Advocates and local leaders face tight spaces, tough challenges

Editor’s note: The reporter for this story is a volunteer and paid staffer at Hundred Nights, a Keene homeless shelter, where the leader is one of the sources interviewed for this report.

By Sierra Hubbard

Granite State News Collaborative

For a highly contagious virus, a homeless shelter with dozens of beds, sometimes less than two feet apart, is extremely vulnerable.

While people who have housing can actively choose whether to follow the Centers for Disease Control and Prevention’s social distancing guidelines, those facing homelessness are living in “matchboxes,” as one advocate described it. 

Most advocates agree on a two-pronged approach to protecting the homeless population from the new coronavirus pandemic: quarantining the sick and thinning out the shelters. More than six weeks after the governor declared a state of emergency in New Hampshire, however, shelters and communities are trying to calculate when the matchbox might light and how to be proactive versus reactive.

People with symptoms of COVID-19, the disease caused by the coronavirus, need to be tested and isolated while awaiting results to avoid potentially infecting others. Because most homeless shelters are already cramped, quarantine requires a separate space, such as a motel room. To reduce shelter populations, many state and local leaders argue for the creation of decompression sites, which essentially would be additional temporary shelters, while some advocates push for getting people into long-term housing.

Gov. Chris Sununu issued an emergency order April 9 directing state and local governments, as well as private sector partners, to cooperate to achieve both of the goals outlined above. 

“During the COVID-19 emergency, New Hampshire has coordinated with shelters, outreach workers, town officials and healthcare providers to provide quarantine and decompression options for individuals who are homeless, and provided testing at homeless shelters with exposure risks,” states an email from the state’s Joint Information Center, which is fielding all media questions related to the virus.

As of April 25, the center reported two people experiencing homelessness have tested positive for the coronavirus.

When a health care provider recommends quarantine for someone living outdoors or in a shelter, the center explained that the shelter and local officials can contact the state’s Emergency Operations Center to determine next steps. The state has coordinated and paid for the placement of a couple dozen people in hotel and motel rooms in communities across New Hampshire.

N.H. Health and Human Services Commissioner Lori Shibinette has said the state plans to establish two quarantine facilities for COVID-19-positive people experiencing homelessness. The sites, the first of which recently opened in Laconia, are slated to include 24/7 staffing and security, food delivery and laundry, and wraparound services to address mental health, substance use and housing.

When pressed about the effort to reduce shelter populations and asked for specifics, though, the Joint Information Center repeated its previous statements. (A phone interview was requested in the initial email Friday as well as in a follow-up Tuesday morning, but in both instances questions were answered via email.)

Other states have turned to public partners and hotels to more safely shelter those without a home, including Vermont. 

The Green Mountain State has a relatively larger per capita homeless population than its neighbor, with 17 people experiencing homelessness for every 10,000 Vermonters, according to its one-day count in 2019. In New Hampshire, 10 people experienced homelessness for every 10,000 residents.

Geoffrey T. Pippenger, the senior adviser to the commissioner of Vermont’s Department for Children and Families, outlined steps his state has taken since the pandemic began, such as:

• Helping cold-weather shelters that would normally close in April continue their services, in some cases facilitating the lease of an empty motel.

• Expanding the strict eligibility for the state’s hotel/motel voucher program, initially targeting “hyper-vulnerable” shelter guests (those over 60 and/or with medical conditions) and then loosening the criteria further to house more people in motels.

• Relocating the residents at an affordable housing complex and converting the space into an isolation site for people with symptoms or those waiting for test results.

• Setting up a congregate recovery center for COVID-19-positive people.

The motel leases and other proposals are funded by the state, Pippenger said, with the expectation of reimbursement through federal aid. Because of existing partnerships in communities, the results look different across Vermont, but he said it has been a coordinated effort between state and local officials, as well as homeless advocates.

Back across the river in New Hampshire, Keene City Manager Elizabeth Dragon said her staff and area organizations had much better luck in the beginning of this crisis working with hotels when self-isolation was needed for people experiencing homelessness, or when shelters were at capacity. 

But as the situation progressed, she added, “the hotels started to get nervous about staff and other guests.” The breaking point seemed to be the governor’s April 6 emergency order that rolled back lodging providers' essential status, now prohibiting them from renting rooms except to house vulnerable populations and essential workers.

“If you put yourself in the shoes of the hotel, the business model has changed,” Dragon said. “I understand why that order was necessary, and it makes a lot of sense, but that did put an additional burden on communities.”

Keene has been communicating with state officials and trying to stay abreast of their plans to address the homeless population, she said, but there have been challenges along the way. 

“The response was, ‘Try to handle the needs for homelessness within your own community,’” and if that doesn’t work then the state will help, Dragon said. 

John Rogers, Keene’s health officer and COVID-19 homeless shelter liaison, said he was facing limited testing capabilities and the CDC’s recommended 14-day self-quarantine, which is nearly impossible in a homeless shelter. So he contacted the state fire marshal and asked for expedited results for people experiencing homelessess. Those tests are now returned within a day or two, more quickly informing people whether they need to continue isolation. 

“I think what we know from handling emergencies in the past … you have to look locally first. You have to be able to solve your own problems, at least temporarily, until there’s a statewide plan,” Dragon said.

Communities would be better prepared for a crisis like this, she added, “if there was a better statewide plan for homelessness.”

Manchester Mayor Joyce Craig said her city identified four groups within the homeless community as needing separate physical spaces: people with no obvious signs of the virus, those with symptoms, the ones who test positive, and the medically vulnerable. The city has worked with Families in Transition/New Horizons, the state’s largest homeless shelter, and planned to use the old St. Casimir School building as a decompression site and Angie's Place, a former women-only shelter, to quarantine symptomatic people.

“That was the plan,” Craig said, but in reality people waiting on test results needed to be segregated, and St. Casimir became a temporary quarantine space.

Cathy Kuhn, chief strategy officer at Families in Transition/New Horizons, said the goal is to hire enough staff for the facilities and then reopen the old school as a decompression site. 

Following a recommendation by the state’s health department, Kuhn said the shelter has closed its doors to newcomers.

“Once we get our decompression facility set up, we will revisit the policy to determine when and under what circumstances it is safe to accept new intakes again,” she wrote in an email.

But the policy, coupled with fears of congregate living, has pushed more people outdoors.

“We are seeing an increase in homeless individuals who are living outside as a result,” Craig said. “So we are working to ensure they are healthy and our community is healthy.”

Ideally, the city could get everyone into housing or hotel rooms, the mayor said, and it has been successful for some people. In the meantime, Manchester officials are following CDC recommendations regarding outdoor encampments: leave tents where they are, and provide regular sanitation and cleaning. Craig said the city and state Emergency Operation Centers are working to identify the campsites, and New Horizons is providing meals and other resources. 

Bob Mack, Nashua’s welfare officer, is leading the city’s Homeless Task Force during the outbreak. He outlined a plan to test 50 shelter guests, covering a majority of residents at the city’s two homeless shelters. 

“Based on what results come out of that, [it] may dictate our actions,” Mack said.

Like other communities, the city has been placing people with symptoms in motel rooms as needed for isolation, which seems to be working when needed, he said. The city staff has also had several meetings with state officials regarding a decompression site in Nashua, Mack said.

“We had a lot of good communications with the state around it, and they then shifted their focus to the COVID-positive sites” for quarantine. The site seems to be on hold, he said.

In email exchanges, New Hampshire’s Joint Information Center did not respond to an inquiry about this proposed site.

Nashua shelters are working with other area nonprofits to get their guests through a rapid rehousing program, a more long-term method of thinning out congregate settings. Mack acknowledged the difficulty of housing people when vacancy rates are so low throughout the state — hovering around 1 percent — but he pointed to creative solutions such as grouping people as roommates. 

Nashua Soup Kitchen and Shelter Executive Director Michael Reinke said he isn’t a big fan of the concept of decompression sites. Rather than setting up more shelters, he proposed using any available funds to instead rent apartments and get people out of homeless shelters. 

“The majority of people staying in shelters have some income,” he said. “It’s just [that] they don’t have housing.”

His organization began actively pursuing this plan last week. Nashua Soup Kitchen and Shelter essentially would serve as guarantor on the lease, listed with the tenants to alleviate a landlord’s concerns about anyone walking out with unpaid rent, Reinke said. 

“If you talk to local providers, and if you talk to people experiencing homlessness, very few people experiencing homelessness want to be uprooted several hundred miles from their support network of family and friends,” he said, referring to centralized decompression and quarantine facilities.

Addressing the immediate crisis doesn't work well when someone doesn’t have a home to return to in the end, he said.

“It’s a very expensive way to try to spread people out, and I think there are solutions that are financially more sustainable and can set people up for long-term success by (saying), ‘You only move once,’” Reinke said.

Craig Henderson, the director of Housing Stabilization Services for Southwestern Community Services, also thinks apartments may be the answer, both during and after the pandemic. Southwestern serves Cheshire and Sullivan counties with shelters, outreach and housing supports.

Henderson said the pandemic is highlighting some of the disadvantages of traditional shelters: While more people can be served under one roof using fewer resources, there are sacrifices. The health risks are the most evident right now, but he also pointed to a lack of privacy for guests, which he said is crucial to trauma-informed care.

Higher-quality service would undoubtedly be more expensive, he said, but he envisions a future in which three or four people live as roommates in an apartment with regular visits from “shelter” staff and continued access to the needed resources through a network of nonprofits. 

Mindy Cambiar runs Hundred Nights in Keene, which was likely about to lose its overflow shelter in a church, and she said there hasn’t been much movement in regard to a decompression site in the area. On behalf of their organizations, she and Henderson have inquired about using different facilities in the city, including the Keene Recreation Center, a gymnasium at Keene State College and local hotels. An old school building seemed promising, Cambiar said, until they learned it didn’t have showers. 

“Both of us have talked to people at the state level at least once a week. … [It] seems like it’s really bogged down, like you can’t move fast enough, which is frustrating,” she said.

Everyone at the city and state level she’s spoken to is trying their best, Cambiar said, but she feels that people are waiting for direction from the governor.

“I would like somebody to say to me, ‘Here, you can use this part of this building,’” she said. “It seems like it ought to be much easier.”

These articles are being shared by partners in the Granite State News Collaborative. For more information visit collaborativenh.org.