A Framework for Developing an Integrated Shelter Health Model in a Mid-Sized Community: The Windsor Shelter Health Experience.

Windsor Shelter Health is an integrated program that offers comprehensive on-site medical services at shelters and drop-in centres for people experiencing homelessness in Windsor, ON. Although homelessness exists in most Canadian communities, there is more understanding of homelessness responses in larger urban centres. Windsor is a mid-sized border city in southwestern Ontario. Here, we explore the structures and processes that have been used to build a shelter health model in a city of this size and some early outcomes. Examples of these include a thoughtful governance structure, a shared electronic medical record, co-location of services, embedded research and educational programs, sustainable funding sources and collaboration between partners. Using this model, we were able to divert patient visits from the emergency department to be better managed in an outpatient setting, increase patient attachment to primary care and create novel avenues for education for both learners and staff in Windsor. Therefore, we demonstrate why these are essential components of this new program, and how other mid- and smaller-sized cities might incorporate these elements into their own shelter health programs.