This memo is part of Beyond Flattening the Curve, a series of policy recommendations for the COVID-19 crisis.
Persons experiencing homelessness face higher risks of contracting, experiencing severe complications, and dying from coronavirus. Mitigating coronavirus risk among persons experiencing homelessness, who are uniquely vulnerable to the spread of the disease, is imperative to reduce deaths, community spread, and stress of the healthcare system, yet doing so comes with unique policy challenges. Collaboration between government agencies and homelessness care organizations is difficult or sometimes nonexistent; in order to slow community spread and protect those experiencing homelessness, it is essential for government agencies to engage in increased and ongoing coordination across all levels of government and various stakeholders.
My research shows that the challenges for providing proper care for persons experiencing homelessness stem from barriers to intergovernmental collaboration. Solutions to homelessness require coordination between multiple levels of government (federal, state, local), and federally designated homeless policy governance systems, known as Continuums of Care. The Continuums are primarily non-governmental organizations receiving public dollars to address homelessness in their jurisdictions. There are also barriers to intersectoral collaboration. Solutions to homelessness and now the COVID-19 threat require multi-pronged approaches across many sectors including housing, behavioral health, Medicaid, policing and carceral systems.
Most local governments do not participate in homeless policy and delegate full responsibility to the Continuums. The lack of intergovernmental coordination, especially between non-governmental Continuums of Care and local governments, restricts their authority and access to design and implement policies addressing coronavirus among this population, Presently, this includes creating access to additional shelter facilities for isolation such as hotels, stadiums, trailers, and permanent housing that are essential to inhibit coronavirus spread.
There has also been a lack of coordination with other, related services and organizations, which is putting a strain on the policy efforts towards homelessness. For example, Continuums are currently seeing higher volumes of persons exiting the criminal justice system and into homelessness, without notice or limited planning, further straining the limited supply of isolated shelter and risking greater community coronavirus spread. Greater communication with related government services including behavioral health, Medicaid, and the criminal justice system would allow homelessness services to better prepare and plan for the people they are trying to serve. Continuums without local government support face greater barriers to collaboration compared to those working with or part of local government. It is clear that successful prevention and mitigation of coronavirus among persons experiencing homelessness requires 1) direct, persistent coordination between
Continuums and local governments, including monetary and other resources for essential services; and 2) expanded, persistent collaboration between Continuums and stakeholder institutions such as the criminal justice system or the Medicaid system.