You are on page 1of 6

TO: ReOpen DC Human Services, Social Services, and Health Subcommittee

FROM: Brianne K. Nadeau, chairperson, DC Council Committee on Human Services


RE: Recommendations for your consideration
DATE: May 1, 2020

Ensure shelter is available and safe


• Entering shelter has been a scary proposition for many people in normal times, but
misinformation about the greater risk of contracting Covid-19 in shelter means that more
people are staying unsheltered or in otherwise unsafe situations.
• We have to address the STIGMA around entering shelter or other available sites for
quarantine to make sure that vulnerable people are not unsheltered or that family members
that are unable to isolate at home, for fear of exposing their cohabitants, have a safe place to
go.
• Just as importantly as addressing the stigma is ensuring that our shelters and quarantine
locations are safe and well-staffed. So, what steps do we need to take?
1. We need to immediately ramp up testing at shelters to be in compliance with the
Mayor’s Order 2020-063 – this means that even asymptomatic individuals in shelter
get tested if they have had exposure to an individual that has tested positive. And then
we need to continue to ramp up testing as we are able.
2. We need to greatly reduce density in our shelters so that TRUE social distancing can
be achieved.
3. We need to procure substantially more hotel or apartment style placements. While
many jurisdictions are working to move their entire shelter populations into these
locations, in the short term it is critical that we at least have enough beds for our most
vulnerable.
4. We need to stem the flow of new entrants into shelter whenever possible by working
upstream with individuals that are at greatest risk of experiencing homelessness.
5. We need to work downstream to move people out of shelter and into more permanent
housing.

Reducing Shelter Density


• Some jurisdictions have started to argue that there is no way to safely social distance in a
congregate shelter setting.
• This very well may be the case, but we also know that it is different for every shelter
depending on the type of floor plan.
• For example, there may be no way to properly social distance in a dorm style shelter like
CCNV, while strict enforcement of social distancing norms at a shelter like Patricia Handy
that has smaller rooms may be sufficient.
• The critical point is that individuals need to be able to sleep at least 6 feet apart and also have
space to social distance during waking hours – including the ability to eat meals at a safe
social distance.
• The next three topics will speak to some strategies that can help us achieve true social
distancing.

More Individual Placements and Rapid Expansion of PEP-V


• Overall, we just need more locations so that we can properly space beds. Ideally, we would
be able to place all if not most individuals in shelter in separate rooms.
• However, the highest priority right now is expanding PEP-V beds.
• The purpose of PEP-V is to provide isolation beds for the most highly vulnerable individuals
in shelter so that they can be protected from contracting the virus. The theory is that this
population is at the greatest risk of experiencing severe health outcomes if the contract
Covid-19, and thus, should be proactively pulled from the general shelter population.
• DHS is working with Unity Health to make determinations about placements in PEP-V, and
they are focusing on a combination of factors including age and preexisting conditions.
• Currently there are only 125 PEP-V beds online and earlier this week, 113 of those beds were
filled.
• The concern is that we are not meeting the need here.
• Looking back at last year’s Point in Time Census, we know that:
o 648 (16.8%) individuals surveyed were over the age of 62;
o 815 (21.1%) individuals had chronic health conditions; and
o 116 (3%) individuals were living with HIV/AIDS.
• Looking at TCP census data from about a week ago (4-23-20), we know that currently in the
homeless services system there are:
o 719 individuals that are age 60 or over; and
o 417 individuals that are age 50 and over have chronic health issues with their liver,
kidneys, stomach, lungs, or heart.
• These numbers show that the need is greater than the current capacity.
• We must expand capacity now and make sure that it can be maintained for an extended
period of time, because the purpose of PEP-V is to prevent contraction of Covid-19 in this
highly vulnerable population.
• We must assume that individuals placed here will have to stay for extended periods of time
unless: (1) the public health emergency is greatly brought under control – likely with a
vaccine; (2) the person is placed in more permanent housing; or (3) the person requires
hospitalization.
• Many of us in government have been working hard to find different creative solutions for this
issue and I urge this committee to bring to bear all resources and tools to bring more PEP-V
beds online now.
• While doing this, we need to be very thoughtful about our staffing. Often people placed in
PEP-V have a higher level of need in terms of physical and medical supports including
special dietary needs, help with toileting and washing, help managing medications and
treatments, and more.
• We need to ensure that these locations are properly staffed with support workers, nurses, and
doctors.
• Finally, on this point, I want to reiterate that DC does not have to handle this financial burden
alone. We know that there are federal funds, including funds from FEMA, dedicated to this
very purpose and we need to be thoughtful in targeting those dollars.

Address the Issue Upstream – Homeless Prevention and Financial Assistance


• Another way to ensure that we are promoting true social distancing in shelters is to try to
reduce the inflow of new residents.
• While we absolutely want to encourage people to come to shelter if they need it, the goal
always should be, but now more than ever, to help individuals stay in their homes or find safe
housing outside of the shelter system.
• We know that our Homeless Prevention Program has been effective for many families and
we need to continue adequately funding this intervention.
• The Mayor’s allocation of $1.5 million to offer tenant-based rental assistance to low-income
renters through our federal CDBG Block grant is a much-needed enhancement to our ERAP
funds.
• Unfortunately, it won’t be enough. ERAP funds are exhausted every year under normal
circumstances, and more than $1.5 million is needed to fill that gap. While we wade through
many difficult budgetary decisions ahead, we need to remember that if we are unable to keep
individuals and families in their homes, they are going to end up in the homeless services
system.
• We will continue to need a blend of federal and local funds for rental assistance to ensure we
are preventing homelessness for all of our residents, including those who are undocumented.
We should also take this opportunity to improve access to the rental assistance program with
a centralized intake system that connects constituents with the first available appointment
with our partner agencies, rather than requiring them to call each agency to find an available
slot.
• Another critical population that we need to continue to problem-solve for in the midst of the
pandemic is our returning citizens population. During “normal” times, this is one of the
largest inflows into homelessness and I have to imagine that during this pandemic it is even
harder for them to find safe placements with family, friends, or even alone. This issue is only
exacerbated by the closing of Hope Village. We need to think of ways to help these residents.

Address the Issue Downstream - Move individuals out of shelter and into permanent
housing
• The final piece of the puzzle is to create a steady outflow from shelter into permanent
housing.
• We already have various programs in place that can be brought to bear including FRSP and
PSH. We need to ensure that these program are sufficiently funded to not only respond to
broader systemic issues with homelessness, but more acutely, to ensure that our shelters do
not become overpopulated during the pandemic.
• One of the silver linings of this public health emergency is that we have consistent access to
our sheltered population. This is an opportunity to engage these individuals with the various
and robust support services that our city has to offer.
• I would like to see our public health experts work with our social workers and case workers
to think of creative and safe ways for them to engage with individuals in shelter so that when
we do reopen, we are ready to better serve this population.

The Future of Service Centers


• In the past few weeks, the city has reinvented how people obtain, maintain, and ask questions
about their public benefits.
• In what I am sure was an incredibly challenging collective effort, we now have a web portal
for our residents to access benefits.
• While there have been some bumps in the rollout, including the continuing need to provide
full language access to the resources in the portal, I am very proud of the effort.
• As we start pivoting to reopening and thinking about how we can improve on what we have
done before and what we are doing now, I believe this web portal represents a very important
inflection point in how we think about the Economic Security Administration’s operations.
• For example, once we start bringing more staff back to service centers, do we really want
people spending hours in waiting rooms?
o Right now, this might be a major public health risk.
o Also, we have known for a long time that these long waits result in a negative
customer experience and often force people to take time away from jobs or other
responsibilities that we should be encouraging them to prioritize.
o We need to be thinking about ways to utilize this newly created technology to
improve access to information and efficiency of the system.
Alliance
• Similarly, we know that in-person renewals of Alliance benefits have resulted in many
people being uninsured for extended periods of time.
• While we know that reducing the frequency of recertifications, whether in-person or
remotely, comes at a cost, I believe that this public health emergency clearly demonstrates
the importance of having all of our residents insured, no matter their race, socio-economic
circumstance, or immigration status.
• On this issue, there is no need to reinvent the wheel. There are two pieces of legislation that
have been passed into law and are ready for funding and implementation. We should be
examining how this period of suspended recertification has aligned with the costs predicted
by the CFO.
A Robust 2-1-1 system to support the work of the agencies
• Prior to COVID-19, the Deputy Mayor’s office had been in the process of standing up a
robust 2-1-1 system. This health crisis has demonstrated how important it is to have well-
trained personnel who can identify all of a caller’s needs and connect them to services,
whether it be healthcare, public benefits, domestic violence resources or housing supports.
• The work DHS has done to quickly move so many public benefit programs online will work
hand-in-hand with a fully-functioning 2-1-1 system, as would a reformed rental assistance
program.

A Resilient Workforce

• We must ensure adequate counseling and supports to those working in all healthcare settings
including hospitals, clinics and home-based care
• We should fund and implement Direct Support Professionals legislation to assist in
recruitment and retention of workers. In the home-based workforce that serves people with
disabilities, we have already experienced a shortage of workers, and under the current
circumstances, there are fears that there will not be enough workers in home-based
care moving forward. Funding and implementing this legislation would help ensure the
supports our residents with disabilities need, now and in the future

You might also like