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Through partnerships across healthcare and community services, UNB’s Connect to Care initiative is supporting individuals experiencing homelessness in Fredericton by improving access to care, building trust, and addressing complex needs.

If you’ve been out and about in Fredericton in recent weeks, you may have noticed an eye-catching van parked at locations across the city.

Get closer, and it’s clear this is no ordinary vehicle, but part of the University of New Brunswick’s Connect to Care mobile unit. Its purpose: to bring healthcare directly to individuals experiencing homelessness by meeting them where they are.

“When you have nowhere to live, and you’re just trying to find shelter and protect yourself, getting to a healthcare appointment on a specific date is a very real challenge,” said UNB researcher Dr. Ali McGill, who leads the initiative through the university's Faculty of Nursing and Health Sciences’ Community Health Clinic at the Fredericton Downtown Community Health Centre (FDCHC).

“The van is great because we can go to the locations our patients have suggested. It’s low-barrier. There are no appointments. It’s for whoever shows up,” she said.

Wrapped in a vibrant scene painted by a member of the FDCHC community, the van is inherently approachable.

So too are the people who greet you there. Most days that includes two registered nurses, a social worker, and a rotation of upper-year UNB nursing students.

When looking inside the van, those cared for by the team can expect to see what looks like a patient's room at a doctor's office, designed for maximum efficiency. It has a wide examination table, a vaccination fridge, a sink with hot running water, and all the supplies the nurses need to do blood work, IVs, and wound care.

“We have patients who know us, who we connect with routinely, and then new patients who are popping in, looking around and asking for a checkup, or wondering how we can help them,” said Tricia van Roeden, an outreach nurse and UNB clinical instructor who serves as the nurse manager of the UNB community care clinic at the FDCHC.

Since the unit hit the road on Aug. 31, McGill says the team has been providing care to upwards of 20 unhoused individuals on days the van is out in the community.

“Every time we're out, we're busy. Every time we go to one of our locations, we have patients waiting for us,” van Roeden said. “We’re connecting with patients who have never received care before.”

Soon, the unit — outfitted with Wi-Fi and Starlink services — will expand its services to include telehealth technology, ensuring patients will receive the care they need when they need it.

“Perhaps one of our RNs is doing wound care and notices there’s an infection that requires an antibiotic, blood work, or treatment,” said McGill. “With telehealth, the team will be able to connect with primary care providers, including nurse practitioners and physicians, at the FDCHC, who will conduct a physical examination using the unit’s digital health tools.”

That means that with support from the team’s RNs, off-site primary care providers will be able to hear a patient's heart and lung sounds through a digital stethoscope, look in a patient’s ears and throats with a digital otoscope, and examine their wounds with a digital dermascope.

“Our patients won't have to schedule a separate appointment with a primary care provider. We know the barriers — they’re just not going to get there,” McGill said.

“With telehealth, our patients will be getting the care they need in the moment, right at the point of care.”

During the initiative’s six-month pilot project earlier this year, the team found that just 10 per cent of outreach patients accounted for more than half of all emergency department visits among the patient group, highlighting the complex health and social needs many participants face.

With the Connect to Care unit on the road, those patients are receiving healthcare that, in some cases, is making an ER visit unnecessary.

Before the initiative was born, members of the healthcare team at the FDCHC conducted outreach twice a week, travelling by bicycle with care equipment to encampments and to community sites operated by the John Howard Society, including Oak Centre and Ironwood Resource Centre.

During that time, the team began hearing from frontline workers.

“Paramedics were telling us they were getting fewer calls to some of the community sites where we were regularly providing outreach care,” van Roeden said. “That’s when Ali said, ‘I think we can do more. Let’s explore this.’”

Soon, Connect to Care was born.

“We want to go beyond caring for people who often seek healthcare for a specific and immediate need,” McGill said. “We can say we think we know what these individuals need, but part of our research is to ask our patients and the people who come to the van what they think we should be doing,” she said.

“We ask them where we should go, how we can help.”

Those interviews continue to shape the initiative.

“Their feedback is helping us understand their perspective and how to best design the service for the people it’s meant for, for those with lived experience,” McGill said.

“We’re learning about the kinds of care that will attract people to the van so that they feel comfortable enough to walk up to it and ask, ‘Can I get a checkup?’,” van Roeden said. “One patient told us, ‘You should have coffee, you should have socks, you should have water, you should have snacks that we can grab.’”

“These are the kinds of comforts that make coming forward and talking about your health that much easier,” McGill said. “If you're cold and shivering, if there are blankets, coffee, and something to eat, that can be really helpful.”

Fulfilling basic and fundamental requests like these is critical to creating an environment and relationships grounded in trust and safety, which McGill says is often the first step in addressing broader health and social challenges faced by vulnerable populations.

“We’re building trust. Patients are asking for help. They’re being treated with dignity and respect,” she said.

Those interactions create opportunities to connect patients with additional support and services.

“When patients come to us for a wound that they’re worried might be infected, we can start developing a relationship with them by asking if their vaccines are up to date, or whether they’ve ever had a screening for heart disease, diabetes, cervical, breast or colorectal cancer,” McGill said.

“Or, if we’re meeting with an individual who isn’t on the list for housing, doesn’t have social assistance, or doesn’t know about certain benefits they’re able to access, we can connect them with our team social worker.”

The initiative is built on that collaborative foundation, made of healthcare providers, social supports, and community organizations to address patients' complex needs.

Beyond the FDCHC and funding partners, community organizations supporting daily care include the John Howard Society, the Horizon Mental Health and Addictions program operating out of the Victoria Health Centre, and the Dr. Everett Chalmers Regional Hospital.

McGill and van Roeden say UNB nursing students are gaining first-hand experience in how to provide care with dignity and respect to individuals experiencing homelessness who have very complex needs and often require support across sectors.

The Connect to Care initiative reflects the understanding of McGill and her partners that health challenges are not always addressed through medical care alone.

“This isn't just about taking care of a wound,” she said. “It's about taking care of individuals with very complex needs, who often require different people from different sectors to help them move forward.”

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