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Coordinating a National Response to COVID-19 with Homeless Service Providers

During a pandemic, speed counts--especially to help those most at risk. But how do the most vulnerable among us, people experiencing homelessness, follow even the most basic guidance the government has for tackling COVID-19? What does shelter in place mean for someone with no shelter? How does someone without access to a faucet wash hands frequently?

The closure of libraries, restaurants, and other public spaces reduces disease transmission for the majority, but cuts off critical access points so that people experiencing homelessness can’t reduce their risk. Speed, it turns out, is not the only metric that counts. So does coordination among public health agencies, homeless service systems, outreach teams, and communities. That often can make the difference in slowing an outbreak. Fortunately, in response to COVID-19, local communities, public health agencies, homeless service systems, and other outreach partners are sharing tools, research, and guidance.

Abt Global is helping them. Abt Associate/Scientist Natalie Matthews regularly works to reduce homelessness as part of Abt’s national homelessness technical assistance (TA) team. Now, she’s adapting her work to help the Department of Housing and Urban Development (HUD)’s Public Health Disaster TA team halt COVID-19’s spread. The team currently provides remote support to 35 U.S. communities with large populations of people experiencing homelessness, and Matthews leads the effort to support Boston, Maine, Milwaukee, Minneapolis and Philadelphia.

“Time is really of the essence,” said Matthews. “We are really focused on slowing the spread of COVID and getting information out that communities can use.”

Matthews explained that the team collected guidance from federal agencies and stakeholders, including the Centers for Disease Control & Prevention (CDC), and began rolling out screening tools to help homeless response systems, or Continuums of Care (CoCs), assess their clients for symptoms of COVID, whether they lived in shelters or were unsheltered.

“If CoCs don’t have a tool,” said Mathews, “we’re sending them examples so they can get that screening tool in place at all of their shelters and street outreach programs. They're not medical professionals, but they’re at the front lines. They need to be able to help identify people who need to be isolated, quarantined, or moved on for additional medical care.”

Coordination for Prevention & Treatment
The next step is making sure communities have safe spaces to care for individuals with COVID while protecting other shelter clients. Finding safe spaces can be hard.

“Many shelters are already maxed out,” said Matthews. “It’s often working with local officials to figure out if we can use empty hotels and motels for this response. Some communities are starting to use convention centers, or even schools, so that there are safe spaces for people we need to isolate or quarantine to stop the spread of the virus.”

Along with safe spaces, individuals are connected to health services and care referrals.

Adaptive Support to Respond in Real Time
In addition, the team works to ensure communities have the most up-to-date coronavirus research and practice information from HUD and CDC. That includes helping to address regulatory or statutory barriers that block change needed to address the crisis. The team supports this effort through regular weekly office hour sessions hosted online via HUD Exchange and through responses to community questions submitted through HUD’s Ask A Question (AAQ) desk.

As cases grow, Matthews expects Abt’s COVID-19 TA support will expand to other communities in the coming days and weeks. While travel restrictions make it harder to deliver hands-on assistance, she’s undeterred.

“Communities are just trying to stay ahead of the virus,” Mathews says. “For me, in some small way, to help communities address the needs of people who are really vulnerable is rewarding in itself.”

Learn more about HUD’s Public Health Disaster TA.

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