One of the more predictable consequences of the current COVID-19 pandemic has been its disproportionate impact on a traditionally marginalized group, the homeless. The more than 560,000 people who were homeless on any given night in 2019, according to the Housing and Urban Development Department, has stretched the usual array of support services to their limits.
“The regular services we provide our clients—shelter, treatment, rehabilitation, case management, crisis management, family support—all of that stuff that is part of our normal day we’ve had to put that on hold so we could address what do we have to do for COVID-19,” said Sharon Dorr, vice president of homeless services at Services for the UnderServed, one of New York City’s largest not-for-profit social service and housing support organizations.
Across the country, organizations serving the homeless faced the same dilemma: ensuring homeless residents’ safety. Their response was designating locations where those with the virus could be quarantined and those at higher risk could be isolated. Such emergency housing programs often offer routine medical checks, meals and help connecting with social services and aid toward procuring more permanent housing.
“People who live in congregate shelters can’t just close their doors to avoid all contact with others,” said Megan Cunningham, managing deputy commissioner at the Chicago Public Health Department. In March, the city and local stakeholders began providing more than 1,000 hotel rooms for those mildly ill from the virus, exposed to COVID-19 or at high risk and didn’t need hospital care but couldn’t self-isolate.
While the concept may be new to some, temporary, comprehensive care meeting the medical, behavioral and social needs of homeless patients is a model that’s been practiced on the medical establishment’s margins since the 1980s.
Medical respite, also known as recuperative care, has served as a bridge to help homeless individuals recover from illness when they are too sick to be on the street but not sick enough to go to or remain at a hospital.
Prior to the pandemic, the vast majority of the 100 or so recognized medical respite-care programs operating were run by not-for-profits at such locations as motels, apartment buildings, nursing facilities, homeless shelters and transitional housing facilities. But now a growing number of cities and states are adopting similar care models to stem COVID-19’s spread in their homeless populations. Many of these temporary, emergency initiatives are recruiting medical respite-care providers to offer technical expertise.
In Chicago, the city partnered with providers with experience delivering healthcare to the homeless. Local hospital networks, including UI Health, Cook County Health and Rush University System for Health, joined the initiative to operate clinical services at emergency sites. “They understand that this is different from delivering care to someone who is stably housed who has a pretty straightforward and mild case of COVID,” Cunningham said.
Now medical respite providers are considering how to lobby stakeholders to expand their programs and make them a more permanent part of the primary-care framework. “We know there is a strong need for more medical respite beds,” said Jennifer Nelson-Seals, CEO of the Boulevard of Chicago, a temporary residential facility providing homeless individuals with respite care on the city’s West Side. “This is now a great opportunity for legislators and medical respite providers across the country.”