People experiencing homelessness are especially vulnerable to COVID-19 for multiple reasons, including a lack of access to healthcare and safe and hygienic living environments and, among those in congregate settings, difficulty practicing social distancing. In this brief, we highlight key steps local governments should take to limit the spread of COVID-19 among people experiencing homelessness and those who serve them, including establishing ongoing processes to monitor risks and impacts associated with COVID19 and develop plans to respond as conditions change.
Key policy objectives
While responses to homelessness may vary across localities, we recommend that at a minimum, cities, towns, and counties affected by COVID-19 develop policies to address the following objectives:
- Ensure all sheltered individuals and families experiencing homelessness have access to a safe shelter in which social distancing is possible and practiced;
- Ensure policies are in place for dealing with outbreaks at homeless shelters;
- Ensure on-the-street individuals experiencing homelessness have access to the facilities needed to maintain adequate hygiene;
- Ensure individuals and families experiencing homelessness have access to medical care; and,
- Develop policies for handling the discharge of individuals experiencing homelessness from the hospital.
Over time, as cities are able to move beyond immediate crisis response, it would be useful to incorporate their homelessness responses into broader COVID-19 Housing Response Plans. To learn more about these plans and available resources to advance each of these policy objectives, visit the COVID-19 resources pages on homelessness response and COVID-19 Housing Response Plans.
Develop ongoing processes to coordinate responses to homelessness during the COVID-19 crisis
Given the wide array of challenges facing people experiencing homelessness during the COVID-19 crisis, local governments should take measures to involve key stakeholders (e.g., public health officials, senior housing and homelessness staff, elected officials, and service providers) in ongoing efforts to prepare for and coordinate responses among government entities and other organizations that provide services and support to people experiencing homelessness. The City of Baltimore, as an example, released an emergency response plan that coordinates planning among the Mayor’s Office of Homeless Services, city agencies, and service providers to implement prevention and response strategies.
To coordinate responses, we recommend that localities take steps to:
- Work with public health officials to create a regular means of monitoring COVID-19 cases in the sheltered and unsheltered populations experiencing homelessness.
- Develop a communications plan and outreach materials to help educate service providers and people experiencing homelessness about the risks of COVID-19, which populations are most at risk of infection or complications if they become COVID-19 positive, and how to prevent its spread.
- Connect with key agencies and community partners on a regular basis to discuss and plan COVID19 responses, such as:
- Service providers – expedite the registration of individuals into the homeless system given the urgent need for housing.
- Procurement and facilities management departments – put plans in place to quickly secure space if a new shelter is needed to promote social distancing or to purchase PPE or other items that protect individuals from exposure to COVID-19.
- Hospitals – develop protocols to safely and seamlessly transfer individuals experiencing homelessness to health care facilities, when needed, and for hospitals to notify homelessness service providers upon the release of (a) individuals recently experiencing homelessness so providers can return them to an appropriate shelter or isolation facility (b) individuals newly experiencing homelessness for providers to register them for services and place in an appropriate shelter or isolation facility.
- Schools – ensure children experiencing homelessness are able to participate in virtual learning activities.
- Criminal and civil justice system – keep track of individuals who may be at risk of homelessness, such as prisoners being released from local jails or tenants in the process of being evicted from their home.
Localities should also:
- Develop or update emergency plans to include steps to take in the event of isolated cases or an outbreak of COVID-19 among people experiencing homelessness, such as isolating individuals with suspected cases from others. Tailor the plans to address the unique risks faced by sheltered and unsheltered populations experiencing homelessness. Additionally, include contingency plans in case there is a reduction in the capacity of shelter staff and others that work with populations experiencing homelessness because of illness or needing to be quarantined.
- Implement CDC-recommended procedures for screening individuals for COVID-19 and referring those who meet the criteria for testing to a designated health care facility.
- Put plans in place to quickly implement contact tracing for individuals with suspected or confirmed cases of COVID-19 and isolate those who may have been exposed. Maintain regular contact with isolated individuals to learn if they become symptomatic or require medical care.
Act quickly to slow the spread of COVID-19
Once cases of COVID-19 are reported in your community, it is imperative to act quickly to slow the spread of the virus. The CDC has issued guidance on steps homeless service providers should take during the crisis to keep facilities, staff, and clients as safe as possible. These include:
- Expanding shelter capacity to better enable social distancing, which may include purchasing or leasing space at hotels or dormitories,
- Installing sanitary and protective equipment and providing staff and clients with PPE, and
- Isolating at-risk clients or those experiencing symptoms from other shelter clients.
For unsheltered populations experiencing homelessness, communicate the importance of social distancing and hygiene, ensure restrooms and handwashing stations are available, and provide masks to symptomatic individuals.
Seattle and King County provide an example of a comprehensive approach to reduce the spread of COVID19 among people experiencing homelessness. The governments are coordinating the work of several agencies, including the areas unified public health agency, King County’s Department of Community and Human Services, Facilities Management Division, and public transit authority (METRO), and Seattle’s Human Services Department. Their four-pronged strategy includes:
- Creating more shelter space for unsheltered individuals. Seattle dedicated 95 new spaces spread across three existing tiny home communities for unsheltered individuals referred by the city’s Homeless Navigation Team or other outreach workers.
- Reducing density of high-use emergency shelters. To increase social distancing in emergency shelters, Seattle added 358 new shelter spaces in four separate facilities that are being managed by nonprofit service providers. In addition, 200 hotel rooms and 80 beds at the airport are now dedicated to clients most vulnerable to COVID complications. City staff have been relocated from other departments to help staff these new city shelters.
- Creating isolation and quarantine spaces. King County is opening at least five facilities with on-site health care professionals that provide single rooms for isolation (for individuals who are exhibiting mild symptoms) and quarantining (for asymptomatic individuals who are at increased risk for exposure).
- Creating recovery spaces for people who do not require emergency care. King County is opening three Assessment Centers and Recovery Centers, which are congregate care facilities that provide supervised care to symptomatic or COVID-positive adults, including homeless individuals who have been discharged from a hospital.
Use federal funding to slow the spread of COVID-19 among people experiencing homelessness
Many of the actions described in this brief will require local governments to expend resources at the same time that their revenues are falling precipitously. In response to the COVID-19 crisis, the federal government has allocated new funding to states and local governments, and has placed restrictions on existing funding sources. Learn more about how local governments can use these resources to help slow the spread of COVID-19 among people experiencing homelessness.
Prevent increased homelessness during and after the COVID-19 crisis
The economic fallout from the COVID-19 pandemic will put great strain on the incomes and savings of vulnerable individuals and households, which can increase their risk of experiencing homelessness. Learn more about policies local governments can enact, including eviction moratoria and rental assistance, to enable tenants to remain housed during and after the crisis.
A Framework for COVID-19 Homelessness Response (National Alliance to End Homelessness)