The Care Bus is a mobile outreach and harm reduction program operated by NorWest Community Health Centres (NorWest CHC). The program provides a safe, lower barrier space for people to warm up, connect with trained outreach staff, access harm reduction supplies and travel to essential services across Thunder Bay. Its flexible model allows staff to respond to changing weather conditions, emerging community needs and rider requests in real time. See the case study about the Care Bus for more information on how the program works.
In partnership with community organizations, the Care Bus supports pop-up events held across the Thunder Bay community (e.g., at warming centres, emergency shelters, health centres). These events bring multiple activities (e.g., testing for sexually transmitted and blood-borne infections [STBBIs], sexual health and harm reduction education) and services together in one accessible space for people who may face barriers to accessing traditional care.
Why did the program start?
The pop-event events were started to make connections to healthcare and wraparound services (e.g., health, social, self-care) more accessible to community members. Pop-up events use the infrastructure of the Care Bus to ensure that community members are aware of, and able to access, these flexible, lower-barrier events. The services provided at the pop-up events are informed by what community members say they need and can respond to service gaps and health trends (e.g., increases in STBBIs) in the community in real time.
How do the pop-up events work?
Pop-up events happen in partnership with the Care Bus and local community organizations including warming centres, lunch programs, emergency shelters and health centres. Pop-up events take place monthly at indoor locations during the winter months. They are open to anyone, although they are usually center the community members who attend the organizations where the event is taking place. Events use a flexible approach, and services can be tailored for each event on the basis of the participating partner’s availability, capacity and identified community need.
Pop-up events are advertised by the Care Bus and partner organizations. The best method of advertising is often word of mouth on the Care Bus on the day of the event.
Services offered
Pop-up events offer a variety of health and social services, including wraparound healthcare and well-being activities. This can include walk-in nurse practitioner services, sexual health education, identification clinics and referrals to other community-based services. Events have various stations that participants can move freely between, choosing the activities and services they want to engage with. Events usually include services in four areas: healthcare services, wraparound social supports, self-care services and food services.
All events offer STBBI testing, including both point-of-care testing and confirmatory blood work. Other services may include:
- identification clinics (e.g., applications for birth certificates, health cards and status cards)
- sexual health and harm reduction education, harm reduction supplies and overdose prevention (e.g., safer drug use kits, naloxone, safer sex kits)
- financial assistance and housing applications
- hot meals and snacks
- haircuts
- tuberculosis education and contact tracing
- foot care (e.g., callous debridement, fingernail care, foot-care packages)
- walk-in nurse practitioner services (e.g., diabetes testing, wound care, mental healthcare)
- sexual and reproductive health counselling (e.g., contraception, menopause, perimenopause)
- referrals to additional health and social support services (e.g., substance use treatment services, primary healthcare)
- culture- and arts-based activities
- elections and voter registration support (e.g., verifying voter registration status, advising on how to complete attestation forms)
Based on an approach used at the public health unit, cash incentives are provided for STBBI testing, including $5 for point of care tests and $5 for confirmatory blood work. There is high demand for the cash incentive and STBBI testing, and community members are therefore seen on a first-come, first-served basis.
Supplies for pop-up events (e.g., testing supplies, safer drug use kits) are provided by a mix of partners and organizations who take turns providing supplies on the basis of who is hosting the event and resource availability. Public health nurses bring the supplies needed for STBBI testing, and incentives for testing are provided by an organization that has the capacity to do so (often the public health unit or NorWest CHC).
Staffing
Pop-up events are staffed by workers from the community partner organizations that are hosting the event, nurses and nurse practitioners from the local public health unit, systems navigators, community health workers and outreach workers from the NorWest CHC, and a program coordinator from the Care Bus. Staff from partner organizations may include counsellors, mental health specialists, social workers, clinical staff and other allied health and community support staff depending on the services offered. Staff from partner organizations greet community members as they enter the event and guide the flow of participants. Care Bus outreach workers circulate and assist with the flow of participants during the event. The Care Bus coordinator leads the organization of pop-up events. Nurses provide STBBI testing and other health services (e.g., foot care, TB contact tracing).
Partnerships
There is a well-established network of community-based organizations that work together in Thunder Bay to serve community members, and these partnerships are essential to the organization of pop-up events. Pop-up events utilize established Care Bus partnerships in the community to identify organizations to host the events. Since the Care Bus moves around the community and visits different locations and organizations, it has great recognition among community members and organizations, which assists with partnership development. Examples of partner organizations include the People Advocating for Change through Empowerment (PACE) Warming Centre, Grace Place and the Mindimooyenh Health Clinic by the Ontario Native Women’s Association. The Care Bus partners with organizations that offer social gathering spaces, even if they don’t provide health services, to increase access to care and bring health and other supports directly to where people already are.
Contact information
NorWest Community Health Centres
525 Simpson Street
Thunder Bay, Ontario
P7C 3J6
807-626-8487
info@norwestchc.org