A report released by the National Alliance to End Homelessness (NAEH) describes findings from a survey and interviews conducted with Continuum of Care (CoC) providers following the onset of COVID-19. The report, “Community-level Responses of Homelessness Assistance Programs to COVID-19: Data from May 2020,” finds that while many CoCs have been able to implement social distancing guidelines and increase capacity in hotels, significant challenges remain. Specifically, CoCs voiced the need for increased permanent housing, hotel rooms, personal protective equipment (PPE), and staffing support.
People experiencing homelessness are far more likely than the general population to require hospitalization and critical care if they contract coronavirus, due to the fact that risk factors leading to the most severe COVID-19 cases are overrepresented in unhoused populations. Individuals experiencing homelessness are more likely to be older and have underlying conditions such as asthma, kidney disease, lung disease, and diabetes. They are also more likely to be people of color. Given these increased risks, CoCs have grappled with how best to serve people experiencing homelessness during the pandemic. Primary concerns include how to provide shelter for those infected with the coronavirus; how to provide shelter to those at greatest risk of severe illness; how to implement social distancing in shelter settings; how to acquire adequate PPE; and how to protect staff.
To collect data on community-level responses to these challenges, NAEH emailed surveys to all 397 CoCs on April 23. Forty-two percent (168 CoCs) responded to the survey. NAEH also conducted phone interviews with a sample of CoC contacts to collect in-depth information about responses, challenges, and future priorities.
Many CoCs have been able to move quickly to address some of the most pressing challenges posed by COVID-19, including increasing temporary housing placements and adapting shelter services to meet CDC guidelines. Ninety-two percent of CoCs reported implementing social distancing guidelines, and 83% reported being able to procure hotel rooms for individuals who had been staying in shelters. Additionally, 30% reported opening new emergency shelters. CoCs have also made specific accommodations for those medically impacted by COVID-19. Thirty-seven percent of CoCs report housing symptomatic individuals in a designated space within a shelter; 62% report housing symptomatic individuals in hotels; and 22% report housing symptomatic individuals in other separate facilities. Only 4% of CoCs reported no special arrangements for those who were symptomatic or diagnosed with COVID-19.
Despite these accommodations, CoCs have also experienced significant challenges. While many CoCs have expanded shelter services, nearly one fifth of CoCs report closing emergency shelters. Many also report a major shortage in PPE: 49% did not have enough masks for symptomatic/diagnosed residents, and 59% did not have enough masks for shelter staff. Sixty percent reported staff shortages due to employees staying home to quarantine or the need for social isolation, employees being out sick, and employees resigning amid fears of contracting COVID-19 at work. These shortages were most prevalent among frontline shelter workers and street outreach workers.
When asked how they were prioritizing current resources, 51% of CoCs ranked hotel room acquisition as the top priority. This was followed by permanent housing (18%) and PPE (9%). When asked how CoCs would prioritize future funding, 56% of CoCs ranked permanent housing as the top priority and 74% ranked it has the 1st or 2nd priority. Sixteen percent ranked hotel or motel rooms as the 1st priority for future funding, and 39% ranked rooms as the 1st or 2nd priority. Interviews with CoCs revealed that permanent housing would curb concerns about where medically vulnerable populations would go once hotel/motel funds expire. This finding highlights the importance of additional funding for non-congregate shelter options, permanent housing, and rental assistance. Additional emergency funding would also allow CoCs to acquire adequate protective equipment to keep residents and staff safe.
The report can be found at: https://bit.ly/3eaY5Um