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Heavy Users project to examine service trends of city's most vulnerable persons

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Improving the lives of Edmonton’s most vulnerable persons is the primary objective behind the Heavy Users of Service project, an initiative being undertaken by multiple stakeholder organizations.

Over the two-year span of the project, a working group that includes social service providers, first responders, justice, aboriginal and government representatives, will monitor some of the city’s most frequent users of social, medical, criminal and justice services with the goal of identifying and bridging gaps in service provision and treatment.

“More than a year-and-a-half ago, EPS commenced discussions with the community and stakeholders regarding the need to re-examine how we could develop a more comprehensive continuum of care for our complex clients,” said EPS Chief Rod Knecht.

“Our initial discussions focused on a concept called the Assessment, Sobering and Care Centre, which later evolved in to the Heavy Users of Services project. The objective of this working group of 16 stakeholders is about improving the quality of life for our most vulnerable citizens, the broader community and finding efficiencies in the delivery of services provided to these individuals.”

The HUoS project will create and implement monitoring processes, systems, structure and policies around the identification of those at greatest risk to themselves, to others and to the community.

Once the project has identified a system gap or an area for improvement, the issue will be explored in more detail, before options are proposed. These options will be reviewed and addressed by the respective agency(s) and/or by the appropriate level of government(s)

The intent of the project is to collaboratively help precipitate the individual’s healing and recovery, explains Jay Freeman, Co-Chair of the HUoS working group.

We know that a relatively small proportion of Edmontonians, often homeless and with mental health and addiction issues, frequently access the social service, health and criminal justice systems,” said Jay Freeman, Co-Chair of the HUoS project.

"Through this collaborative effort we will improve our understanding of people with complex needs and how the systems must evolve to address those needs, ultimately improving the quality of life for our most vulnerable citizens.”

The HUoS working group developed a set of criteria to select a number of vulnerable individuals who are the greatest draw on Edmonton’s social, health and justice services. A personalized case plan will be developed and executed, which will assist in the gathering and analysis of information throughout the project.

By tracking these individuals over a 12 to 24 month period, information, gaps, overlaps and strengths can be identified in the existing models.  Results will be used to improve the collaborative system employed to support vulnerable persons.

The HUoS stakeholder group is comprised of Alberta Health Services, Alberta Human Services, Bent Arrow Traditional Healing Society, Bissell Centre, Boyle McCauley Health Services, Boyle Street Community Services, the City of Edmonton, Edmonton Homeless Commission, Emergency Medical Services, the Edmonton Police Service, George Spady Centre, Homeward Trust, Hope Mission and REACH Edmonton Council for Safe Communities.


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