HT REPORT _WEB_singlepage

Maddern Square, Footscray
The Friday BBQ, Footscray
Part 2: Key Learnings on Delivering Health Time
1. Resources
2. Systems and Processes
3. Sustainability
4. The Cumulative Benefits of Health Time
Acknowledgements
Acknowledgements
Introduction
Part 1: The Seven Health Time Programs
St Peter’s, Eastern Hill
St Brendan’s, Flemington
The Gatwick, St Kilda
Half Moon Caravan Park, Brooklyn
Gronn Place, Brunswick West

The Steering Committee comprising representatives from VincentCare
Victoria, Inner South Community Health Service, Cohealth (the former
Doutta Galla and Western Region Community Health Services) and
the Victorian Department of Health would like to acknowledge the
contributions to this project and Health Time programs made by:
• Anglicare Victoria Homeless Support
Services
• Avalon “The Moving Wardrobe”
• Baptcare
• BridgingWorx
• Cohealth (Community Connections
Programs and Outreach Allied Health
Team based at the former Western
Region Community Health Services
and Doutta Galla Community Health
Services)
• Clarendon Community Mental Health
Services (CMHS)
• Cultivating Community
• Good Shepherd Family and Youth
Services
• Homeless Outreach Mental Health
Service
• Inner South Community Health Service
(Community Connections Program,
Outreach Physio and Podiatry. Drug and
Alcohol Outreach, Insecure Housing
Worker, Dental Outreach, Outreach
Health Nurse, Midwife and Sexual
Health nurse, Assertive Mental Health
Outreach)
• Merri Community Health (Allied Health
and Healthy Ageing Demonstration
Project)
• Moreland City Council
• Public Interest Law Clearing House
Homeless Persons’ Legal Clinic
• Royal District Nursing Service (RDNS)
Homeless Persons Program (HPP)
• Royal Women’s Hospital Well Women’s
Clinic
• St. Peters Eastern Hill Anglican Parish
Church
• The Gatwick Private Hotel Proprietors
• The Half Moon Caravan Park Proprietors
• VincentCare Victoria ( Community
Connections Program and Access &
Support Program)
• Wintringham Over 50’s Club

T
his project grew from discussions in 2012
between VincentCare Victoria and the
Victorian Department of Health North
and West Metropolitan Region office about
VincentCare’s efforts over the previous few
years to connect people experiencing or at
risk of homelessness to primary health services
using a model called Health Time Days. The
Victorian Department of Health North and West
Metropolitan Region office was able to signpost
VincentCare to Community Health Centres who
were also taking a leadership role in connecting
people experiencing or at risk of homelessness
to their primary health services through similar
models some that used the “Health Time” label.
The North and West Metropolitan Region Office
was also able to support the funding of a project
to create an account of several similarly focussed
programs both to describe the impacts and
workings. This project has achieved some key
learnings through an analysis of the common
and differing factors surrounding these Health
Time programs that aid their initiation and enable
them to be sustained as well as articulating the
beneficial impacts and risks.
A steering group formed was from among the
agencies who were invited to participate in the
project and included representatives from the
Victorian Department of Health. The steering
group has both provided oversight to the
project as well as acted as an important point of
reference to support the project and analyse
the findings. VincentCare Victoria assumed the
overall responsibility for managing the project.
This report describes a flexible outreach model of health service delivery
called ‘Health Time’, and summarises the key learnings from seven Health
Time programs operating across Melbourne.
Two key specialists were engaged, Peter
Feldman, and Mick Cummins. Peter
Feldman, specialises in human services
program assessment and evaluation and had
undertaken previous evaluation projects with
VincentCare around both Health Time and
place-based engagement and services access at
VincentCare’s Ozanam Community Centre. Mick
Cummings (Hand in Hand Productions) has been
involved in the production of a number of video
documentaries focussing on homelessness (e.g.
Len’s Walk) as well as the work of Homelessness
Agencies. The steering group were pleased that
a working partnership conducive to the project
quickly developed between the two specialists
and with the steering group. Most importantly,
they both demonstrated sensitivity and respect
for the people and programs whose stories
were being told and put in front of the lens and
which is subsequently evident in the material.
The primary intended audience for this
resource (this report and the companion
video documentary) are Community Health
and Homelessness Services who together with
other interested health and welfare agencies
would like to find out more about commencing
similar programs of flexible service outreach to
highly marginalised or deeply disadvantaged
people. The settings for this outreach include a
range of marginal accommodation types such
as caravan parks and rooming houses, semi-
private community facilities and public open
spaces where people visit for a meal, company,
recreation, or simply to pass time.

Ultimately, there is one overall purpose for
undertaking this project – to promote the
Health Time model. The first audience are
the aforementioned Community Health,
Homelessness and allied human services
agencies. This resource is intended to whet
the appetites of services that are interested in
‘assertive outreach’ as a means to otherwise
engage ‘hard to reach’ clients in health and
welfare services usage.
It is hoped that a variety of funding stakeholders
form a valuable secondary audience. The
purpose of promoting the Health Time model
to this audience is to enable them to also gain
a valuable first impression of a model which
the material demonstrates is capably delivering
services on the ground and in a manner that is
an effective low-cost primary intervention into
these communities.
For funding stakeholders who are interested
in answering the question ‘How do we find
and assist those people who have the greatest
need?’ this resource demonstrates how this
can be undertaken through the described case
studies. It also demonstrates that the solutions
are not necessarily dense and large scale - but
that well targeted, regular and reliable delivery
is required over a period of time to build trust
and to achieve effective engagement. It was
not the scope of this project to undertake a
social impact measurement or avoided costs
study. However, the material suggests some of
the areas where further measurement of social
impacts or avoided costs could occur in large
scale evaluation studies.
The material points to the risks that are not
insurmountable if they are well managed.
The material provides first hand evidence that
suggests that the benefits in terms of immediate
health and social impacts are very concrete – as
told by the clients and community spokespeople
themselves.
This printed resource is a companion
publication to a short video documentary
which has been developed as part of the
project. The video documentary provides
the viewer with a first hand impression
of the Health Time model and first hand
stakeholder commentary - from clients,
community spokespeople, service providers and
accommodation operators. Readers are urged to
watch this 17-minute video to fully appreciate
the environments and voices of Health Time.
The project gathered evidence about
Health Time through the review of program
documentation, interviews with lead agency
staff, clients, partnering services and agencies,
community informants, accommodation
operators and other stakeholders. It gathered
evidence through interviews undertaken to
complete the video documentary as well as
those interviews specifically used to gather
evidence for this written report.
In this resource there is a more detailed
description about each of the programs that the
project researched.
Although they all follow the same basic formula
the details of each Health Time initiative are
very different, demonstrating the flexibility and
robustness of the Health Time model.

The report is arranged in two parts. Part
one visits the Health Time programs in turn,
describing what is unique about each program
as well as focusing on one or two features that
are common to all.
Part two addresses the key issues and processes
that Health Time programs must all deal with
to function effectively and be sustainable, and
summarises the benefits for Health Time clients
and providers.
The resource is not a ‘how to’ guide. Instead
it provides the reader with a palate of Health
Time experiences and analyses. On reading
the resource and viewing the video, the reader
will become aware of the range and details
of those issues that need to be considered
in developing the model – resources, risks,
opportunities, partnering, leadership and other
factors that increase the likelihood of ‘success’.
As such, the resource shares key learnings and
understandings that the three agencies who
came together for this project wanted other
agencies to achieve.
Health Time programs provide assertive
outreach services to people who would
otherwise fall through health, housing and
support services gaps. Their clients often
have complex needs, they may have difficulty
accessing mainstream services and they may not
fit the criteria for other outreach programs.
The primary target groups for Health Time
programs are people experiencing homeless
or at risk of homelessness, people who live in
insecure and marginal accommodation and
depending on the program, people who are
more stably housed but with complex needs.
The Health Time programs are designed flexibly
around the needs of their clientele to provide
outreach and mainstream service access across
the spectrum of health, housing and social
services.
Because Health Time clients do not readily
come to agencies, these programs take
services to where clients live or prefer to
congregate, or otherwise attract them to venues
that are local, accessible and user friendly.
The programs all provide meals, which gives
people a reason to attend in the first instance
and creates a more relaxed atmosphere for
clients to engage with workers and services.
So the basic formula for Health Time is simple:
Health Time = Venue + Food + Services
In practice, delivering Health Time programs
successfully involves substantial planning and
co-ordination, and long-term commitment from
project partners and workers on the ground.

S
t Peter’s Eastern Hill is well known to
people experiencing homelessness for its
breakfast program provided by Anglicare
Homeless Support Services every day of the
year. St Peter’s is situated at the eastern edge of
Melbourne’s CBD and can be accessed easily by
foot or public transport.
Health Time barbecues are held once a week in
an internal courtyard and an adjoining dining
room where attendees can sit, eat and socialise
or read and relax.
The program is for people who are sleeping
rough or living in marginal accommodation
such as rooming houses. Health Time sessions
provide healthy food and access to services for
40 to 45 people every Friday.
Anglicare Homeless Support Services and
Cohealth jointly manage the program, with
Anglicare providing venue-staff, food, material
aid and homelessness assistance, and Cohealth
co-ordinating the services of visiting agencies.
Anglicare provides base funding for the
program covering capital costs and venue-staff.
Visiting services include nursing, allied health
services such as dietitians and podiatrists, legal
assistance, drug and alcohol support, housing
and mental health.
Health Time at St Peter’s began in early 2012
after running for two years at a Flinders Lane
venue behind St Paul’s Cathedral. The move was
prompted by cramped working conditions and
Occupational Health & Safety concerns at the
previous site that made many agencies reluctant
to provide services there.
Since moving to St Peter’s the Health Time
event has expanded, with the number of
clients doubling, more services attending and
more types of cooked and fresh food on offer
including a variety of barbecued meats, salads
and fresh fruit.
There are no signs on the street advertising
Health Time and the passerby has little clue
of what is happening inside. Knowledge of
the event is mostly by word of mouth, which
spreads quickly amongst rough sleepers.
On entering the courtyard attendees can select
from a range of foods prepared and served
by Anglicare staff and volunteers, and then sit
among friends and acquaintances – including
agency and Church staff – to chat and eat
together. A deliberate engagement strategy at
Health Time is for workers to mingle, sit and eat
with attendees to reduce the distance between
client and worker.
Agency staff who service people experiencing
homelessness often emphasise that for rough
sleepers especially, the opportunity to sit
comfortably, relax and eat a good meal in the
company of others – something that most of
us take for granted – is just about impossible in
their normal daily life.

One St Peter’s Health Time client had this to say:
Historically when people sit down to
break bread, they break bread, you sit
down and talk and yarn and get friendly
with each other. Well, that’s what people
here do. It seems to satisfy them, like
having a feed, having a full stomach, it
settles people down once they know that
they’ve had a feed and everything. Yes,
it’s like that. Everybody’s defenses all go
down, and that we all sit down, have a
good yarn about things and whatnot. We
help each other with our problems, the
kind you get in any place, yeah.
This is the cornerstone of Health Time:
providing the opportunity for people to take a
load off their mind and body by meeting these
fundamental human needs, and creating a
moment of social inclusion where participants
may be a little more ready to engage with the
rest of the world, talk with agency workers and
have some of their health and other needs met.
The engagement process can take many
months, as one Anglicare staff member
explains:
There’s one particular fellow who has
been a client of ours for many years I
believe, prior to me coming on the scene.
He’s a fellow who’s been in and out of
housing. When we were at the other
site at St Paul’s, the Health Time workers
would come in and try to engage and he
would put up the barriers and say “no”.
We would often say to them, “don’t
keep trying to engage with him because
he doesn’t want to”. It took, I would
think, 12 to 18 months of him watching
these people coming in and engaging
with other clients until he was prepared
to have a conversation with someone.
For him to finally engage was a huge
breakthrough with him. And from that
conversation he’s now been housed.
These observations are echoed in the account
of another St Peter’s Health Time client, whose
mental state had shut him off from the world
and help that was available:
I was stressed out from work, being a
chef, and I worked in a high-pressure
kitchen in a large international hotel. My
past caught up with me and I started
to have some problems at work. I got
stressed out and then I got depressed.
In the end I just broke down. I just broke
down because of my mental problems
that I came away from home with. I lost
my job. When I got depressed I had no
communication with anybody, just locked
myself in my house probably for about
two and a half to three months. The
bills just added up. I had no income or
anything like that. I really needed some
help.
I am so glad that I came to St. Peter’s and
I ran into the nurses, and yeah, they’ve
kept me on track. I was practically about

to give everything up. One of the nurses
came up and introduced herself to me,
and I was in a really, really bad way. I
refused their services for a while because
of my mental state at the time.
So I actually sussed all the nurses out,
and I found the right person that would
do that for me, and everything. I give all
credit to St Peter’s, the staff here and the
food that they serve. Also to the nurses
themselves, the nurses that visit here and
everything. I really, really, really appreciate
the things that they’ve done, now that
I’m on track and I’m ready to go back to
work, and things like that.
St Peter’s Health Time also helps people who
are living rough with their immediate material
needs, so they do not have to wait until their
longer-term problems are solved before they
can have a shower, new clothes or a good
pair of shoes. As one of the Anglicare workers
describes:
Homeless (people), particularly the rough
sleepers, tend to spend a lot of time on
their feet and often have wet feet: wet
shoes, wet feet. So that impacts on the
condition of the hooves as it were. So
the podiatry services are useful, and the
supply of a decent pair of shoes. Real
fundamentals, you know?
C
ommunity volunteers from five different
churches get together every Monday at
St Brendan’s Parish Hall to cook and serve
lunch to anyone who walks in the door. They
have been doing this since 2009.
Cohealth began providing services there in 2012
following on from their Health Time program
that had been running at Holland Court in the
nearby public housing estate at Flemington for
the previous four and a half years. Cohealth
received 0.5 EFT recurrent funding for a Health
Time Worker following the completion of a pilot
project that established the value of Health Time
in this location.
Workers from Cohealth’s Health Time and
Active Connections Programs, and RDNS
Homeless Persons Program attend the sessions.
The Cohealth dietician and other services also
attend periodically.
Lunch at St Brendan’s is unusual because unlike
other Health Time events, the visitors are served
at tables.

Monday lunch at St Brendan’s began in
response to people calling on local churches,
missions and rectories and asking for assistance.
The lunch component of Health Time is staffed
entirely by a team of volunteers, more or less
the same fourteen people every week.
This large complement of workers makes it
possible to cook and serve a three-course meal
for 40 to 45 people, with numbers swelling
to 65 at Christmas time. The parish hall is
equipped with a full commercial kitchen, and
one of the volunteers is an ex-army cook.
As people enter the hall they are welcomed by
the volunteers and guided to tables set with
cloths, cutlery, napkins, bread and condiments.
The volunteers remember their guests’ table
preferences and friendships and seat them
accordingly. Full table service was chosen
deliberately by the volunteers for two reasons,
as a sign of respect and to enable a certain level
of control over the event:
We wanted to treat them like our guests
and wait on them rather than just
shove things at the people. Everybody
is a human being and they all deserve a
certain amount of respect. I guess that
comes from our church background.
We made that choice initially…and also,
although buffet-type meals are less labor
intensive, they are also compounded by
all sorts of potential problems.
Table service avoids those problems encountered
at self-serve buffets of all types – whether free
or not - such as jostling, overloading of plates
and food contamination. Likewise, a selection
of fruit for guests to take away is supervised by
a volunteer who ensures there will be enough
for latecomers.
The overall effect of the seated orderliness is to
create a calm and relatively quiet atmosphere in
the parish hall:
Most of them I would say enjoy it. A
good lunch and a good environment
and a lot of them, they just sit and chat
afterwards and have a cup of tea or a
cup of coffee after lunch. We all mingle
with them and try to make them feel
comfortable or welcome. There is a need
but also, let me tell you … Probably as
volunteers, we have a need too. We get a
lot from each other. The rapport between
us is fabulous. We’ve all grown to love
each other. It might sound silly but I love
every one of these people that come.
While many of St Brendan’s guests live locally in
public housing, some are known to be itinerant.
Lunch at St Brendan’s turned into Health Time
after the volunteers realised that some of their
guests were sleeping rough and they contacted
Cohealth requesting support services to attend.
For Cohealth this was an opportunity to
continue providing Health Time in the area in
association with an existing service that many
of the clients already attended. The earlier
Health Time project at Holland Court was
labour intensive because it required all food
and equipment to be bumped in and out each
session. Over time a large proportion of the
residents became more knowledgeable about
services available to them and how to access
them directly. The program was also getting less
frequent attendance by people experiencing
homelessness. The focus of the Program at
St Brendan’s has been broadened to include
aged people who have complex needs and
are socially isolated via the Active Connections
Program.

T
he Gatwick Private Hotel is one of a
few low cost accommodation houses
remaining in St Kilda, providing short and
long term housing for up to 100 people. Health
Time has been running at the Gatwick since
1995.
Twenty to thirty people attend Health Time
every second Wednesday. The sessions attract
Hotel residents and past residents as well as
transient and homeless people in and around
the St Kilda area.
Afternoon tea is held in a small dining room
adjoining the kitchen, and the event spills out
into the back lane where a ‘mobile wardrobe’
distributes clothes and a podiatrist works from a
health bus.
Health Time is coordinated by Inner South
Community Health Community Connections
Program.
Services attending Health Time include
nursing, dental, drug and alcohol, podiatry,
physiotherapy, housing for the aged, mental
health, assertive outreach and free clothing.
Some services will not attend the Gatwick due
to perceived worker safety concerns, even at
Health Time.
The concept of Health Time arose in St Kilda in
the early 1990s as a response to the needs of
hotel proprietors and the broader community,
who were dealing with large numbers of
transient people with mental health and drug
and alcohol issues.
Confronted with new types of crisis incidents,
that they were not used to handling, and
unaware of appropriate health services, hotel
managers habitually called the police who were
likewise not equipped to deal with these health
or drug crises.
Health Time sessions began in December 1995,
first at the Gatwick and spreading to other
private hotels in St Kilda such as the Hollywood
and the Regal. However in recent years intensive
gentrification of the St Kilda Beach precinct
has eliminated nearly all of the low cost hotels
and boarding houses that have common areas
large enough to host Health Time, leaving now
just the Gatwick, which continues to be family
owned and managed.
One of the Gatwick’s proprietors, Rose,
comments on how the nature of difficulties with
guests has changed in her 42 years of working
at the Hotel:
Back then there wasn’t as many drugs.
I think our biggest problem would’ve
probably been a drunk but you can
deal with them. There are only so many
certain types of drunks. They can be
happy or sad or sleepy, all out. So you
know straightaway what you’re up
against, whereas nowadays with the
drugs you don’t know what you’re up
against because they don’t even know
themselves... Everybody is so angry. I
think it has that sort of effect on them.
They’re all so depressed and so angry.
That’s why it’s good to have Health Time.
Health Time is co-ordinated by Community
Connections Program (CCP) assertive outreach
workers from Inner South Community Health:

We work to engage with the residents
or people who are homeless for the
purpose of getting them assessed and
linked in with supports and services and
housing. We organise the food. We make
sure that people are attending and are
welcomed into the space. We’ve got the
occupational health and safety outlook.
We are doing all the liaising, so keeping
the whole session running. At the same
time we are also engaging with residents
and taking referrals and intake and
making phone calls.
Health Time at the Gatwick also celebrates and
observes significant events in the community
such as birthdays, deaths, Women’s and Men’s
Health days, Easter and Christmas. Every year
near Christmas, Health Time organises a large
street party where the street is closed by permit
from the City of Port Phillip, and the local
community comes together with live music,
dancing, free food and “give aways”.
Good Shepherd Youth and Family Services were
also involved in running Health Time from its
beginning in 1995 through to December 2014,
but the agency recently moved its resources
from St Kilda to St Albans, where it now feels
their services are needed most.
Other participating agencies have come and
gone mostly for resourcing reasons, as an Inner
South CCP worker explains:
We have a very strong team at the
moment. It hasn’t always been this big
and strong. Over the years we have
had services involved and dropped out.
That’s always been a tension and a
challenge because I think we’re working
in a very unstable and volatile physical
environment, that is the Gatwick, and
we’re asking services to be involved in a
program that they’re not actually funded
for. Sometimes it requires people to be
in the space for an hour and a half. They
sometimes have competing demands…
There’s a local housing agency who used
to come down to Gatwick, very much
their target group but I think there were
just competing pressures with different
programs not being funded to be away
from the office - and in that space and
the amount of work that generated -
there wasn’t a body back at the office to
be doing that.
In fact, Gatwick Health Time involves much
more than the hour and a half session at the
Hotel. Participating workers meet an hour
beforehand to share information about current
issues at the Gatwick such as tensions between
residents or prevailing drug use, as well as
to case conference clients in common and
strategise accordingly:
If you look at the environment that we’re
working, it’s challenging and complex.
There are a lot of different people,
different players, different issues and
different themes. It’s basically about
going, “Well, today we’ve heard this
piece of information. Everyone’s on
board. This is what’s happening.” Then
everybody knows what’s happening as a
team.
Workers meet again after each session to
debrief and co-ordinate any follow up work
with clients.
Despite the difficulties of its setting Health
Time at the Gatwick is a win-win situation for
the attending agencies who, through safety in
numbers, are able to service highly transient
and/or vulnerable populations in a potentially
risky enclosed environment; and for the
proprietors Rose and Etty who have fewer crises
to deal with when their residents are supported
by a network of services:
I think Health Time’s biggest thumbs-up
was helping people connect with services
and other people. It’s easy enough to say,
“Connect with other services,” but when
you look at the type of people that we
look after, it’s very difficult for them to
connect because even if they know the
address of where it is they’re supposed to

go, just that fear of going inside the door
or even getting to talk to somebody…
generally, they won’t do it because it’s
just too big a problem for them.
And for Gatwick residents and other attendees,
participation in Health Time can bring far-
reaching benefits. Patrick lived at the Gatwick
for eight months after an extended period
of transience and homelessness. He recently
moved into community housing nearby but still
works part-time at the Gatwick as concierge
and cleaner, and still attends Health Time
sessions regularly. He describes his experience of
Health Time:
I’ve had a bad back for a long time
and I suffer with migraine from time to
time and I was suffering stress a lot and
anxiety and when you suffer with both
it’s not easy to cope with.
Me and the little dog Bobbie, we were
hungry so we went there [Health Time]
and when I got appointed my outreach
worker. She must have been a saint
because she turned up to see me and I’d
be drunk and that and she’d say “Come
back and see me next week and make
sure you’re sober.” And this went on for
probably about three weeks and in the
end I just cracked myself out of it and
that woman worked tirelessly for me to
get me on the straight and narrow, help
me with some legal matters, she helped
me get another place.
With Health Time everything’s
condensed, there was the podiatrist
there, the outreach worker, there were so
many opportunities like the dentist, even
if you just needed someone to talk to
about problems, everything was there. A
lot of people that are on the streets can’t
afford to travel. It’s alright to say just get
the tram and the bus, go to Collingwood,
and when you’ve been to Collingwood
go to Hawthorn and that’s how you get
it done. Everything’s there and I feel it’s
one of the big advantages.
The only way Health Time could be
improved was if it was publicised a little
more so others that are just on the
streets and that know what services are
out there because you can’t get help
unless you ask. And this was all new to
me, and until you ask people you don’t
know.
When asked about the difference that Health
Time can make to living in a boarding house,
Patrick had this to say:
It would be pretty much like paying to
go to jail. You’re paying to go into a
room where everything’s communal but
you’ve got no-one to turn to, no-one to
ask anything, you’ve got no-one who
can provide assistance or steer you in the
right direction of where to go or what to
do. It’s a distinct difference. I went to two
different boarding houses before I was
on the streets and they were just pigs of
houses and you’d come home and your
door lock would be smashed off and your
room would have been ransacked and,
if not, there was always someone bigger
and better than you that would stand
over you and take whatever you had so
you could never keep anything that was
of any great value in your room.

H
alf Moon Caravan Park is situated on
just over an acre of industrial land at a
busy intersection of two arterial roads.
It was originally set up for visitors to the 1956
Olympics.
The Park presently contains 52 usable caravans
and accommodates up to 100 people, primarily
for emergency and temporary accommodation,
but the Park is also a permanent home for
about 25 local workers and older people.
Health Time operates every Tuesday from the
shop next to the Park entrance. Hobson’s Bay
Council ran the program for six years prior to
Cohealth and The Salvation Army taking up
co-ordination in mid-2013. This is an interim
arrangement until ongoing funding can be
secured for the program.
The visiting services are vital for many of the
people living at the Park who have come from
the streets with no possessions whatsoever, or
been evicted from other premises or released
from prison. There are a number of residents
who never venture beyond the site’s boundaries.
Services attending Health Time include housing,
nursing, legal, emergency medical, Centrelink,
mental health and optometry. Some services
also attend the site at other times during the
week.
Arriving at Half Moon Caravan Park tells a
person they have reached the end of the line.
One resident, a retired truck driver, described his
first reaction as “shock and awe”.
The 52 operational caravans are very old,
and there are a further 11 on site which
are unlivable mostly because of trashing by
residents. One van had to be burnt on advice
from a biohazard team who were called in to
clean up after a tenant who did not leave the
van at all for three months.
The caravans contain sleeping and cooking
facilities but no bathrooms. Residents use a
central shower block with fixtures for six males
and six females.
Casual visitors to Half Moon Caravan Park may
find themselves confronted in unexpected ways
as two law students on placement found out:
It’s a lot more confronting than what
you think when it’s actually right in front
of you, and a lot of the time they come
across as abrasive but we just basically
said hello and greeted them. Some of
the people I saw here, I thought, oh,
they look quite well presented and they
don’t look like they’d be in that kind of
situation. I suppose that was the most
confronting thing: they weren’t what I
would picture as facing homelessness or
mental health issues or things like that.
You need to do things like this to get
outside the small box that is your life…
You wake up in the morning you think,
oh shit, there’s no fricking cereal, and it
ruins your morning. Whereas you come
here, you witness this, and you just think
oh well, I’ve got a lot less things to worry
about.
Turnover at Half Moon is high – more than 350
people pass through the Park each year with
the majority of exits being evictions. The Park’s
manager maintains a zero tolerance policy on
violence and drugs, and he keeps a list of names
– currently 500 – of people who are barred

from re-entry. The Park does not accept children
due to the criminal histories of some residents,
and more generally because of the bizarre or
violent behaviours that children could witness.
According to the manager, twenty percent of
residents have major mental health issues, and
the Park is a common referral destination for
people experiencing homelessness including
the youth bracket (18-25) and those exiting
the prison system with nowhere to go.
Consequently the Park receives priority attention
from mental health services including the local
Crisis Assessement Team (CAT), and from police
who do a nightly patrol as much as to keep an
eye on known offenders as keep the peace.
Despite having to continuously hose down
tensions, break up fights, evict tenants and
handle death threats, Colin, the manager, keeps
an upbeat perspective on the role that he and
Half Moon can play in helping people to get
back on track:
You do tend to find there is some social
benefit for the people that are here.
They do get off the streets. A lot of the
people who come in here have been
living in their cars. Now you see that and
I see that and think, ‘well, they’ve got an
opportunity here’. I’m not a psychologist,
I’m not a bouncer, I’m not a babysitter
but I do talk to them. Because they
actually, all they need sometimes is just
someone to talk to.
We have a shopping centre which is five
minutes down the road. We are central
to three Centrelink locations. There are
medical practices less than 5 minutes
away and public transport is directly out
the front. So with that plus the services
provided, it’s a good opportunity for
people to get back on their feet. And we
try to help them out as much as possible.
A lot of them have found their own
premises, which is great.
Colin believes that Health Time plays a crucial
role for many of the residents and should be
expanded to at least two days a week. He
has between five and ten tenants who rarely
leave their vans and never leave the Park, so
the visiting services are the only ones they see.
Also many residents are on Newstart and often
miss out on Health Time because of outside
appointments.
Colin’s opinions are echoed by a lady who has
lived at the Park for 12 months with her partner
who works at a local meatworks:
There’s people here with all different
types of issues, so there should be people
here a bit more constant to help maybe
deal with the people they work with a
bit more, one on one more, instead of
the once-a-week. They have a bit of a
chat, and then, bang, they’re gone. They
don‘t see them for a week. The agencies
should be working together to help get
those people out as quick as they’re in
here. They should be helped along to be
out of here for their own good. There’s
every type of help here but it’s just not
constant enough.
One resident of eight months has made best
use of the opportunities available at Half Moon
and at Health Time sessions:
We seem to get really good service.
We get visits from a lot of people. They
sort of oversee the mental things and
medical. I’ve had my eyes done. I’ve had
my teeth done and other medical things
done and it just helps so much really. If
there’s something wrong they want to
know about it straight away and they
look after you.

I’m on the pension. I make my money last
from week to week. The only way I can
make it last is being in a place like this
where I can get some money ahead to
move out of this place into a proper unit.
That’s what I want to do is eventually
move out of here. I’m 65 now and I just
want to live the quiet life.
Health Time at Half Moon Caravan Park is a
good example of how devoting relatively small
amounts of resources in the right places can
prevent much larger spending downstream on
emergency and custodial services. One of the
managers responsible for Cohealth’s Health
Time programs makes this observation:
We are talking about a client group who
traditionally are in and out of jail, in and
out of hospital, in and out of accident
and emergencies. They will be multi-
presenters at any of those institutions.
You are saving money if you can stop
someone going into jail because you’ve
engaged with them and done some
support around them, if you can stop
someone going back into hospital for
long periods of time, or stop someone
going to accident and emergency
regularly because that’s their only access
to treatment. If you can do all of those
things you’re saving the community
bucket-loads of money.
Unfortunately Health Time is presently
struggling to survive at Half Moon Caravan
Park. The capital costs of Health Time – rent
for the shop and food - are largely covered by
Hobson’s Bay Council and Foodbank Victoria
respectively, but staffing for the event is
insecure. Beyond the visiting specialist services,
two facilitators plus volunteers are needed to
conduct sessions safely and provide a basic level
of outreach service, but only one of the current
facilitators is funded flexibly enough to cover
these types of duties. The sustainability of the
other facilitator’s involvement, which extends far
beyond initial expectations due to cessation of
project funds, is very uncertain.

H
ealth Time at Gronn Place is the latest
incarnation of a series of Health Time
programs that have operated on or near
public housing estates within the Moreland and
Hume municipalities since 2008.
Gronn Place was chosen to host Health Time
because of high levels of complex unmet needs
among the culturally and demographically
diverse population at the estate. The issues
include mental health, substance use, ageing,
maternal and child health, overcrowding,
transience, poor housing conditions, child
protection, disengagement from primary and
secondary education, neighbourhood disputes
and cultural tensions.
Sessions were initially held as a monthly
barbecue in the estate’s central courtyard.
However safety issues, constraints on workers’
time for engaging participants and inclement
weather prompted the organisers, VincentCare
Victoria, to move the event to an adjoining
community hall. Food is now brought to the hall
ready-made, allowing workers to concentrate
on engaging with attendees, assisting with
linkages and completing follow-up tasks.
Overall, a mix of families, singles, younger
and older adults attend Health Time sessions.
Services provided include nursing, allied health,
maternal and child health, multicultural youth
workers, the Office of Housing for maintenance
issues, and guests invited for themed events.
Homeless and vulnerable populations are less
visible in the outer suburbs than the inner
city: they may be dwelling in unsafe and
unregistered rooming houses, sleeping in sheds
and cars, or couchsurfing at public housing
estates and overcrowded private houses.
In addition, the agencies funded to deliver
services to these populations are spread
far apart, making distance and transport a
significant service access and engagement
barrier.
Public housing estates were selected by
VincentCare Victoria as best venues for Health
Time due to their clustering of multiple-needs
residents and transient visitors, with the first
year of program operation being at the Hilda
St estate in Glenroy. However relatively stable
populations at housing estates mean that
eventually the success of Health Time at one
venue demands that the project moves on to a
new venue with greater levels of unmet need.
The Health Time team tried shifting the event
to non-estate venues such as Neighbourhood
Houses and parks close to independent living
units but attendance was limited, so Health
Time returned to public housing at Gronn Place
in 2011.
Because they are dealing with these relatively
stable communities, including many families,
agency workers view Health Time through a
broader public health and wellbeing lens, as a
Moreland Council Home and Community Care
(HACC) worker with long involvement in the
project explains:
When you’re in group living situations,
for all intents and purposes it’s what the
housing estates are, they can have drastic
effects on surrounding neighbours and
also the quality of life that people have in
these estates. There’s a greater benefit to
the whole community, as well, because
a high percentage of the people that
we come in contact with have multiple
ongoing social issues or social problems,

and good practice seems to say that you
can’t treat one and discuss one problem
in isolation from another. So if you’re
not addressing people’s health and their
wellbeing, then it’s extremely difficult to
address their housing issues, it’s difficult
to address their employment issues
because they’re all interrelated.
Consequently Health Time at Gronn Place takes
a broad-brush holistic approach to wellbeing.
Every Health Time session has a theme with
accompanying give-aways and activities that
tie in with the theme. Examples include healthy
eating - with sample foods and recipe packs
complete with ingredients, dental hygiene
clinics, gardening, SunSmart and hairdressing.
Staff find that they need to begin their health
promotion strategies at a more basic level
than the approaches aimed at the general
population:
A lot of the health programs that are
coming out now are aimed at people
that have fairly high literacy levels and
who are actually engaged and thinking
about their health and wellbeing. This
cohort of people are not those people.
They’re not thinking about their health
and wellbeing. They’re often very pushed
for time and/or money. So the last thing
they’re thinking of is whether they’re
going to join the gym or come into a
life program or a HEAL [healthy lifestyle]
program or any of those things because
they don’t know. Even if you’ve got
information in someone’s language you
are assuming that they are literate in that
language. Well there’s a big percentage
of those people who are not.
A lot of them certainly are at risk of
diabetes, blood pressure problems, renal
problems, kidney problems. There’s a
whole range of illnesses that they may
have had in their families that they’ve
never taken any notice of. They’re often
malnourished or overweight. There’s
both end of the spectrums because
their eating habits are poor. They’re not
feeling well and they don’t know why
they’re not feeling well.
And at the individual level, Health Time staff,
who are working with clients with multiple
issues, often find that their clinical objectives
have to take a back seat temporarily until a non-
health issue that is blocking the person from
engaging with services is resolved. For one client
this was getting her drivers’ licence renewed
before it lapsed –not that she had a car, but
her anxiety over the prospect of going back to
a learners’ permit was overwhelming. Another
Health Time client, an elderly man with terminal
illness, was not ready to talk about services until
his more pressing issue was dealt with:
I was in his home and we were working
with him and I said to him “If I had a
magic wand and I can grant you anything
you like, except for your health back,
I can’t do that, but what is it that you
would like that I could make better?” -
thinking that it would be “I’d like to walk
a bit further to the shop.” He said to me
he’d like to have his car spray painted
because he sits inside the house and
he looks out at his car and it’s a terrible
mess. He can no longer take his car to
get fixed. Now, how do I talk about heart
disease when the thing that he worries
about is the car outside his window?
Then you say right-o. How about I look
into who we can get to do your car, but
how about today I work with you around
your heart disease? And I’ll get onto your
car tomorrow. He’ll say, okay. And we
have, we’ve worked around that.
For the residents at Gronn Place, Health Time
sessions have brought people together who
would otherwise be isolated in their community.

Resident Pherina remembers a time when the
estate was more community-oriented. When
Pherina came to Gronn Place 13 years ago with
a young child, she started up a community
group aimed at providing diversionary activities
for the children and youth living there. Before
long her group attracted Council funding
and expanded to cover all ages with activities
like volleyball, karaoke, trips to the snow,
community meetings, embroidery classes and
more. However after running the group for six
years she returned to work out of necessity,
and the activities faded away. Six years on from
the end of the community group, she now
observes the effect of Health Time on the newer
residents:
They come and they have a chat with
the ladies, because some of the ladies
they don’t come out of their house so
now they’re coming out. I’m not shy,
I’m from the Cook Islands. But for the
other ladies sometimes it’s a bit different.
Lately they all come out and we all have
a good chat, we all get on really well
now. They’re not as shy as they used to
be. Staying at Gronn we come from all
different countries but we have to be all
one family. At the moment I’m thinking
that I should get the community group
going again to help out our children and
youth and everything.
M
addern Square is a small public space
hidden behind shops that front
Footscray’s main streets. Health Time
moved there in 2011 when its previous venue
– a park near the railway station frequented
by daytime drinkers and users of other
substances – was taken over for infrastructure
development.
Despite the new venue’s CCTV and alcohol-
free zoning, the square is a popular place for
people to hang out and Health Time attracts
a large number of participants to its barbecue
every month: people who are experiencing
homelessness or at risk, and people with
complex health needs - along with the
occasional elderly passerby interested in a free
meal.
The event is coordinated by Cohealth Centre
and hosted on rotation by the Centre and
its agency partners in the Assertive Outreach
Program.
Services regularly attending include nursing,
housing, mental health, tenants union, legal,
alcohol and drug, Centrelink, and blood testing
by the Burnet Institute.

A free barbecue in the park is for most people
an irresistible meal invitation, not least for
its aromatic self-advertising. This informal
approach to meal delivery works hand in hand
with the intention of Maddern Square Health
Time to create a positive model of service
interaction by bringing needed services to a
place where clients choose to be. It also ensures
that attendees, of whom many would prioritise
substance use over food, eat at least one good
meal in the month.
The barbecue attracts 60 to 80 people each
session, with many looking forward to it as
a means of catching up with friends and
acquaintances, and making contact with
services:
I know a lot of people there. Even though
I don’t use no more I still go there and
still talk to them. They’re still my mates,
I still care about them. Two of my close
friends died last year from overdoses and
it made me think just because I don’t use
doesn’t mean I don’t care and I shouldn’t
worry about them now, but I do, I still
worry about people and tell them to be
careful if they’re having a hit or whatever.
I just go there and catch up on all the
goss and catch up with the workers.
You feel safe and you feel like you’re
not getting judged when you go there.
You feel comfortable and if you have any
problems you just go up to the workers
and you talk to the workers and they
direct you in whichever way you have to
go. Whatever’s wrong with you they help
you.
Health Time at Maddern Square has a large
number of attending services to match the
volume of participants. Consequently, if a
worker can’t help with someone’s problem it is
more than likely they can introduce the person
to another worker on site who can:
So if somebody has some obvious health
needs I can quite readily face to face, at
one of our events, refer the individual to
one of the nursing services or a health
centre. Again, if someone’s in need
of housing we’ve got local housing
organisations represented. We all prefer
what, in my business, we call ‘warm
transfers’. Far easier that I bring someone
directly to a service, introduce them
and indicate this person requires some
advice about their podiatry than just send
them off into the distance assuming it all
gets sorted. And it just builds for good
relationships there as well, whether it’s
my client base or the other stakeholders I
work with.
In many instances a worker is able to deal with
a client’s issue on the spot by phone, which
gives the person confidence in the worker and
the service, perhaps enough for them to make a
subsequent visit to the agency:
For my service users it might be around
pharmacotherapy like methadone,
those sorts of things. They might be
having problems with their chemist or
whatever it might be. So we would be
able to call Harm Reduction Victoria
who have a program for PAMS, which
is the Pharmacotherapy Advocacy and
Mediation Service and they can call the
chemist or the doctor and advocate on
the service user’s behalf. That all could be
done standing out there.
So if you can then resolve that issue but
they’ve still got a couple of other issues
that need addressing, they are more
likely then when you say, “Why don’t you
come down to Health Works after the
barbecue or tomorrow or when you have
time and we can look at addressing those
other things that you mentioned to me
today?” They have more confidence and
trust that you’ll be doing something.
Hence this model of service delivery works in
favour of agencies as well as clients by reducing
the amount of time workers spend identifying,
locating and chasing up people, especially
if they are charged with delivering outreach
services. The Maddern Square barbecue is an

efficient way for workers to contact multiple
clients who otherwise can be very difficult to
engage or locate, as people who live in rooming
houses or sleep rough often leave when they
get up and don’t return until late at night.
Health Time at Maddern Square also overcomes
some of the other obstacles facing outreach
services. For example, it is not practical for
Needle and Syringe Programs to do outreach
at accommodation places with zero tolerance
policies, since their visits can identify residents
who are injecting drug users and cause their
eviction.
Though at its current site for only two years,
Maddern Square Health Time is the product
of ten years’ co-operation between agencies
involved in the Assertive Outreach Program.
Some agency partners are not technically
funded to do outreach but find Health Time the
most effective means of reaching their target
groups. Other agencies, like Centrelink, have
services that are funded to do exactly this type
of work:
We’re actually funded through the White
Paper of the Australian Government to
support people who are homeless or at
risk of homelessness. A lot of the people
with service outside the mainstream
office environment have a range of
reasons for not attending the Centrelink
office. It may be because of a previous
incident which resulted in them not being
allowed to attend an office. It may be
just because their lives are so chaotic that
by the time you’ve worked out where
you’re going to get your next meal from,
you’ve had your medical appointments,
you’re working out where you’re going
to sleep tonight, it’s close of business.
So it’s easier for people to access our
services where they’re going to be than
us force them into a relatively structured
environment where a lot of us don’t feel
comfortable. So it’s a no brainer, that’s
the way I see it.
Cohealth, which is involved in several other
Health Time events as well, finds spare capacity
in diverse program areas to help resource these
projects because the agency sees Health Time
as a means of achieving one of its core business
objectives:
From a human rights perspective
everyone has a right to health care. And
by “everyone” we also include people
who are more marginalised and have
more complex needs and who are more
disenfranchised as being “everyone”.
And that permeates throughout the
whole organisation which means it’s core
business. So we’re able to then draw on
those resources. You have to look at who
doesn’t have access to health care, why
they don’t have access to health care,
and what does that look like? In many
instances that’s actually the people who
aren’t coming into traditional health
services. So therefore you have to change
what you do. And Health Time helps
support that process.

E
very Friday, Cohealth hosts a barbecue
and drop in space in the courtyard of
their Nicholson St Footscray premises.
This Health Time is primarily aimed at young
Africans who are at risk of a lifetime of social
marginalisation, substance abuse, periodic
incarceration and deepening health crises.
Four program partners including Footscray
Police materially support and facilitate Health
Time sessions on a rostered basis and a fifth
agency co-ordinates the responsibilities of
partner agencies and other visiting services.
A DJ plays music every session and invites
people to get up and rap. Visiting services
attend on a rostered basis so as not to
overwhelm the participants’ space.
The Health Time sessions are held on Fridays to
coincide with the availability of on-site GPs as
well as ensuring that participants eat a good
meal before the start of the weekend.
For several years the venue for this Friday
barbecue followed the movements of an
extended cohort of 35 to 45 mostly male and
Sudanese young people aged from late teens
to early thirties, taking the event to wherever
they would hang out in the Footscray-St Albans
area. Many of the group are without housing
and couchsurf in large numbers at the homes of
friends, often resulting in noise complaints and
tenancy problems for people they stay with.
The most recent move to Cohealth premises is
designed to give participants a safe space that is
theirs for the afternoon for socialising, rapping
and dancing, where they can attend even if
intoxicated and engage with agency workers
and health services. Ten to fifteen people attend
each session, with eight or so attending most
sessions and the rest of the group attending on
and off.
Barkly Arts Centre provides music, a DJ and a
microphone for participants to join in. Kauma
the DJ explains why:
Maybe they haven’t had time to hear
music in the whole week. Sometimes
they want to dance. When you get
on the mike they’re supposed to free
whatever they feel like in their mind. It’s
all right if they think out some negative
lyrics, that’s fine because every human
being have those lyrics. Instead of using
your physical energy and go out there
and fight or whatever, I think it could
help you release the stress by saying all
the frustration you’ve had in a week.
That’s what the music does really. We’re
hoping that more people come around
and know about this thing on Friday so
that they can get more involved in the
positive doings instead of negative.
Most of the cohort have multiple health issues
including alcohol abuse, depression, post-
traumatic stress disorder or a significant disease
such as tuberculosis. Some of the older men
were child soldiers. Many were orphaned by

civil war, and most came to Australia via refugee
camps in Kenya, Uganda and Egypt.
Collectively they call themselves ‘the boys’ and
strong bonds of loyalty tie them together as in
a family, which is how the group functions for
members.
One older member of the cohort making his
first appearance at the barbecue explained why
he came:
It’s not because I’m hungry that’s why
I come here to eat at barbecue, it’s not
because of that. Because we want to
come and sit together and recognise
ourself and talk. Your problem I can’t
solve it and you can’t solve my problem,
but it’s not because of just the food I
come here. I want to come and meet a
lot of my colleagues here and we will
…they will tell me what is wrong with
me, and I got to tell them what is wrong
with them. If we didn’t come and get
together, how are we going to tell each
other the truth?
The group as a whole is stigmatised by the
broader community because they congregate
in large numbers in public places, they may
drink alcohol in those places or cause a public
disturbance or damage property, and they are
very visible because of their skin colour and
height.
Over time their behaviours led to increasingly
confrontational encounters with police as the
latter attempted to disperse the group, make
arrests or serve warrants for unpaid fines from
previous encounters. Local agencies recognised
that if nothing was done to stop the spiral
of marginalisation there was a high risk the
group would evolve into a ghetto-style gang,
destroying the life chances of members and
seriously damaging multicultural relations in the
broader community.
Community agencies together with Footscray
Police have put in a continuous effort over
several years to break down barriers on
both sides by running barbecues, music and
education programs, and participating in
leadership camps together. The barbecues
act as an initial engagement mechanism and
ensure continuity of contact, while the camps
provide opportunities for deeper and quicker
understanding between parties. At these camps
agency workers, police and young men who
are chosen for their group leadership potential
undertake physical challenges together, see
each other get pushed out of their comfort
zones, and learn to understand each other as
humans first.
These engagement strategies are significantly
improving police-group relations, especially
during law enforcement encounters that could
otherwise escalate into violent confrontations.
Jodie, a police officer who has worked with the
group for several years describes one example:
I had an email from a sergeant in
Sunshine and he said, “Well, we had an
arrest. The guy had warrants at the train
station,” and they were just expecting
the situation to get ugly. But instead they
got cooperation, and interaction with the
group was good. They actually walked
back to Sunshine station with this big
group of African guys, and there was
banter and whatever. The sergeant asked
them something like “How come you
guys are so good?” One of them, who
was calming the others down said,
“I went to a camp with Jodie last week”.
So these opportunities have a good
ripple effect.

In terms of health, agency workers say
that progress for the group as a whole is
incremental, yet also fundamental as members
shift towards a more considered and pro-active
approach to looking after themselves:
I think one of the changes that I’ve seen
is that the young people are taking
more responsibility in terms of their
health. They are taking more pride in
who they are as young people, and
more responsibility in terms of their
drinking and all that sort of thing. More
responsible in terms of the decisions they
make, life choices and what their future
projections are. So you’ll start hearing
that shift of what they want to be, what
they want, whether they can get support
around different things, which was really
different from before.
Results for individuals can be very significant.
Several group members have started or
returned to tertiary education and others have
found work or stable housing. One young man
now works for Cohealth and is studying at
university. Although he keeps connected with
the group, he decided to change his life after
the deaths of two friends:
The barbecue was the doorway to
everything. It’s opened the door to health
facilities, recreational facilities, music,
everything. I know most of the boys, I’ve
seen a whole lot of people go down the
drain. We had two friends die within two
months. I thought look, it’s time for us
to wake up. If no-one wakes up we’re
all just gonna die to be honest. That
was my whole perspective. My friends

started drinking and I thought that’s not
me, it’s not going to solve my grieving
and everything. I’d rather do something
productive.
The Friday barbecue is an inspiring example
of how relatively small amounts of resources
focused consistently in the right direction can
produce big results for individuals and the
wider community. Jodie from Footscray Police
comments:
It’s always hard to prove what you
prevented. But I can absolutely say it’s
really playing a big part in preventing a
lot of crime, a lot of unnecessary deaths,
of all those problematic behaviours just
going to the full extent.

The necessary material resources are
venue, facilities and food. Human
resources require core service
providers, program co-ordinators
and event facilitators.
Venues:
Health Time projects need to adapt their
approach and delivery to the environment of
the client.
Venues must be highly accessible, convenient
and user friendly. Health Time clients will not
attend locations that are difficult for them
to get to or where they feel out of place or
threatened. An unsuitable choice of location
will result in poor attendance.
When a Health Time program sets out to
engage clients where they live, it is more
successful when sessions are held exactly
at their site of residence. Examples are the
Gatwick, Half Moon Caravan Park and
Gronn Place.
It is instructive to note that prior to running
Health Time at Gronn Place, the program
attempted to attract residents from a housing
estate in Coburg to Health Time sessions being
held for them at a Neighbourhood House just
around the corner. The results were dismal with
just a few clients attending. This was despite
advertising the sessions with flyers and having
already run Health Time successfully inside
the same housing estate a few years earlier.
Even with Health Time at Gronn Place, moving
the sessions from the estate courtyard to the
community hall next door lost participants,
particularly single people.
When a Health Time program’s intended clients
do not all live in the same place or do not have
accommodation, Health Time sessions can be
held at places where people like to hang out,
such as Maddern Square; or failing this sessions
can be held at accessible, user-friendly venues
that are credible and trustworthy to clients.
St Peter’s, St Brendan’s and the Friday BBQ at
Cohealth fall into this category. St Peter’s was
already well known by people experiencing
homelessness; Cohealth’s program partners
had been servicing their Friday BBQ clients for
several years prior to moving the sessions to
agency premises; and the St Brendan’s site was
familiar to many of the clients who had been
attending the Holland Court Health
Time program.
Facilities:
Since the location of the program is dependent
on the preferences of clients not agencies,
Health Time providers must improvise with any
existing venue facilities.
In the case of programs held at indoor locations,
the ideal venue would be equipped with a full
commercial kitchen, adequate seating and
tables for participants, plus enough workers to
do all the cooking, serving and cleaning. Only St
Brendan’s has all of these ingredients, including
importantly a volunteer professional cook. At
the other indoor venues – the Gatwick, Half
Moon Caravan Park and Gronn Place - which
have lesser kitchen facilities and fewer workers
available for kitchen duty, food is partially or
fully prepared elsewhere before the sessions.
The three events held outdoors – St Peter’s, the
Friday BBQ and Maddern Square - cook on site
using a barbecue. St Peter’s and the Friday BBQ
have the advantage of being held in courtyard
premises that allow for equipment storage and
at least semi-permanent hygiene and fire safety
measures, whereas Maddern Square requires
all necessary equipment to be bumped in and
out each session. This is a significant time
and energy factor for agency staff, who may
spend more time looking after event logistics

then engaging with clients. These issues plus
repeated foul weather prompted Gronn Place
Health Time to shift from the estate’s courtyard
to the neighbouring community hall.
Food:
All the Health Time programs aim to provide
healthy food that their clients may not always
have an opportunity to eat, so proteins,
vegetables and salads are present in abundance.
Water is often provided as a preferred drink,
while tea, coffee or fruit juice are offered at
some venues.
Most programs receive donated food from
SecondBite or Foodbank Victoria and then buy
the remaining ingredients needed for each
session. For Gronn Place which has a large
Muslim population, workers buy ready-made
halal food from a nearby take-away restaurant.
On site service providers:
To get up and running, Health Time programs
need core service providers who are funded to,
or otherwise have the freedom to work flexible
outreach duties.
Depending on agency resources these
positions are usually drawn from a Community
Connections Program and the RDNS Homeless
Persons Program, or otherwise a Community
Health Nurse. These two positions of outreach
worker and nurse provide the core service
capabilities around which a Health Time
program can be built.
The visiting services most needed by clients are:
• housing information and referral
• nursing
• legal
• mental health
• drug and alcohol
• Centrelink
• allied health, especially podiatry.
Constant high demand for legal services often
makes it difficult for these agencies to provide
outreach.
Co-ordinators and facilitators:
Every Health Time program needs a co-
ordinator to organise all activities and logistics
surrounding Health Time sessions. These duties
include:
• Preparing a timetable of Health Time
sessions for the coming months or year.
• Preparing advertising material eg flyers.
• Rostering all duties and responsibilities
for every session.
• Rostering and/or confirming the
presence of visiting services for every
session.
• Organising pre- and post-event debrief
meetings.
• Ensuring that Occupational Health and
Safety (OH&S) protocols for Health Time
sessions are developed and followed by
participating workers and agencies.
• Organising food (if this responsibility is
not devolved by rostering to a program
partner.)
• Communicating the above to all partner
agencies and positions.
Event facilitators (who may also be program co-
ordinator) are needed to run the Health Time
sessions on the day. Their duties include:
• Doorknocking at venues where clients
live
• Setting up equipment
• Buying, preparing, cooking and serving
food

• Monitoring OH&S issues
• Managing participants and handling any
incidents
• Liaising with venue proprietors
• Welcoming and engaging clients,
facilitating linkages to other workers.
• Taking referrals and providing
information.
• Facilitating the pre and post debrief
sessions.
More often than not the event facilitators
are, themselves, outreach workers, who
must fit their outreach work around their
facilitation duties as best they can. This is where
community volunteers can be most useful, as
at St Peter’s where volunteers do some of the
cooking and serving; and at St Brendan’s where
the large team of volunteers look after every
aspect of providing for and managing Health
Time sessions, leaving service providers to focus
solely on their work.
Good food and a good location help make the
setting right for clients to engage with services.
The next part is up to the workers.
All agency workers say the same thing about
engaging with clients or guests at Health Time
sessions: it all starts with building a relationship:
You tend to have a conversation where
they’re thinking that you’re just having
a chat to you but actually I’m having a
health assessment, without too much
fuss. It’s a much nicer, easier forum to
work in because they’re not feeling
threatened and you’re on their turf
basically. So they feel quite comfortable
with that, so they’ll often tell you a whole
lot more about their health because they
feel more relaxed.
I tend to say to a lot of volunteers that
come and work with us that they need
a sense of humor, broad shoulders and
thick skin. I think that’s pretty much the
case with workers too, is that you have to
be quite tolerant and patient. Sometimes
it takes time to build a relationship, as in
a lot of other spheres of life and for trust
to be built up.
Consistency builds confidence and trust. In
order to gain the confidence and trust of people
whose lives are characterised by instability and
periodic chaos, Health Time needs to happen at
the same time, same day every session:
It has to be long-term and it has to be
consistent. The thing that wins is that
you’re there, every month, rain, hail
or shine and that you’re consistently
listening and providing for them.
Continuity of staff is also important. When a
client takes a risk on building a relationship with
a worker and that worker is suddenly replaced
by another, this can be a negative experience
for the client if done without careful planning
and preparation.
Consistency helps venue proprietors too, so they
can remind clients and new arrivals that Health
Time will occur on a particular day, or discuss
concerns they may have about clients with
Health Time workers.
The multi-disciplinary environment of Health
Time is one of its greatest assets, as it demands
constant knowledge transfer between workers
about services and clients. One Health Time
coordinator who recently moved to Victoria
found it a revelation:

I’m from New South Wales where
you work on your own. If you meet
with another organisation it’s a case
conference about a client, you don’t
work together like this. This is so
unique for me. So to be able to do
that, and be coordinator of that is an
amazing way to network and keep you
interested in the role, making you feel
like you’re making a difference. You
really get a good understanding of how
other organisations work as opposed
to reading a website or having one
conversation on the phone. It really gives
you a good understanding.
All Health Time programs hold planning and
debrief meetings between Health Time sessions.
These meetings are also opportunities to co-
ordinate service responses to the needs of
individual clients.
If the venue is in a fast-changing or volatile
environment, the debriefing arrangements
used for the Gatwick are a commendable
example. There workers meet immediately
before and after each session to share up-
to-date knowledge about clientele changes,
current drug use, incidents and risks; arrange
follow-up work; and ensure that workers have
an opportunity to talk about any incident or
conversation during the Health Time session
that may have impacted on their wellbeing.
Occupational health and safety (OH&S) is a
serious consideration for Health Time projects.
Beyond observing routine outreach safety
procedures such as always working in pairs,
specific OH&S and emergency protocols are
developed for each venue.
Cramped venues with limited entry and exit
points should be avoided where possible.
Anglicare Homeless Support Services in
consultation with Cohealth closed the venue
near St Paul’s Cathedral because of these
problems, and moved Health Time to St.Peter’s
which offers more space with multiple exits.
At the Gatwick Health Time, which does
operate in a confined space with narrow entry
and exit points, the workers keep a constant
eye out for their own safety and the safety of
clients, and observe a strict protocol as follows:
If the lead person who’s running the
show that day says, “We have to go
now” we go. Whatever that person says
goes. We don’t argue, we leave and
discuss it later. It might be that person’s
got word from Rose or Etty or someone,
there is someone there that it’s not good
for us to be around, they’re in a bad way,
they’re very drunk, or they’re having a
psychosis and we need to be out. We
don’t ask questions we just go.
Despite the apparent risks, Health Time workers
report that they experience very few incidents.
Cooking with barbecues presents extra risks,
especially for clients. In these outdoor situations
Health Time workers position the barbecues to
limit access as much as possible, and arrange
trestle tables to serve as barriers. At events
where children are present these precautions
may not be enough: Gronn Place workers came
to dread school holidays when their Health Time
sessions involved barbecuing in the estate’s
courtyard.
Health Time projects tend to operate in the grey
area between funding agreements and position
descriptions. Several but not all of the projects
described in this report are sustained by Low
Cost Accommodation Support Programs such
as the Community Connections and Active
Connections Programs which provide the
flexibility and assertive outreach capacity that
underpin the Health Time approach.

Occasionally a program may be kick-started or
revived by limited project funding, but on the
whole Health Time programs get by without any
dedicated funding, continuing from year to year
on the goodwill and commitment of partner
agencies and/or individual workers.
It’s a multilevel approach because it is
unfunded. The energy has got to make
up for the funding. That’s why some
people drop out because they haven’t
got funding or they haven’t got the
energy.
Unless there is the capacity for the
department to provide some core
funding for this on a regular basis then
we’ll always have these conversations
over the next number of years as people
are trying to work out how do we keep
this going.
Programs that operate inside territories that
are relatively dense with outreach services for
people experiencing homelessness – such as
St Peter’s in the CBD – are able to draw on
this concentration of resources to keep their
programs running. This is not to say that
managers do not need to be frugal and creative
to resource their Health Time sessions.
Health Time projects further away from the city
centre struggle much more to keep running
continuously from year to year: they are located
in suburban landscapes where homelessness
and disadvantage are more hidden, and
agencies that would be ideal partners for Health
Time are thinner on the ground and not all of
them see this type of outreach service as part of
their core funding mandate.
One of these suburban Health Time projects,
working with some of the most disadvantaged
and marginalised people in Victoria, has been
bridging the resource gap by the perseverance
and commitment of a particular worker.
Another project that has fought hard since its
inception to gain partner agencies has been
relying for years on the commitment of a single
worker to keep one partner agency involved,
and the project gained management support
at another vital agency after a new incumbent
took over the CEO role.
Without dedicated funding and inter-agency
MOUs, Health Time programs are underpinned
by a high degree of uncertainty and rely upon
a large degree of worker resourcefulness and
personal commitment from year to year for their
continued operation.
If commitment is one wing, creative partnership
is the other that together enable Health Time
programs to stay airborne.
Health Time workers and managers recognise
that sustainability requires multi-level
partnership between agencies:
Unless you’ve got buy-in from very high
up it’s not going to work. It’s a two tiered
system so your level of managers who
can sign off on brokerage and funding
and all of that say yes, we can give X
amount of clinicians in kind, and then
you need the workers. You need to have
the coordination of what’s happening
on the ground and who’s responsible
for the door knock and the day-to-day
running, but you then need to have the
managerial buy-in up here.
I’ve always been involved in establishing
the services rather than just leaving it to
the workers because you need that buy-
in, because we know that people won’t
see the worth for six months. If people
buy out in that six months because they
can’t see the worth, they’re not seeing
anybody, then where will that leave us?
Some projects draw together the most unlikely
partnerships to service their clients. For example,
the coordination component of the Friday BBQ
at Footscray is funded for the time being by
the Victorian Multicultural Commission via a
Transition to Independence program operating
from the Maribyrnong and Mooney Valley

Local Learning and Employment Network. The
other agency partners materially supporting this
program are the Centre for Multicultural Youth,
Footscray Police, YSAS (Youth Support and
Advocacy Service) and CoHealth.
This collaboration demonstrates that ultimately
it is the program beneficiaries that determine
the project partners because there is no single
way of ‘doing’ Health Time, rather it is a flexible
approach to supporting a client group:
As opposed to coming in and saying “this
is what it’s going to look like, you’ve got
to do this, you’ve got to do it this way,”
the model itself comes out of working
together to engage clients who aren’t
engaging in services.
Health Time programs bring diverse
benefits that spread far beyond
their clients.
• An opportunity to have healthy food
that is in itself an ultimate good for
people experiencing homelessness or
in marginal housing, and for people
who are struggling financially and
experiencing food insecurity.
• Streamlined and prioritised access to
services they would not or could not
normally attend, such as dentistry,
podiatry, physiotherapy and nurse
health checks. This leads to better
engagement and follow-through with
mainstream services.
• Opportunities for social connectedness
and social inclusion. These opportunities
to relax, eat and chat with others or just
sit near other people in relative comfort
and safety can be rare for many Health
Time clients.
• Safer access to their clients by working
within a team.
• Easier access to clients when you know
where they will be.
• Identification of vulnerable and isolated
residents who need support but are not
already linked in or accessing services.
• Proprietors have improved access to
services and referral pathways for
residents, and increased knowledge of
the service sector and intake processes.
• Opportunistic and “on-the-spot”
referrals to services and appointments
with improved assessment, care
planning and linkages.
• Increased awareness of community and
client issues that are impacting clients
such as drugs, violence and health
vulnerabilities.
• Learning opportunities through working
in multi-disciplinary teams.
• Faster and/or deeper client engagement.
• Better access to otherwise hard-to-reach
target groups.
• More efficient assertive outreach
processes.

• Decreasing ‘did not attends’ from
Health Time clients as they become
more confident in using agency-based
services. For services like dental this can
be a significant saving.
• Decreasing aggressive behaviour at
agency shopfronts, according to some
reports.
Health Time also benefits the places where
people live. Programs that operate in very
difficult residential environments like the
Gatwick and Half Moon Caravan Park do a
large amount of preventative work in terms
of averting crises that can negatively affect all
residents.
This points to the broader social advantages of
Health Time as an assertive outreach platform:
by engaging their clientele the programs not
only assist people to move forward, they also
protect those individuals from greater harm.
In economic terms this protection creates
savings in emergency and tertiary services.
In terms of social inequality, the Health Time
model provides a robust vehicle for health and
welfare agencies to fulfil their charters:
If we’re going to address social
inequalities from a human rights
perspective you have to look at who
doesn’t have access to health care, why
they don’t have access to health care,
and what does that look like? In many
instances that’s actually the people who
aren’t coming into traditional health
services. So we kind of say that the
clients who don’t come in the door are
probably the clients that we need to be
seeing more of, so therefore that’s where
our attention goes to.
And so you have to actually find ways
of engaging that community. Taking
services to where the clients are, in
their environments, in their spaces
is important. And we recognise that
that’s a really effective tool in terms of
engaging clients. So health time activities
are a way of taking services to the clients
or potential clients, and building up
a relationship with them so that they
actually then feel more comfortable
coming in the door.

Text and interviews by Peter Feldman (pfeldman1605@gmail.com).
Images by Adis Hondo and Peter Feldman
Report and DVD artwork designed by Vira Falcone (virafalcone@hotmail.com).
Editorial input provided by the Health Time Programs Key Learning and Dissemination Steering
Group comprising: Karen Antrim, Helen Ferguson, Leonie Kenny, Judith Prigg, Lisa Sammut, Brian
Sardeson, Jo Serafim, Paul Spratt, Ian Symmons and Paul Zanatta.
The development of this publication was made possible by support and funding from the North
West Metropolitan Department of Health.
Thanks to the Department of Human Services (Office of Housing), VincentCare Victoria, Inner
South Community Health, Cohealth (formerly Western Region Health Centre and Doutta Galla
Community Health Service), Anglicare Victoria Homeless Support Services, St Brendan’s Parish Hall
volunteers and all the other agencies and individuals involved in the Health Time programs:
Doutta Galla Community Health, Western Region Health Centre and North Yarra Community
Health merged to become Cohealth in May 2014.
And a special thanks to all the Health Time participants who generously gave their time to be
interviewed for this report.
• Anglicare Victoria Homeless Support
Services
• Avalon “The Moving Wardrobe”
• Baptcare
• BridgingWorx
• Cohealth (Community Connections
Programs and Outreach Allied Health
Team based at the former Western
Region Community Health Services
and Doutta Galla Community Health
Services)
• Clarendon Community Mental Health
Services (CMHS)
• Cultivating Community
• Good Shepherd Family and Youth
Services
• Homeless Outreach Mental Health
Service
• Inner South Community Health Service
(Community Connections Program,
Outreach Physio and Podiatry. Drug and
Alcohol Outreach, Insecure Housing
Worker, Dental Outreach, Outreach
Health Nurse, Midwife and Sexual
Health nurse, Assertive Mental Health
Outreach)
• Merri Community Health (Allied Health
and Healthy Ageing Demonstration
Project)
• Moreland City Council
• Public Interest Law Clearing House
Homeless Persons’ Legal Clinic
• Royal District Nursing Service (RDNS)
Homeless Persons Program (HPP)
• Royal Women’s Hospital Well Women’s
Clinic
• St. Peters Eastern Hill Anglican Parish
Church
• The Gatwick Private Hotel Proprietors
• The Half Moon Caravan Park Proprietors
• VincentCare Victoria ( Community
Connections Program and Access &
Support Program)
• Wintringham Over 50’s Club

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