Table 1.

Key Lessons for Pandemic Response in Homeless Populations

Key Lessons	Participant quote(s)
1. Implement/ strengthen interagency community partnerships.	“I think another thing that we’ve put in place during this that we want to continue is just the way we’re coming together as a community to problem solve and work together. So, these weekly calls emerged out of a crisis response, but it’s really kind of built a new sense of community and trust and transparency among lots of different partners that I think we will continue well beyond this.”
2. Provide mental health and substance use services in homeless settings.	“We definitely saw a shift in the need during COVID-19 of expanding access to behavioral health services, specifically around connections to mental health services and substance abuse treatment.”
3. Maintain and expand telehealth access.	“A lot of health providers are saying like hey telehealth is actually a pretty good way to connect with people. And so we’re trying to figure out how to continue building the infrastructure to support telehealth for people experiencing homelessness or newly housed to be able to continue to access their healthcare in that kind of way, and not have to physically go to a location to see a provider.”
4. Track and share data to better inform practices.	“We’ve been forced to do some more data sharing and data tracking to really understand the impact of COVID-19 particularly on those experiencing homelessness … to do data tracking in a way to help inform our community and to make informed practice is something I think that we’re really learning through this process of the importance of being able to understand in as real time as possible, how things are affecting those experiencing homelessness. So that’s been, I think, an important practice that we will absolutely need to continue to improve on.”
5. Expand targeted outreach strategies.	“The way in which, for example, we’re doing street outreach and things like that … outreach teams have been amazing … coordinating crisis response to making sure those living unsheltered really have access to not only their basic needs but then access to getting connected to resources and hopefully housed, and making sure like the whole city is covered in terms of where there might be pockets of unhoused people. And so I think that’s a practice that we’re definitely looking at continuing and scaling doing outreach in a much more targeted and dedicated way.”
6. Increase shelter diversion resources.	“For the shelter, I would really love to keep a reduced capacity, because I think it’s more trauma informed … I think it’s undignified to have to share space with someone else, particularly if you’re going through trauma. So I’d love to keep that but the only way to keep that would be to keep up the increased amount of resources we have for shelter diversion like hotel rooms and deposit first month’s rent and rental assistance.”
7. Reprioritize ending, not just preventing, homelessness.	“During COVID-19, I think we’ve also just seen the importance of, and demand for permanent housing. It’s really hard to keep people safe and healthy in congregate shelters or living in unsheltered locations.” “So, there’s a difference between preventing eviction and preventing homelessness … what about all these people that don’t have housing [now]. I just wish we could reprioritize what matters because I’ve seen what happens when people experience homelessness, and how their health, both physical and mental deteriorate after a while living in a homeless shelter or on the street, it is absolutely horrendous to see what happens to people.”
8. Prepare for long-term impact mitigation.	“I think that people understand that COVID might end tomorrow, but our work is not going to end tomorrow, people are going to struggle with this for a long time, because you don’t lose that much income and come right back from it... So it’s going to be long term. We’re going to have to be willing, as a nation, to help people for a long time.”
9. Leverage the COVID-19 crisis to increase visibility of homelessness.	“If there was a silver lining in all of this, I would say that what COVID has done for those who are experiencing homelessness … like people now kind of care, right, because we’re in the middle of a pandemic and … we’ve got these people that can’t shelter in place and they can’t protect themselves and they’re perhaps, they’re out spreading this virus to everyone as a public health crisis, or they’re all going to die. So, what, wait a second, is that okay? no it’s not okay. And so, it’s been interesting to see from a local, state, and national level the type of conversations that are being had that homelessness is not okay. Like what we’ve allowed as a country for these people that have happened to them is not okay.”