trauma informed care, and strengths-based goal setting. Following Best Practices in Supportive Housing, the program promotes the rights of individuals served and also follows a harm reduction approach to substance use, housing tenants with substance use disorders.
Completed within the first few months of admission, the OCAN (Ontario Common Assessment of Need).
is a tool that assists with mental health recovery and identifies individual needs; it matches these needs to existing services, and highlights any service gaps. The OCAN is utilized on an individual level to reduce repetitive information gathering, it is reviewed annually, and adapted as needed.
With the information from the OCAN, and client input, a wellness plan is completed. The CMHA CHO staff, home staff and when available, the community treatment team will be involved in creating the wellness plan as directed and guided by the resident. The wellness plan is resident driven and based on Best Practices strengths model of goal setting. The SMART method is used and plans are reviewed at least annually.
CHO staff will encourage and support participation in community programs, services and activities that may enhance individual’s well-being and independence (e.g. mental health day programs, self-help groups, life skills training, exercise classes, library, shopping, recreation.) Support may be offered in the home environment where participants can develop new skills, for example, daily living skills, according to the wishes of the participants.
Medications are managed by the private CHO Home Staff, and independence with medication is encouraged. Participants must be able to take their own medications with prompts, for example self-administered insulin.
The CMHA CHO nurses support with admission and discharge medication reconciliation, and provide ongoing medication education as needed to participants moving forward with medication independence.
Nursing staff are available for clinical support and oversight on a weekly basis. Additional access to the nursing staff will be planned in advance as needed. The CHO nurses complete monthly vitals and can provide a variety of health teaching groups for the CHO home participants and staff. The nurses provide input and consultation with treatment teams, empowering the participants to be active in their health care. Foot care is provided every second month in house to those tenants that require care.
Partnerships:
Working alongside independent CHO Homeowners, CMHA Thames Valley Addictions and Mental Health Services CHO staff provide community support to participants of the program. Limited in-home 24-hour support is offered by the CHO Home staff, providing board and lodging, meals, medication management, appointment reminders, laundry and cleaning support. Health and Safety, fire drills and maintenance are the responsibility of the homeowners, and some participant programming support responsibilities are shared between CMHA and the CHO home staff collaborating to improve the quality of life of the CHO participants.
Target Population:
The target population is adults, age 16 and up diagnosed with mental health and addictions who require 24/7 care. The homes are not accessible, and participants need to be able to ambulate throughout the home, feed, toiled and bathe themselves independently, and transfer independently for community transportation. Participants must be willing to work towards their recovery goals, access the community including banking and shopping for their personal needs with support if required, and actively engaging with the supports of the CMHA CHO Program and other community supports such as PSWs.
Admission/ Enrollment/ Entry Criteria:
The Intake package is reviewed and assessed for suitability by both CMHA and the Private CHO homeowner. Additional information may be requested, and or a face to face meeting for suitability. A risk management assessment is required for all referrals and consultation is available with the CHO Housing Navigator and the CHO Program Manager. Once all of the information is collected, the Housing Navigator will contact the referral source, and arrange a tour with the candidate when a vacancy becomes available in a CHO home, following best practices in waitlist management. Transportation to tours are supported by the referral source and or family, further visits and further collection of information may be necessary to determine suitability for the home. When the final intake/transition meeting is held, and a transition plan is complete and signed, a placement is offered when all parties are agreeable. The waitlist for the CHO Program is quite lengthy, and can be longer for some regions.
Exclusion Criteria For CHO:
The CHO homes are not accessible, participants that cannot ambulate independently throughout the home, feed, independently toilet and sense the urge to toilet, and transfer independently for community transportation are not eligible.
Participants that have a history of fire setting, those with the inability to evacuate the home independently during a fire drill, and those that refuse to adhere to Smoke Free Ontario regulations are not eligible for the CHO Program.
Participants that have a history of falls risk, those eligible for LTC, those that are not agreeable to external PSW support, those who have complex mental health and physical health needs that exceed the capacity of the program are not eligible.
Participants that have been previously evicted from a CHO home; have assaulted others require 2 years without incident, 5 years without incident for sexual assault.
Participants with a primary Developmental Diagnosis, and primary Acquired Brain Injury.
Inability or Unwillingness to consent and/or engage with CMHA and CHO home services.
Participants must be able to take their own medications with prompts, for example self-administered insulin.
Participants that struggle with group living are not eligible for the CHO Program.
The private CHO homeowner makes the final decision on who is admitted into their home, and may have additional exclusion criteria not included in the above list.
Transition / Discharge Criteria:
The program falls under the Residential Tenancies Act with some homes exempt, and occupancy is not offered until after a transition plan meeting is completed, and the CHO Homeowner, the referring treatment team, and CMHA are all in agreement to transition supports required for each tenant. Upon discharge from the program a discharge summary is completed with referrals to additional programs, review of crisis plans, transition of care meetings and community follow up for up to 6 weeks to provide continuity of care.
Fees:
CHO falls under room and board fees and fee are paid by the participants, based on their income.
Nutritious meals, snacks and boarding supports are provided by the home owner. Fees includes a shared phone line, access to cable in the common room and shared Wi-Fi. Medications and most health care expenses are covered by the program. Transportation to medical appointments and some program activities are also provided by the program.
Length of Stay:
Length of stay is dependent on the resident’s readiness and goals. The homes are permanent housing, however the goal for some participants will be to move on to a community setting with greater independence.
Access and Referral:
Completed Referral Forms can be found on the CMHA TVAMHS website, or Connex and received during business hours (8:30am – 4:30pm) via fax to 519-668-3641.
A comprehensive Intake Package is required and should be completed by the treatment team referral source along with consents for CMHA and the CHO homeowners.
Admissions:
Admissions take place Monday to Friday from 830am- 430pm, and orientation is completed by both CMHA and the CHO homeowner.
Staff Qualifications/Compliment:
A Degree or Diploma is required to work within the CHO Program and the team is multidisciplinary. The CMHA team is comprised of Team Coordinators, Addiction and Mental Health Workers, Nurses, Residential Service Liaisons, a Housing Navigator and a Program Support staff. The ratio of primary worker to client is usually 1:16.
