COVID-19: What State and Local Leaders Can Do for Homeless Populations

Individuals experiencing homelessness include many older adults, often with compounding disabilities, who reside in large congregate facilities or in unsheltered locations with poor access to sanitation. Their age, poor health, disability, and living conditions make them highly vulnerable to illness. Once COVID-19 is introduced to this high-risk population, further transmission will be very difficult to contain.  Homeless service providers and system leaders are uniquely situated to partner with state leaders to protect the health and well-being of this highly vulnerable population, and should implement all possible measures to do so.  

Last week, the President signed the Coronavirus Preparedness and Response Supplemental Appropriations Act (H.R. 6074) to provide emergency funding to combat the coronavirus outbreak. The programs funded under the bill include grants for state, local, and tribal public health agencies and organizations, who are now developing plans to reduce the risk of virus transmission to vulnerable populations within their jurisdiction. 

To be as effective as possible, these groups should be certain to involve homeless service system providers and leaders in strategic planning, and explore how they can support homeless providers to reduce the risk of virus transmission. This post provides guidance around three main areas: involving Continuums of Care (CoCs) in planning, funding for homeless services providers, and how to stay informed of federal guidance and other resources.

Involving CoCs in State and Local Planning

State and local leaders should tap representatives from CoCs  to participate in strategic planning. This will help ensure the needs of a high-risk population are well understood and attended to in the development of a comprehensive plan. The federal government relies on CoCs to assess local need and prioritize federal funding for housing and service interventions for people experiencing homelessness; as such, CoCs should be a necessary part of COVID-19 response to vulnerable populations..  Primarily made up of local homeless service providers, advocates and individuals with lived experience, CoCs assess the extent of homelessness (including unsheltered homelessness) within a locality and evaluate the performance of the collective local response. They are well-positioned to identify local strengths, gaps, and vulnerabilities within the locality or state they cover, and can be a critical resource in addressing a COVID-19 among people experiencing homelessness.

Provide Funding to Homeless Service Providers to Reduce Transmission Risk

States and localities should fund CoCs to implement interventions that can reduce the transmission of the coronavirus within the homeless population. Homeless service providers (including providers of medical street outreach, emergency shelter, day shelter, outreach programs, case managers and diversion and housing specialists), are on the front line each day working with those at greatest risk. These providers can implement key interventions prioritized by public health departments to reduce disease transmission.

While use of funding must reflect the needs of each individual community, public health officials and homeless service providers may want to prioritize spaces in which highly vulnerable homeless adults congregate in large numbers. Examples of how new funding can be used to reduce risk of transmission into the homelessness population include:   

  • Expanding outreach services to unsheltered individuals. This may include dedicating homeless outreach staff to accompany mobile public health services staff to ensure public health screening, education, and support services reach unsheltered individuals. It may also include equipping people living without shelter with supplies to stay safe (e.g. hand sanitizer, access to water) and resources for to bring indoors those in acute need (e.g. motel vouchers for older adults with respiratory illnesses).
  • Reducing high concentrations of highly vulnerable adults living in close proximity:
    • Targeting housing subsidies and available affordable housing units to highest risk individuals experiencing homelessness (older adults in poor health and/or with respiratory conditions) and expedite take-up of resources (reduce time it takes to inspect units, process paperwork, etc.).
    • Providing short-term rental assistance to help people quickly return to housing where they will be safe.
    • Providing help for homeless adults to reconnect with family or attain independent permanent housing, including:
      • limited flexible financial assistance (equivalent to 2 months of rental assistance)
      • Housing navigation services
      • Problem-solving and diversion services
    • Expanding temporary shelter capacity to reduce both unsheltered homelessness and reliance on overcrowded shelters. This may include:
      • bringing new temporary housing options online (e.g. renting apartments that can be used for short-term shelter);
      • working with faith communities to bring unused space on-line for shelter;
      • extending “seasonal” shelter options; and
      • allowing shelters and day programs to increase hours of operation (e.g. allow emergency shelter to stay open 24 hours a day, or allow day shelters to operate 7-days a week).
    • Ramping up efforts to reduce barriers to shelter and transitional housing programs. When homeless shelter programs do not admit pets, or provide shelter conditioned on following a service plan, vulnerable people will choose to forgo a bed and remain outdoors.  We cannot afford to let safe beds go unused in the midst of this crisis.
  • Improving the hygienic conditions where large numbers of people experiencing homelessness congregate. This may include providing funds to increase the sanitary conditions of building facilities (e.g. shelters or churches that regularly host lunch or dinner programs), or providing mobile services (e.g. handwashing stations) that allow unsheltered individuals to regularly wash hands and provide self-care. It may also include funding to allow for ongoing deep cleaning of shelter and food programs, whoh might require funding for maintenance personnel and cleaning supplies.
  • Expanding case management capacity to help homeless individuals access health care screenings and services, including providing support services to homeless individuals who may need to be quarantined by local health officials as a preventative measure.
  • Reduce new entries into homelessness by ensuring individuals exiting prison, jail and hospitals are connected to housing.  Provide legal representation, social work services, and flexible financial assistance to prevent vulnerable adults and families from losing their housing.

It may be too much to hope that individuals experiencing homelessness will not join those already impacted from the coronavirus.  Like everyone else, individuals who experience homelessness will require a safe place to self-quarantine.  They will have fewer financial and social resources to withstand the need to self-quarantine, so they must be considered when developing plans for those who are diagnosed.

Stay Abreast of Developments

The suggestions outlined above are among many other strategies that states and localities can adopt to protect people experiencing homelessness.  Information about the coronavirus is developing rapidly, and the Alliance is grateful to federal and nonprofit partners who are adding to the knowledge base. Some valuable (not exhaustive) resources to protect homeless people from the coronavirus include: