Home and Healthy: Supporting people leaving hospital into stable homes
The Home and Healthy social impact investment supports homeless people and those at risk of homelessness who are leaving hospital or health facilities by offering holistic support to achieve sustained housing, increased workforce capacity and improved wellbeing.
The program is delivered by Mission Australia and will support up to 1200 people in the Sydney, South Eastern Sydney, Western Sydney and South Western Sydney Local Area Health Districts, over six years. It will start in Central Sydney in July 2019.
Each participant will be supported during their transition from a health facility then ongoing for up to two years, with an allocated case manager, effective housing strategies and access to a holistic team including mental health clinician and lived expertise worker.
On Census night in 2016, over 37,000 people were homeless in NSW. This represents a significant and escalating issue for the state, as the homelessness population has increased by 37% since 2011.1
People exiting health facilities are particularly vulnerable to homelessness, as shown in the evidence base around bi-directional relationships between homelessness and mental health, physical health, and substance abuse issues.
Leaving hospital or ceasing an engagement with a health facility, such as a drug and alcohol treatment program, can be a key risk point in a person’s journey towards homelessness.
On leaving hospital, a person may be facing a sudden or big change in their health circumstances and often find themselves not knowing how to respond. Also, individuals managing a longer-term health condition may be unable to mobilise the support needed to avoid homelessness.
The NSW Government is funding the Home and Healthy program as a social impact investment, through its $63 million Homelessness Strategy. Mission Australia is investing capital through the term of the program.
The Home and Healthy program aims to reduce the prevalence and impacts of homelessness for adults leaving health facilities in Sydney, including hospitals, mental health centres and alcohol & other drug facilities. The program supports people to establish and sustain long-term housing, and to participate in volunteering, training and / or employment
The program will commence in July 2019. It is expected that the first phase of results will be communicated in 2021.
- Investment type: Payment by results
- Contract value: $18.5million (based on expected performance)
- Outcome Payments: based on a Rate Card approach
- NSW Government investment: advance payments and outcome payments
- Mission Australia investment: initial funding and capital support through term of program
- Term: 6 years
- Service provider: Mission Australia
- Government agency: NSW Department of Family and Community Services
- Referring partners: Local Area Health Districts
Outcomes will be measured and independently certified throughout the investment.
The NSW Department of Family and Community Services will also measure the success of the program via an independent evaluation.
1Australian Bureau of Statistics (2016) Census of Population and Housing: Estimating homelessness, DataCube 2 State and territory of usual residence
Update June 2021
Home and Healthy has been operating as a pilot in central Sydney since July 2019 and is due to end in June 2021. During this pilot period, Home & Healthy has integrated well through the referral and intake process within the health services in central Sydney and has supported over 210 people. Many of these individuals (over 80%) have histories of homelessness and have experienced alcohol or drug use, mental health issues and/or a disability. About a third were either street sleeping or in highly insecure accommodation (such as emergency accommodation and motels) from which they could have cycled into street sleeping.
A planned Annual and Performance Review has found that the characteristics of the Home & Healthy service users were different from the cohort for whom Mission Australia designed the program; and the number of Home & Healthy service users achieving sustained housing and employment outcomes as defined by the program’s payable outcome definitions was lower than expected.
After collaboratively exploring possible refinements to the target cohort and other program changes, all parties have agreed to not extend the Home & Healthy program beyond its pilot period.
The NSW Government and Mission Australia will work together over the next few months to transition existing service users to other support services currently operating in central Sydney. New referrals from health facilities will cease, to facilitate a smooth transition-out process. Health staff with patients who are at risk of or experiencing homelessness on exit from health facilities are advised to contact the Department of Communities and Justice local housing services.
All parties acknowledge that Home & Healthy has provided valuable learnings in the homelessness space that will assist future decisions to benefit the community, the NSW Government, and social impact investing activities.
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