Consider the perspective of Sarah, a community health nurse in Vancouver’s Downtown Eastside. For Sarah, the fragmentation of services is a daily operational crisis. She frequently encounters individuals who have secured housing through municipal programs but lack access to the specialized addiction counseling required to maintain that stability. From her vantage point, the separation of housing authorities from health care providers creates a bureaucratic vacuum where vulnerable individuals fall through the cracks, leading to repeated cycles of hospitalization and eviction.