Responding to COVID-19 in Emergency Shelters

How DC is protecting and supporting those experiencing homelessness during the coronavirus (COVID-19) pandemic

Overview

On March 11, 2020, Mayor Bowser declared a coronavirus (COVID-19) public health emergency in the District of Columbia. Since then, the DC  Department of Human Services  modified operations and implemented a strategy to prevent the introduction and spread of COVID-19 in low-barrier shelters. The following details the steps and actions taken to protect the District's most vulnerable residents from the novel coronavirus and to prevent its spread in congregate shelters throughout the city.

Strategy & Approach

Our prevention and protection strategy for our emergency shelters has five key activities:

Ensuring the safety of staff and providers is a top priority for DHS. Since the public health emergency was declared, we have partnered with providers to share guidance on operations and logistics, highlight national best practices and federal guidelines, and distribute personal protective equipment.

DHS worked closely with shelter providers and stakeholders to implement the following procedures to prevent the introduction and spread of COVID-19 within District shelters.

  • Institute daily screenings to check for COVID-19 symptoms;
  • Rapidly test residents to quickly identify new cases and conduct contact tracing in order to move any new positive cases and close contacts to isolation and quarantine sites;
  • Extend shelter hours to 24/7 and institute a same shelter, same bed policy to reduce movement across the continuum and city;
  • Reduce the number of beds compared to pre-COVID capacity;
  • Stagger meal times and moving to grab-and-go meals;
  • Provide personal protective equipment for all shelter residents and staff; and
  • Provide on-demand transportation only, with priority for those seeking shelter.

DHS established a daily screening system for all customers upon entry and carefully tracks new cases at each shelter. This allows us to quickly identify any outbreaks and implement a rapid response of isolation and quarantine as needed.

We quickly identify new cases and conduct contact tracing in order to move all positive cases and close contacts to isolation and quarantine sites. We provide deep cleaning to all impacted dorms and common spaces.

We partnered with the DC Department of Health to develop a mass testing strategy. Mass testing at a shelter is triggered by an outbreak (which is defined differently at different phases of the District reopening, depending on level of virus transmission).

Quarantine and Isolation

The District has dedicated hotel rooms to serve as isolation and quarantine sites for anyone who has tested positive for COVID-19, is waiting for test results, or is a close contact of a positive case, and cannot safely quarantine at home. Demand for rooms has been driven by shelters, outreach workers, and hospitals, and the District has managed the number of available rooms as the need and situation develops.

Residents are provided with a private hotel room and ensuite bathroom, and amenities include internet and television, meals and snacks, laundry, security and privacy, transportation to and from hotels, daily wellness visits by medical staff, and case management supportive services.

The availability of hotel rooms has been critical in our strategy to quickly remove positive cases and close contacts from our low-barrier shelter system, while also meeting the quarantine needs for others in our community.

Workbook: DHS COVID19 Dashboard for StoryMaps

Medically Vulnerable Residents

In March 2020, DHS opened hotels exclusively for medically vulnerable customers residing in congregate shelters or who were unsheltered and were at high risk for COVID-19.

Prioritizing those with highest need

Eligibility criteria include anyone who is over 55 years of age, or customers of any age who have certain underlying medical conditions that put them at highest risk. Medical staff review all referrals to determine eligibility.

Prioritizing paths to permanent housing

For many at the hotels, this will be their last stop in the shelter system before moving to permanent housing. In order to facilitate this path to permanent housing for as many customers as possible, the District has taken a number of steps, including:

  1. Adjusting coordinated entry criteria to prioritize medically vulnerable customers at hotels;
  2. Providing on-site case management to support initial documentation gathering for housing applications and to facilitate connections to Permanent Supportive Housing case managers;
  3. Expediting eligibility review of housing applications; and
  4. Proactively identifying potential housing units and landlords where customers can use site-based or scattered-site housing vouchers.

The numbers above reflect yesterday's counts, updated daily.

Vaccinations

In partnership with DC Health, DHS and Unity Health Care are making it easier for residents experiencing homelessness to access the COVID-19 vaccine. Beginning in February 2021, we are setting up vaccine clinics at shelters, hotels and encampments across the District in order to bring the vaccine to residents. In order to answer questions and address concerns about the vaccine and its safety, we are holding town halls at each shelter, led by Unity Health Care and DC Health medical professionals, and are distributing materials to clients with more information about the vaccine. Through our COVID-19 Peer Educator Program, 23 District residents currently or formerly experiencing homelessness, are sharing information and resources on COVID-19 protective measures, promoting compliance with COVID-19 guidance, and encouraging vaccination participation among shelter residents. 

Getting vaccinated against COVID-19 is one of the best ways to protect our peers, friends, family members and those in our communities from contracting the virus, but the vaccine for COVID-19 is only one of the ways to stop the spread of the disease. Programs will not change any of their COVID-19 protocols and the vaccine is voluntary for all clients; each client’s individual decision to receive the vaccine or not will not impact clients’ access to shelter or services.

Note: The "Total Number" metric below includes individuals that could not be determined as client or staff.

Looking Forward

We are proud of the work we have done and the steps taken to prevent the introduction of COVID-19 to our low-barrier shelters, and to mitigate the spread and impact of the virus at shelters where it was introduced. But we are concerned with each and every illness and saddened by the loss of life among the twenty-six people who died from COVID-19 without the dignity of a home.

Looking ahead, the Bowser Administration and DHS will continue to work with our federal partners to leverage funding from the recent federal relief laws to help residents access additional food supports, maintain existing housing and/or find new housing. We have worked with the DC Housing Authority and providers to establish virtual processes to safely lease up households who have been matched to supportive housing programs.

We are working closely with the DC Department of Health to determine what reopening looks like in the shelter system and when it should happen. This may differ from the metrics used for the District's phased reopening given the different context and needs of those staying in emergency shelter.

For more information on the District response to the coronavirus (COVID-19) public health emergency, visit  coronavirus.dc.gov .