Originally appeared in the Toronto Star on February 24, 2025: A Toronto hospital network opened Dunn House to help homeless ER patients. Now they’re expanding the model – The Toronto Star
When a new housing project opened in Parkdale last year, offering homes with health supports to homeless Torontonians who frequented emergency rooms, enthusiasm was tempered only by its scale. With just 51 homes, it paled against a homelessness crisis that has ensnared more than 11,000 people across the city.
But the approach taken at Dunn House will soon extend beyond its doors — not by replicating the brick-and-mortar development, but by extending the same kinds of health supports to people moving from homelessness into existing housing around Toronto.
The $2-million expansion to the University Health Network’s social medicine program, revealed exclusively to the Star, will extend health and social services from psychiatry to nursing and personal support care to up to 100 people leaving homelessness in the coming year.
Physician Andrew Boozary sees the project, in partnership with social agency LOFT Community Services, as a chance to further prove their strategy — which looks to help individuals with complex medical and social needs move out of shelters, encampments or hospital beds and into stable, long-term housing. It’s an approach he sees not only as more cost-effective, but healthier for their patients and less straining on public systems.
“Knowing there’s real desperation out there, we tried to look at different funding models or supports that can be rapidly mobilized,” Boozary, executive director of social medicine for the hospital network, said in an interview. “The reality is, there needs to be more access than just 51 housing units.”
The expansion model creates a kind of portable supportive housing. Traditional supportive housing — whether specialized sites like Dunn House or others that were built before it — starts with affordable housing units and adds on-site services, such as health care for those dealing with mental illness or addiction.
The new project will provide the same kind of supports in existing housing where intensive services are “not funded or available,” Boozary said, noting they could be available for residents in both public housing units and other available rental homes.
Despite the steep upfront capital costs of new buildings, officials have increasingly pointed to supportive housing as a key ingredient in tackling the city’s homelessness crisis, with a lower operating cost than shelters or hospital beds. But recent efforts to increase supply haven’t yet been enough to change the tides. As of August 2024, more than 28,000 individuals were on Toronto’s supportive housing waitlist, with more than 4,200 added in the last fiscal year while just 326 were housed.
This expansion will have the advantage of speed, Boozary said, skipping a construction phase by offering supports in homes that already exist. Interventions can’t come fast enough, he argues, pointing to public health data that shows the median age of death for homeless women in the first half of 2024 was just 36 years old, and 50 years old for homeless men.
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The individuals receiving support will be selected similarly to residents of Dunn House, the hospital network says. Starting with a list of patients who frequently wind up in the emergency room with what are considered “complex” medical and social needs, officials will then consult city-held data, which can include the amount of time a person has been homeless. The program will have an “emphasis” on older adults, the hospital network says.
“These are the type of solutions we need if we are serious about ending the homelessness crisis that is affecting far too many, especially older adults that have nowhere else to go,” LOFT CEO Heather McDonald said in a statement.
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In a city where long-term affordable and supportive housing is in short supply, the hospital’s model isn’t the first to deploy more portable assistance. Facing enormous need for regular subsidized housing without supports — with more than 100,000 households on that waitlist — recent years have seen the federal and provincial governments jointly fund a portable rental subsidy program called the Canada-Ontario Housing Benefit, which covers the difference between market rent and what a household can afford. Both models, as Boozary sees it, were born from similar frustration and need for workarounds.
The expansion effort will include a study of the strategy’s effectiveness, he added, conducted alongside homelessness researcher Vicky Stergiopoulos at Toronto’s Centre for Addiction and Mental Health. It’s the kind of evidence Boozary sees as essential make their case for more funding and scale up their approach.
“There needs to be the evidence when we’re talking about such an important policy issue — one that is affecting tens of thousands of lives every night.”