ºìÁì½í¹Ï±¨

Avis Favaro

Across the country, there are more Canadians who have no home and who live on the streets.

How many times have you been homeless?

Unhoused female

A lot. And I’ve slept on the street and I get robbed.

Avis Favaro

This woman was sitting on a busy street corner in Toronto asking for donations. She says she’s 42, has diabetes, and is partially blind.

Unhoused female

Everywhere I’ve been, oh, you have to leave because I’ll call the cops on you. Then I’m like, okay, I’ll leave. But it doesn’t make sense when they have nowhere to go.

Avis Favaro

It’s estimated that over a quarter of a million Canadians experience homelessness each year, according to Statistics Canada, the consequence of poverty, illness, addiction and the rising cost of housing. And when they become ill, they’re among the highest users of emergency services.

David

This. My leg is burned.

Avis Favaro

This is David, who said his leg was burned in a fire. Keeping it clean and applying medication is hard when you live in a tent.

David

Twice, in the hospital — actually 3 times — I always go nighttime because the nighttime, there’s not that much people — after midnight, always.

Avis Favaro

On today’s episode, I’ll look at homelessness, the cost to their health and our health care system, with new data from the Canadian Institute for ºìÁì½í¹Ï±¨ Information showing that the burden of homelessness is massive.

We have 2 guests talking about this pressing issue. Andrew Bond is part of a team in Toronto that delivers medical care directly to those living on the streets.

Andrew Bond

Housing is actually the single most potent social driver of health. And someone who’s homeless or unhoused has the life expectancy, about half of someone who is housed.

Avis Favaro

We’ll also hear from an Edmonton ER physician, Louis Francescutti, who’s frustrated with the cycle of treating the sick and homeless, only to send them back to the streets where their health usually worsens.

Louis Francescutti

ºìÁì½í¹Ï±¨ care facilities in Canada today should not be allowed to discharge a patient into homelessness.

Avis Favaro

Hello, and welcome to the Canadian ºìÁì½í¹Ï±¨ Information Podcast. We call it the CHIP for short. I’m Avis Favaro, the host of this conversation.

A note, the opinions expressed here don’t necessarily reflect those of the Canadian Institute for ºìÁì½í¹Ï±¨ Information, but it is an open discussion. And this one is about the thousands of Canadians living in ravines, by roadways, and in parks, who often end up in hospital, a problem that’s growing but that those on the front line say can be solved.

Joining us is Dr. Andrew Bond, Executive Medical Officer of the Inner City ºìÁì½í¹Ï±¨ Associates. And that’s a group of about 120 doctors and 40 nurses that offer care for people who are homeless in Toronto. Thanks for coming on the show, Dr. Bond.

Andrew Bond

Thanks for having me, Avis.

Avis Favaro

So before we get going, I want to talk about the term homelessness and homeless. That’s the word that I’ve always heard. But now, I’m hearing words like unhoused or unsheltered. Is the lexicon changing?

Andrew Bond

Yeah. Exactly. The reason for the shift from homelessness to unhoused for many people is that homelessness is starting to take on a pejorative sense to it for many people where, certainly, for individuals who are chronically homeless, they make homes just like we all do, wherever we are, and they make experiences and community.

And so by labelling people as homeless, it takes away that part of their experience, their agency and strength, which is really what helps people recover from being unhoused and focuses more on the fact that the condition is that they’re unhoused, not that they’re actually homeless.

Avis Favaro

A lot of people, when they see homeless encampments or people who are unhoused asking for money, they don’t want to look at them. You can see them avert their eyes. You’re seeing the homeless in a different way. What do you see?

Andrew Bond

Yeah. I think the first thing I think, whenever I see anybody who’s overly, inexplicably in an unhoused situation, is it’s a tragedy. It’s something that should have been avoidable. But because of how we’ve structured things, it’s become an unavoidable reality.

Right now, we know that the way we’ve designed cities, we don’t have them designed in a way that is able to achieve what’s called net zero, which is the ability to actually absorb and have all the people who are there housed.

And I can tell you, I have the same feeling at times, too, where it may come from a different place, potentially, but I think we all probably share that at some gut level, which is there is a failure that’s happened here, and it’s hard to look at, and it’s hard to see that lived right in front of you.

And then, I think, none of us like to feel powerless, is that generally speaking, I think accompanying that feeling for many people is, and what can I possibly do? Can change possibly help?

Avis Favaro

I was at an encampment yesterday. And everyone, when I said, what do you want, and they said, a home. They talked about being robbed. They talked about assaults. They talked about if their behaviour isn’t good enough, they get kicked out of shelters. And if they’re not bad enough, the jails are not available.

A lot of them — actually, every single one I spoke to, uses emergency as a last resort, which is what the data is that’s come out. It’s the first time that ºìÁì½í¹Ï±¨has done data on patients who are homeless.

And they introduced this code in 2018, Z59. Am I saying it right?

Andrew Bond

You got it right. It’s actually Z59, and then there’s 0.1 to 0.9, depending on sub-identifiers, but it’s the Z59 code. It’s an international classification of diseases code with like the Canada specifier for it.

Avis Favaro

So in 2018, Canada introduced this new code that mandates hospitals to report on patients who are homeless and use this code so that they could be counted. And my first question was, why weren’t we doing it before 2018?

Andrew Bond

That’s a great question. So I would say the vast majority of health systems haven’t historically prioritized or been acutely, actively concerned about identifying and tracking homelessness, nor understanding why it might be so important, so valuable to track.

I will say that, even with the mandate, a very large number, certainly, either do not use it still or very significantly underreport on the use of the Z59 code. It takes a lot of change to be able to actually implement a mandate and execute, effectively, a mandate. So certainly, it is being used, but we have a lot of work to do to actually have it be used effectively and systematically.

Avis Favaro

So this is the first snapshot, but they are indicating that there were nearly 30,000 hospitalizations across the country in 2022–2023. So it’s their first data set.

The average length of stay in hospital for someone who was unhoused was almost double that in the national average, 15 days versus 8 days for people who have homes. And that’s like — that’s a lot because there’s a cost that goes with it. These people are in hospital longer. Does that number of hospitalizations surprise you?

Andrew Bond

Not at all. It’s quite likely about 3 to 4 times undercount. It’s probably closer to about 100,000 to 120,000 a year who are hospitalized, I would suspect.

Avis Favaro

Wow. Really? What makes you say that?

Andrew Bond

Just because we know that they’re not reporting it, and that we have comparisons from individual hospitals, for example, that if extrapolated, that would be far greater than that as well. And so we know that it is going to be significantly higher.

But what matters about this is that, number one, it’s a systematic priority. It gives us the ability to have level setting. It’s something to build from. And even if it’s an undercount, what’s important is, is that we know that it is specific, it’s rarely wrong, and so it at least gives you a floor level of knowledge about where we might be. And so it’s a start.

Avis Favaro

So what does that number, as preliminary as it is, indicate about the cost of people who are homeless to the health system?

Andrew Bond

It depends on what kind of condition people are hospitalized for. We know that for mental health diagnoses, admissions are usually about twice as long compared to general medical or surgical admissions. And we know that the ratio of unhoused individuals who are admitted for mental health reasons tends to be about 3 to 4 times greater than those who are admitted for medical reasons.

So not only are unhoused individuals needing to be admitted to hospital more often, often 2 to 3 times more likely than the unhoused population, but that they also have much more significant medical complexity. And so staying longer doesn’t mean staying longer inappropriately. It may often mean that they’re staying longer because they’re just that much more medically complex.

But what we do know is the return to emergency department visit upon discharge is about a 50% return to emergency departments within 30 days of being discharged, 40% within 15 days. And so that’s a lot of people who are not only using care, but being discharged and immediately coming back within the month, [surely], the same condition for more care, which means we did not achieve our goals of that admission. So that becomes costly too, where one type of issue might take 3 or 4 admissions to actually resolve. So it probably is actually even that much more expensive per issue.

Avis Favaro

Yeah. It doesn’t sound like a good use of resources, does it?

Andrew Bond

It is not. And I think what we have found, and this is the really fundamental issue, and something that continues to teach me, is that when one does not have a stable or safe home, you physically cannot follow public health guidance, for example.

And so we know that for all kinds of conditions, resting your legs, staying off of an injury, if you’re in a shelter where you are forced to leave in the morning, come back late at night, you can’t do any of those things. If you’re on the street, you absolutely can’t do that, wound changes, taking medications. You’re speaking of people being robbed, for example. Having medications often get stolen. So these are real challenges.

And it’s amazing how quickly everything about health care gets disrupted if you actually don’t have one. And so our challenge in the work for us now is trying to figure out how to mitigate and reduce that damage to make it easier to have better quality and better outcomes of health care, while we, at the same time, work to ensure that we get people housed.

Avis Favaro

Related to that, among the ºìÁì½í¹Ï±¨data was that 93% of the people who were without a home end up going to the hospital through the ER. And what does that tell you?

Andrew Bond

We know that 6 million Canadians right now are suffering without access to primary care/regular physician, let alone those who, for physical and social and medical reasons, may not have access as well. Means you have no other meaningful alternative, and that much of our primary care system has been designed with an idea of, quite frankly, middle to upper class social lives — are able to actually use centre-based care.

But there will always be a sizable group and population in the country who that form and that model of care is just not appropriate for their social lives. And it isn’t realistic in terms of being able to deliver on their needs. And so that’s why, for example, we go out and deliver care on the streets, in shelters, and drop into community agencies. We build health care into the existing community spaces because that’s where people already are.

ºìÁì½í¹Ï±¨ care has to go to people. We have a very, at bottom, paternalistic system that not only says follow the doctor or nurse’s orders but, also, you come to us and we provide care. For a large number of people, that actually doesn’t make any sense. And we can actually provide more efficient, more cost-effective care and more high-quality effective care by doing it differently.

And so there are groups of us who are doing this across the country, but as the numbers are showing, as you’ve referenced, for 93% of people who are unhoused, they don’t have that kind of care yet.

Avis Favaro

So your teams physically go to where they are living, the encampments, to help them. Do you find that that is helping enough to reduce the stress on the health system? On the hospitals?

Andrew Bond

So the question of, did you avoid emergency department visits? The answer is yes, all the time and every day, because every single encounter would have happened in a different way. And it would have happened in the emergency department, to your point around the data.

What we are doing right now is trying to build up not just a group of isolated outreach activities, but build an entire integrated system of care that goes across, and we use one electronic medical records, for example, across the entire homelessness system to connect all of our providers together, whether that’s primary care physicians, psychiatrists, pediatricians, nurse practitioners, and nurses, all within an integrated way, across the whole system, that includes mobile teams and sort of set outreach teams.

Avis Favaro

How do you stop your heart from breaking when you see these people, and you see the system, and you see how it’s difficult to solve?

Andrew Bond

You don’t try to avoid stopping having your heart broken. I think having your heart broken, day in and day out, is what you need to do to motivate you to keep going and to never stop, is the first part. And the second part is, hey, as long as we are not the ones experiencing being unhoused, we have the privilege and the responsibility, I would say, particularly because I’m [proving] is a collective failure and a responsibility to do something about it.

And this happens to be an area where we can do a lot. There are some intractable social problems that are extremely difficult, if not maybe impossible, to fix. This is not one of those. This is one that we actually do know what are the things that we need to do. And we actually happen to know that it’s cost efficient to do it.

Avis Favaro

If you had to whittle it down to the 3 things, in order, that need to be done to reduce the number of people who are living in tent cities being evicted, what would be the 3 things, in order, that you would want to see done in the next year or 2? Or sooner?

Andrew Bond

I so rarely get the opportunity to dream quite that big. The first would be to ensure that the range of available, affordable housing that’s appropriate for many of the communities who are unhoused is created. That means social housing. It means co-op housing. We have one of the lowest ratios of social and co-op housing to market housing of almost any OECD country.

So it’s not just with a national housing strategy, are you building more and bigger, but you have to make sure that you’re building the right things for the right people with a priority on those who are unhoused or significantly underhoused. So that would be number one.

The second part is we need to make sure that our health care system is an equal player in solving the housing crisis, that health care and housing here in the work that we do is inextricably intertwined. It is good for people. It’s good for the communities. It’s good for housing. It’s good for the health care system. And it’s good for public government budgets.

And the last one is bigger, but it’s across the board, which is that we can’t forget to the vast majority of folks who become unhoused, it’s because of broad, sweeping affordability crisis that we’re facing right now.

And so the vast majority of new unhoused individuals are those who are just making it above the poverty line and hit a crisis and hit an acute situation, whether it’s a family issue, a loss, a job loss and, all of a sudden, have nowhere to go, and they realize that they’re — that is where the vast majority of folks are coming from.

And so we have to do better to not just have plans that protect the middle class. We actually have to make sure that we have those who are in lower income are actually buffered against that protective space.

And so we did that with CERB, for example, during COVID. We need to start looking at what are the acceptable features of safety nets, because getting it wrong and doing it badly is certainly bad for the community, bad for public, but it’s horrendously costly at the same time.

Avis Favaro

Thank you so much, Dr. Bond. Really appreciate your time explaining it. And best of luck with getting your 3 wishes.

Andrew Bond

Thank you so much, Avis. Appreciate it.

Avis Favaro

The men and women I spoke to around the encampment were very clear about one thing. What would you need to have a better life?

Unhoused female

Oh, just a house, a place called my own.

Avis Favaro

And across the country, solutions are being proposed and enacted with programs to build tiny homes at no cost to those in poverty, outreach programs, even tests of unconditional cash transfers of $7,500 in BC to reduce homelessness.

And in Alberta, there’s an innovative program that’s gaining a lot of attention using those emergency room visits by people without homes to turn their lives around.

We’re joined now from Edmonton by emergency physician, Dr. Louis Francescutti. Welcome to the show.

Louis Francescutti

Thank you.

Avis Favaro

So I’d like to start at the beginning with what you’re seeing in Edmonton. And I understand that last year alone, your hospitals treated some 9,000 patients who had no fixed address, who were homeless. That sounds like an incredible number. Is that right?

Louis Francescutti

Well, that represents the number of patients that we’re seeing in all the emergency departments. If you take a look at the overall visits, we know that in Edmonton the visits increased from 13,000 — I’m just checking the numbers — to 17,000. So there was a 49% increase.

Avis Favaro

And that’s over what period, that increase that you were quoting?

Louis Francescutti

Over a one-year period.

Avis Favaro

One year? Does that surprise you?

Louis Francescutti

No. It doesn’t surprise me because I work in the emergency department, and I see it on a daily basis. So if I go in at 6 o’clock in the morning for my 6 o’clock shift, there’s at least 12 to 15 patients that have spent the entire night in the waiting room, not complaining because they’ve got a warm place to stay, to be seen in the morning.

And for some of these folks, are folks that we know by name because they come so regularly, and that’s not their fault. They have no other place to go. The emergency department is society’s last line of defence. What we do is we provide that 24/7, 365. Our door is always open. We’re not going to turn you away. Look, these are our sickest patients, and they are.

Like that 46-year-old gentleman I saw about a week ago who came in with his wife, and he was in a room, and when I opened the door, the smell was really terrible. And he said, hey, Doc, sorry, I didn’t warn you but, yeah, something stinks pretty bad. He goes, I think it’s my leg. And his wife had done up a bandage on his lower leg, his left leg. And when we took the bandage down, all we saw was pretty well a rotten, swollen, festering leg.

And I said, what happened? And he goes, well, you know, I broke a bone in February of this year, and they put me in an air cast, but I’m homeless. And so I’ve just been wandering the streets trying to take care of it, and it got infected, and it doesn’t look too good, does it, Doc? And I said, no, it doesn’t look good at all. And he goes, uh, it’d probably be easier if you just cut it off.

Well, you know what? After plastics came and after orthopedics came, that was what’s going to end up happening to his leg. And they’re going to have to amputate it below the knee, simply because he had no place to stay.

And so the old notion that hospitals stop where the boundary of the hospital is, and they don’t go into the community, those days are over because providing housing and providing continuing care to this patient is good medicine. And it makes absolutely no sense that they show up in emergency and get top-level care, and then the best we can do is put them right back out on the street again. There’s actually a term for it. It’s called treat them and street them.

Avis Favaro

Treat them and street them?

Louis Francescutti

Yeah. So it’s causing great moral distress amongst not only nurses, but social workers and doctors and everyone that works in the emergency department.

Avis Favaro

What you were referring to is a fairly young homeless man and his spouse. Both of them were homeless?

Louis Francescutti

Yeah. I try not to press it because they’ve got pretty well limited bandwidth when they’re in that situation. So someone that’s living in homelessness is basically addicted to chaos. Their life is just one chaotic event after another, trying to survive.

Avis Favaro

So the health teams, the hospitals are clearly trying to do their best to patch them up. And in most cases, they can’t keep them, so they discharge them. But there’s that treat them and street them. How do you stop that cycle?

Louis Francescutti

ºìÁì½í¹Ï±¨ care facilities in Canada today should not be allowed to discharge a patient into homelessness. There should be a standard that says if you show up in a health care facility in Canada, you will not be discharged back into homelessness.

Now health care administrators are going to go, what the heck? How the hell are we supposed to deal with that? Well, deal with it. We’ve dealt with it. We’ve shown you that it can be done. Now do it. Because otherwise, what ends up happening is you create a revolving door that costs the system an enormous amount of money.

It’s estimated that for a homeless patient, it’s $160,000 per patient per year. And so you take that 35,000 visits that we’re seeing and you multiply it by 160,000, you’re in the billions of dollars. So you’re going to spend the money sooner or later. Spend it in the right way.

Avis Favaro

And is that what drove you to the moment where you said we need to do something?

Louis Francescutti

No. It just — after a while, you sort of scratch your head and you go, this isn’t working, and there’s got to be a better way to do it. I teach an advocacy class at the university and our students pick a project every year to work on. And about 4 or 5 years ago, the project they picked, with a little probing, was on how to better care for patients experiencing homelessness that show up in the emergency department.

And so we came up with this idea. And then what happened was we looked for community partners. And Jasper Place Wellness in the west end of town had come up with a novel concept of 3 buildings with only 12 units in each, and that’s based on the Eden model. And so it looked like maybe this is a possibility of what I’m looking for. And that’s the genesis of how we came up with the idea of doing it and doing it very differently.

Avis Favaro

You’re talking about the creation of the program. And I think the formal name is Bridge Healing Transition (sic) [Transitional] Accommodation Program, but you call it Bridge Healing.

Louis Francescutti

We call it Bridge Healing for short. Yeah.

Avis Favaro

So explain, how does this work?

Louis Francescutti

So it’s very simple. You show up in emergency, and I have a conversation with you and I find that you’re experiencing homelessness. So I just ask you, we’ve got this program that, if there’s a bed available, I can get you to right away and help you move on and find permanent supportive housing. You get your own room. Room and board is free. You get one warm meal a day, and then there’s food in the pantry that you can make your own meals. I said there is 11 other clients, and there’s workers on-site. And we’ll send you there by cab with your permission and then start you on your road to recovery.

And, yeah, the majority of them will say yes. And so then we call a cab. They go over. They’re welcome. They’re shown to their room, and they can sleep for a day or 2 to catch up on their sleep.

And then when they come back down, we have a checklist. Do you have ID? Do you have a bank account? When was the last time you had a place to stay? What sort of place are you looking for? Would you rather try and go back to — if you’re First Nation — to your First Nation community? Or would you rather go back to a community where you have more support? Here’s the rules of the house. Let’s get started.

Avis Favaro

So how many people have you put through your Bridge Healing program so far?

Louis Francescutti

We’ve probably put about 120. And for the ones that go through and get permanently housed, there’s an 85% reduction in return visits to emergency, which is pretty amazing.

And even for the ones that don’t stay the full length to find permanent housing, there’s a 35% reduction because we’ve been able to find ID for them, we’ve been able to help them get started. And for a lot of them, they’re just not quite ready yet.

Remember at the beginning, I said these folks are addicted to chaos. And all of a sudden, they find themselves in an environment where we’re not peddling religion. We’re not peddling anything. It’s a safe environment. Nobody’s abusing them. And for a lot of them, that’s like too much to go from utter chaos to a structured, caring, warm, safe environment. And it just — it’s just not the right time for them. And that’s perfectly fine. They can come back again whenever they’re ready.

Avis Favaro

If they do come to Emerg, and you try to give them medications or follow-up appointments, when they’re homeless, they have no way of accessing regular appointments.

Louis Francescutti

It’s a little complicated sometimes to just figure out how you’re going to get your medicine, how you’re going to pay for it, how you’re going to take it, how you’re going to make sure it doesn’t get stolen from you, or you lose it or you forget it somewhere. Life is pretty rough on the streets. But for a lot of them, they don’t survive. They die on the streets, homeless.

And those numbers have gone up quite considerably. I think there was an 800% increase in the number of homeless patients that died on our streets in the last couple of years.

So, A) we do have a problem and it’s pan-Canadian. It’s not just in Alberta. B) we have a health care system that’s costing us an enormous amount of money, that’s not delivering the care that it should have. And C) these men and women show up on an hourly basis, telling us, please, I’ve tried everything else. I can’t get help anywhere. You’re my last line of defence. Can you help me? And if all we do is put on a bandage, give them a sandwich and a fresh pair of socks, and put them back on the street again, then we’re complicit in this poor care.

Avis Favaro

I hear 2 emotions. I hear sadness, and I hear anger or frustration.

Louis Francescutti

Well, you’re hearing 30 years of I’ve done the best I can, and it doesn’t seem that I’m doing enough. And you’re hearing, maybe, anger housed in a little bit of optimism that, I think, with reporters like you and ºìÁì½í¹Ï±¨getting involved, with the public stepping up. Yesterday, we had a fantastic meeting at Bridge Healing with a developer who stepped up and said, hey, I’d like to build one of these for you.

And so I suspect that within the next year, we’ll probably have another 20 buildings. So 20 buildings at 12 beds, that’s 240 beds plus what we’ve got right now. We should be tipping about 300 beds, which would be fantastic, so that every patient that shows up at Emerg, that’s willing, will have a place to go.

Avis Favaro

You mentioned that there are only 12 units, and that’s the Eden project you mentioned. Why? Why 12?

Louis Francescutti

If you put 8 to 12 adults together, what ends up happening is they form an instant community or an instant family. And we’re seeing it. There’s always somebody that wants to cook. There’s always somebody that wants to organize the karaoke night. And if you make the building far bigger than that, what ends up happening is they isolate in their room, and that’s bad. Once you have people that are isolating in their room, that’s where there’s increased likelihood of using drugs or increased likelihood of all sorts of bad things happening for them.

And so the building is 3 stories. The main floor has got a common area, a common kitchen, all the computing and entertainment that they need, and laundry facilities. And then the second and third floor each have little 6 suites per floor that are all wheelchair accessible.

But what we’re finding is people spend most of the time on the main floor. And on the main floor is where they start forming that bonding and finding that they have more similarities than differences and starting their path to recovery. And it’s beautiful. I was there yesterday, and you can just see them laughing and enjoying themselves. And if someone has a bad day, there’s enough of them around that I’ve had that experience and they’ll comfort the individual. But they’ve got to work towards finding their permanent supportive housing as well.

Avis Favaro

And how long can they stay there in these residences?

Louis Francescutti

Yeah. You know what? What we’re finding on average, they’re staying between 45 and 60 days. Some stay longer, some stay shorter. So it’s realistic that they stay however long they need, based on their complexity, and that we’re not pushing them out the door too quickly. Right?

And they don’t pay a thing. Like our Alberta ºìÁì½í¹Ï±¨ Services pays the operating costs of the building. We have to go find the funds to raise. But our city pays about 25% the cost of the building, and now there’s some federal and provincial funding, and donors step up as well.

Avis Favaro

This must be a burden for you that you’ve turned into a sense of hope with your project.

Louis Francescutti

Yeah. No. I’m really enthused because now that we’ve got a year under our belt, and we’ve shown that it works, we’ve got the attention of policymakers. And now, various ministries are coming to us saying, hey, how can we be part of the solution?

Avis Favaro

What do you see? You have any stories from homeless to someone who has a home?

Louis Francescutti

Yeah. Probably the most famous one was the third person that ever went into Bridge Healing. I saw him in emergency and I said, wow, man, you would be the right fit for this project. Would you be interested? And he goes, absolutely. He had just lost — his family broke up. He had problems drinking, lost his job, lost his dog. I’ll never forget how he was so sad about that.

But he went, and then I followed his journey. And then, not only did he, but 2 other guys that were there become such close friends, they moved into the same apartment to remain together. They all found jobs. And he actually comes back to Bridge Healing to volunteer and just talk to people and say, hey, I went through this. I’m doing okay. Hang in there. It’s going to work out for you.

That was worth it. And I envision the day that I can build enough of these that people can actually walk to them off the street, knock on the door and see if there’s room. And if there is, then they just go straight into them, and they don’t go through the emergency department or call an ambulance.

And shelters are good, but shelters need homeless patients. So what we need to do is break that model. And our building costs are a fraction of what they normally are. And we’ve got developers. Actually, one very generous woman stepped up and bought all the remaining lots we had. And she’s going to build them for us and we’re going to buy them back from her. So there’s a lot of good people out there. I mean, I should have retired years ago, but now it’s hard to retire because we’re on a roll, and I don’t want to lose the momentum.

Avis Favaro

You think it could work across the country?

Louis Francescutti

Yeah. I’m worried about Alberta. The rest of the country has got to step up and say they want to do something about it. But if they’re willing to learn, we’re more than willing to share what we’ve learned.

Avis Favaro

Wonderful. Thank you so much for your time, Doctor. I really appreciate it.

Louis Francescutti

Yeah. My pleasure.

Avis Favaro

A final note. Canada does have a national Homelessness Strategy program that’s aimed at preventing and reducing chronic homelessness by 50% by 2027.

And you can find much more data on hospitalization among those experiencing homelessness on the ºìÁì½í¹Ï±¨website. That’s C-I-H-I dot ca. Thank you for taking time to listen in. And remember, there’s a story behind those who you see living on your streets.

Our executive producer is Jonathan Kuehlein, production assistant Heather Balmain, and a shout-out to Alya Niang, the host of our French show. And please subscribe to the CHIP wherever you get your podcasts.

I’m Avis Favaro. Talk to you next time. 

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