“We’re trying to keep people alive.” 

While connecting people to housing has always improved and even saved lives, the immediate consequences of the coronavirus has raised the stakes for communities working to move people experiencing homelessness to safety.

The challenges identified by Built for Zero community leaders last month persist as the needs have only grown: communities are still struggling to find enough space to isolate vulnerable or symptomatic clients. A lack of personal protective equipment continues to hamper outreach efforts and endanger workers making it even more challenging to have the necessary staff to stand up and operate these new shelter resources. Communities are spending money now, without always knowing when expected funding or reimbursements will come in — for some, this means having to run up charges on credit cards just to keep operations going.

“We’ve gotten creative,” said one community leader. “There is no protocol for this.” 

Here are five common concerns we’ve heard from leaders in the homeless COVID-19 response, collected over the past two weeks.

1. Providers are still struggling to stand up and staff the necessary quarantine and isolation spaces.

Sheltering in place is impossible if you don’t have a home. Across the country, shelters are reducing their capacity, in order to spread people out to comply with social distancing guidelines. Some shelters are turning away people with fevers. Some emergency shelters have closed altogether.

The focus for many communities are securing quarantine and isolation spaces for people experiencing homelessness who may be asymptomatic, symptomatic, or at high risk of contracting COVID-19. Hotels and motels are the most common options, but communities have also reported using vacant nursing homes, sports facilities, camps, churches, abandoned buildings, trailers, and even heated wedding tents. 

Across the board, communities do not have enough spaces secured for all the people experiencing homelessness who need to isolate or quarantine — nationally, it’s estimated we’ll need an additional 400,000 beds to manage this crisis. Leading researchers estimated that it would cost more than $11 billion to secure the quarantine and isolation beds needed for people experiencing homelessness. The last stimulus bill carved out about $4.5 billion that could be targeted for this response.  

2. The lack of personal protective equipment continues to serve as a bottleneck for the most urgent activities, from outreach to transportation.

Communities across the country are reporting they lack the personal protective equipment (PPE) they need to keep their outreach workers safe. Alarmingly, some communities have reported having no access to PPE and instead are just relying on social distancing for protection. Last week, the CDC changed their guidelines to recommend that everyone cover their mouth and nose with a cloth mask when in public, to avoid transmission of the coronavirus.

Outreach is a critical link to providing services to people experiencing homelessness and helping people get inside or the resources they need. In most places, outreach has declined as communities deal with dwindling frontline staff capacity, due to safety concerns and shelter in place orders. In other places, outreach continues by staff who do not have adequate PPE, compromising their own safety and the safety of others at risk. Without PPE, communities have struggled to staff quarantine and isolation units and to safely transport clients to safety or services.

3. Many housing programs and housing authorities are struggling to continue housing processes.

This crisis has underscored that housing is a critical public health measure. But though it’s more important than ever to get people into permanent homes, communities have reported that these processes have stalled, preventing them from placing clients into housing. 

In the face of this challenge, there are a growing number of landlords, public housing authorities, and housing specialists devising creative solutions to ensure people are able to get to safety. Some agencies have started conducting virtual housing inspections, using options like video tours. Other landlords have unlocked the door in advance, allowing staff to go in and conduct inspections alone and take photos and videos to continue the process. Public Housing Authority counselors have moved the submission of documents or lease signings virtually.

4. Communities are hard pressed to fund necessary staffing and interventions to combat the pandemic.

In the best of times, homeless service providers are operating on a narrow margin. In this crisis, they’re reporting tremendous funding gaps. Communities are put in a position where they must spend money now to solve public health issues, without knowing when reimbursement or funding will happen. For example, even though reimbursements from FEMA are promised, communities must have access to the capital needed to cover these costs up front. Communities urgently need flexible funding to expand their quarantine and isolation capacity, secure ambulance rides to transport COVID-19 positive clients to quarantine, ensure adequate personal protective equipment for staff, and staff isolation and quarantine facilities.

5. State and local governments are playing a critical goal in whether or not there are resources and units for quarantine and isolation.

We’re under a public health crisis, and homeless response providers will not be able to solve this alone. Effective response requires a whole of government approach, with state and local leaders playing a vital role in securing and allocating resources and setting up effective incident command centers that prioritize the homeless population. Communities are reporting a variety of responses from local government, running the gamut from strong engagement to no response. Among the encouraging responses we’ve heard from communities: one mayor helped immediately secure 100 hotel units for isolation; a county is leading the efforts to secure PPE for frontline homeless response staff, shelter space, and supplies; another state has provided millions to move people off the street and out of mass shelters into individual rooms.

How you can help

Support the leaders of your homeless response system. We’ve compiled a list of organizations leading the Built for Zero work at the local level.