Why police must continue homeless outreach during the COVID-19 pandemic

By Daniel McDonald, MPA

Police agencies with homeless outreach teams (HOTs) are concerned about the impact of COVID-19 on how they perform homeless outreach and are wondering how the pandemic should alter their response.

Homeless outreach officers can permanently solve problems by linking the homeless with shelter, housing, healthcare and income-producing opportunities, as well as treatment for addictions and behavioral health conditions. During COVID-19, these officers should continue, or even expand, their engagement with the homeless population while temporarily transitioning from a problem-solving model to a public health and safety model.

The homeless population in your community will likely be significantly impacted by COVID-19. The National Law Center on Homelessness and Poverty in Washington, DC recently stated that “People without housing are especially vulnerable to poor health and communicable diseases, including COVID-19.” The organization added that “unhoused people have limited options for safe, sanitary shelter, making an effective response to the deadly virus extremely difficult.” In California, Gov. Gavin Newsome recently estimated that up to 60,000 homeless persons could become infected with the coronavirus.

Defining the Problem

Homeless service providers are scaling back operations in many communities to prevent illness amongst their staff and volunteers. Social service agencies have closed their offices or transitioned to serving their clients via telephone or by appointment only. Drop-in centers have closed. Soup kitchens have stopped serving in dining rooms, often providing to-go meals. Libraries and other public facilities formerly available to the homeless have also closed. The lack of availability of these facilities and services often leave the police to be the de-facto response to homelessness.

Homeless Outreach During COVID-19

Police homeless outreach teams (HOTs) should temporarily shift from a problem-solving model to a public health and safety model.

Iain De Jong, a leading homelessness consultant and CEO of Orgcode, Inc. suggests outreach options depending upon available shelter options in your community:

• For communities that have expanded their shelter or motel options, outreach can be shifted to connecting the unsheltered homeless to available emergency shelter options.
• For communities without increased shelter capacity, take the time to plan your outreach efforts and don’t compete for increasingly scarce shelter resources. Instead, focus upon assisting the most vulnerable populations within your community. Consider leaving disinfecting wipes and hygiene supplies at encampments (if available).

Homeless outreach officers are critical to keeping the lines of communication open with the homeless community so they can remain informed.

“Be very clear the purpose of your outreach at this time, and how the intention of the outreach may currently be different than if these were normal times. You don’t want to confuse people now or later,” said De Jong

Maintain social distancing and do not conduct outreach as a group activity. Agencies that use a co-responder model should consider working individually.

Existing homeless outreach teams have already had the opportunity to develop trust between the police and the homeless. Police agencies can leverage this trust at a time when it is needed the most.

Mike McConnell, an advocate for the homeless in San Diego, California, offers three recommendations for homeless outreach officers:

• Continue to educate the homeless community on this rapidly developing and evolving situation.
• Keep the lines of communication open to reduce distrust and rumors.
• Offer the ability to reach out to the police (anonymously, if necessary) if they become sick or observe others who are sick and require medical attention.

McConnell adds that a lack of communication with the homeless is a “missed opportunity to educate” as many are concerned about being locked up against their will.

Enforcement Activities

Police should view ordinance or law violations as an opportunity to communicate and educate the homeless population on current resources and developments within their community. Additionally, many jails are not booking arrestees for minor law violations, which often include homeless violations. Some jails are also reducing their populations by releasing low-level offenders, which include the homeless.

Panhandlers who are attempting to meet day-to-day needs should be warned that their activities are unsafe due to lack of social distancing. They should be directed to food pantries, soup kitchens or addictions and mental health resources, depending upon their needs.

Police Agencies Can Lead the Way

Homeless shelters and social service organizations have limited budgets and are often dependent upon grant funding and donations. Few of these agencies are experienced in disaster preparedness and lack the resources to rapidly scale an increasing demand for shelter beds and other services.

In contrast, local governments and police agencies are skilled in disaster response planning and should consider assisting local NGOs with additional funding or resources (which may be FEMA reimbursable).

The greatest needs for local organizations include:

• Sanitation stations and portable toilets to reduce the risk of COVID-19 transmissions.
• Motel rooms for those living on the street that provide a safe, socially distant place that can be used to shelter-in-place. This should be a voluntary choice and not mandated. Food can be supplied from food banks or soup kitchens.

• Opening unused public facilities such as convention centers or schools for temporary dormitories for the homeless. Many communities are already familiar with providing hurricane or cold-weather shelters in their community.
• Rental of empty cruise ships in port cities to provide additional shelter capacity. Their crews are already experienced in sanitation and quarantine procedures.
• Allowing temporary, sanctioned encampments: Not all of the unsheltered homeless will want to stay in a motel room. Additionally, shelters may need to reduce their population to maintain CDC social distance guidelines. Recently a shelter in Florida moved mattresses to a nearby highway underpass to accommodate CDC guidelines on bed spacing. This option, if considered in your community, should include a sunset provision to prevent temporary encampments from becoming permanent encampments once the pandemic is over.

Quarantine Locations and Involuntary Commitments

Any of the aforementioned solutions can also be used for temporary hospitals or quarantine facilities. However, as Ian De Jong, CEO of Orgcode, Inc. observes, “In many communities, there is a struggle to figure out where the best location will be to quarantine people who are homeless because of the virus. The best advice on this one is this: do not let the homeless services system become solely responsible for solving this potential need.”

The public health system should be responsible for quarantining those infected with COVID-19, whether they are homeless are not.

You will likely encounter homeless subjects displaying COVID-19 symptoms who refuse treatment. Situations such as this may require an involuntary commitment, called the Baker Act in Florida if they are a danger to themselves or others and/or unable to make an informed decision about their healthcare. They should be evaluated and transported by medical or public health professionals.

Centers for Disease Control and Prevention (CDC) Guidelines

The Centers for Disease Control and Prevention (CDC) recently issued “Interim Guidance for Responding to Coronavirus Disease 2019 (COVID-19) among People Experiencing Unsheltered Homelessness.” Recommendations include:

Encampments:

• Unless individual housing units are available, do not clear encampments during community spread of COVID-19. Clearing encampments can cause people to disperse throughout the community and break connections with service providers. This increases the potential for infectious disease spread.
• Encourage people staying in encampments to set up their tents/sleeping quarters with at least 12 feet x 12 feet of space per individual.
• Ensure nearby restroom facilities have functional water taps, are stocked with hand hygiene materials (soap, drying materials) and bath tissue, and remain open to people experiencing homelessness 24 hours per day.
• If toilets or handwashing facilities are not available nearby, provide access to portable latrines with handwashing facilities for encampments of more than 10 people.

Communications:

• Provide straightforward communications to people sleeping outside in the appropriate language. Identify people who are influential in the community who can help communicate with others. Post signs in strategic locations to provide information on hand hygiene, respiratory hygiene, and cough etiquette. Request up-to-date contact information for each person.

Information to share includes:

• The most recent information about COVID-19 spread in their area
• Advice to avoid crowded areas if COVID-19 is circulating in their community

• Social distancing recommendations
• Hand hygiene instructions, cough etiquette instructions, and advice not to share personal items
• How to recognize the symptoms of COVID-19 and what to do if they are sick
• What to do if their friends, family, or community members are sick
• How to isolate themselves if they have symptoms
• Updated information on where to find food, water, hygiene facilities, regular healthcare, and behavioral health resources if there have been local closures or changes

The CDC also released guidelines for homeless services outreach staff. Recommendations include:

When COVID-19 is spreading in your community, assign outreach staff who are at higher risk for severe illness to other duties. Advise outreach staff who will be continuing outreach activities on how to protect themselves and their clients from COVID-19 in the course of their normal duties. Instruct staff to:

• Greet clients from a distance of 6 feet and explain that you are taking additional precautions to protect yourself and the client from COVID-19.
• Screen clients for symptoms consistent with COVID-19 by asking them if they have a fever, new or worsening cough, or shortness of breath.
  • If the client has a cough, immediately provide them with a surgical mask to wear.
  • If urgent medical attention is necessary, use standard outreach protocols to facilitate access to healthcare.
• Continue conversations and provision of information while maintaining 6 feet of distance.
• Maintain good hand hygiene by washing your hands with soap and water for at least 20 seconds or using hand sanitizer (with at least 60% alcohol) on a regular basis.
• Wear gloves if you need to handle client belongings. Wash your hands or use hand sanitizer (>60% alcohol) before and after wearing gloves.
• If at any point you do not feel that you are able to protect yourself or your client from the spread of COVID-19, discontinue the interaction and notify your supervisor. Examples include if the client declines to wear a mask or if you are unable to maintain a distance of 6 feet.
• Provide all clients with hygiene products, when available.
• Street medicine and healthcare worker outreach staff should review and follow recommendations for healthcare workers.
• Review stress and coping resources for yourselves and your clients during this time.

In summary, police agencies should remain committed to homeless outreach to reduce the impact of COVID-19 upon the homeless in their community. This population is especially vulnerable to this virus, and now is the time to deploy an effective and safe response.

References

• California governor: 60,000 homeless could get COVID-19.
• Response, Action and Wellness During a Pandemic.
• Homeless shelter moves mattresses to underpass to maintain social distancing.
• Seattle’s homeless have few options to self-isolate to avoid coronavirus.
• COVID-19 Statement & Recommendations.
• Why the homeless, ‘surviving the best way they can,’ are vulnerable to coronavirus.
• As the coronavirus pandemic continues, homeless communities are particularly vulnerable.
• Interview with Mike McConnell, San Diego, CA advocate for the homeless. Conducted via telephone with Daniel McDonald on 3/22/20.
• Interim Guidance for Responding to Coronavirus Disease 2019 (COVID-19) among People Experiencing Unsheltered Homelessness.

About the author

Officer Daniel McDonald, MPA is a 27-year veteran of law enforcement and corrections, and currently leads a police homeless outreach team for a large Florida police agency. He has presented at the International Association of Chiefs of Police conference as well as conferences throughout the United States. His work has been covered by People Magazine, the Today Show, the BBC and media around the world. He also consults for other agencies and cities, developing effective police responses to homelessness. Contact him at info@homelesspolice.com.