Why shelters are integrating health care

Over the past several years, many shelter providers have learned an important lesson: health care needs to be part of the shelter system.

People arriving at shelter are frequently managing serious physical health concerns, untreated injuries, chronic conditions, mental health challenges, or addiction.

So often, homelessness and health needs overlap.

At the same time, these community members are hesitant to approach or struggle to navigate the health care system. When someone is living without stable housing, even basic medical care can be challenging to access and even more difficult to maintain.

Over the past several years, we’ve learned that integrating health services directly into shelters can make a significant difference.

When care is available in the same place where people are already seeking safety and stability, it removes barriers to healing. People can access treatment earlier, receive consistent care, and connect to longer-term supports.

That realization has shaped the way many shelters operate today.

Building health services inside shelters

At Hope Mission, we’ve seen this shift firsthand.

In 2020, our health services began with a team of three nurses. Today, that work has grown into HopeHealth — a clinical team of more than 50 staff members serving six shelter sites in Edmonton, Wetaskiwin, and Red Deer.

HopeHealth includes nurse practitioners, social workers, registered nurses, licensed practical nurses, healthcare aides, paramedics, and other professionals working together to provide compassionate, barrier-free health and social supports for people experiencing homelessness.

Shelter today is about more than simply providing a warm bed and a hot meal. They are often the first point of safety and stability for people experiencing homelessness. When health services are integrated into that environment, it becomes much easier for people to access care and begin addressing urgent needs.

In practice, that integration means bringing medical care directly into the shelter environment.

What integrated care looks like

One example of this model is the 110-bed health shelter at the Herb Jamieson Centre in Edmonton. The health shelter provides 24/7 medically supported shelter care for individuals who are medically stable but still require ongoing health support.

This type of stabilization environment fills an important gap in the health system. Many people are discharged from hospital—with no home in which to recover—before they are fully ready to manage their health independently.

Through our partnership with the Royal Alexandra Hospital (RAH), patients who are medically cleared but unhoused can be transferred to the health shelter, where they can continue recovering in a supportive environment. Our teams also provide transportation and work with health access navigators embedded in the RAH’s emergency department to help connect patients to housing supports, income assistance, identification services, and recovery programs.

HopeHealth teams also operate low-barrier walk-in clinics within our shelters, providing services such as wound care, frostbite treatment, general health assessments, and connections to community resources. Treating issues early helps prevent more serious complications later and helps build trust with people who may have struggled to access traditional health care.

Rapid response teams are another part of this integrated approach. Operating around the clock at our downtown shelters, these teams respond immediately to overdoses and other medical emergencies while also helping connect individuals to detox, treatment, and recovery services when they are ready.

The focus is always the same: provide care, then help people take the next step forward.

Stabilization and the path forward

Shelters are not hospitals, and they are not designed to replace the broader health care system. But they can play an important role in stabilization.

Without health supports integrated into shelters, people often cycle between the streets and emergency departments. When care is available where people already feel safe, it becomes easier to address health concerns earlier and connect individuals to the supports that move them toward stability.

At Hope Mission, we continue to analyze the data from our programs to better understand where the gaps remain and how these partnerships can grow. Looking ahead, we hope to expand the health shelter model, add physicians, and strengthen partnerships with other providers like pharmacists, optometrists, and dentists. As our services expand, they’re outgrowing our facilities, so we also need to develop additional physical space to meet the need.

Shelter today is about more than a place to sleep. When shelters connect people with health care, housing pathways, and recovery supports, they become an entry point to something much more important: the opportunity to stabilize, rebuild, and move forward.