NH’S EMERGENCY HOUSING COLLABORATIVE

Supporting New Hampshire’s Individuals Experiencing Homelessness during the COVID- 19 Pandemic.

Introduction/Purpose: The purpose of this plan is two-fold: 1) develop a plan to meet the needs of those who experience homelessness and require quarantine and/or isolation and 2) develop a plan to prevent the spread of COVID-19 among those who experience homelessness. The plans success is based on key partnerships between the State of New Hampshire, community providers and partners, and philanthropy.

Action:

  1. The Emergency Operations Center (EOC) has secured and is working towards occupying a location for those who have symptoms of COVID-19 to isolate.

  2. The Emergency Operations Center (EOC) has secured and is working towards occupying a location for a decompression shelter for up to 50 people.

  3. The Bureau of Housing Supports (BHS) and Housing Action NH will continue to work with shelters to develop local compression sites. The EOC can provide consultation as needed.

  4. Continued work by the BHS and Housing Action NH to continue with outreach and assistance to community providers to mitigate community spread for those experiencing homelessness.

Prevention/Mitigation:

As COVID-19 is easily spread through contact with others, it is important to work with communities, shelters and providers supporting individuals/families who are experiencing homelessness. Shelters and outreach providers need to have tools and resources to support social distancing, assistance to develop protocols for cleaning, screening, and supporting during this pandemic. With a decrease in access to public buildings, individuals who are unsheltered need access to clean water to mitigate the spread of COVID. Providers and individuals need access to medical professionals to assist with screening, diagnosis, and treatment.

Through a partnership with Housing Action New Hampshire and the New Hampshire Charitable Foundation, resources are available to support shelters, outreach providers, and community groups to mitigate the spread of COVID. It is the belief that people should be supported in their home communities, with access to the supports they receive. With that in mind, the following has been enabled and established to assist those programs that support people experiencing homelessness.

Mitigation/ Prevention:
Reduction of Community Spread for Shelters:

  1. In consultation with the Bureau of Housing Supports (BHS), shelters have the option to restrict admissions during the State of Emergency. Each shelter shall submit a plan to the BHS, which includes how they will assist those who are not admitted with locating shelter.

  2. In consultation with the BHS and the EOC, Shelters will be encouraged to reduce the numbers of individuals residing in the shelter to meet safe social distancing. The preliminary numbers from shelters anticipate this to be between 75 and 100 people statewide.

    1. The DHHS and EOC has identified a location and is finalizing the contract for a decompression shelter for 50 people. The BHS will work with the existing shelters to identify people to temporarily move to this site. There must be an agreement by the sending shelter that they once the emergency has subsided, the sending shelter will enable the person to return, unless permanent housing has been established.

       BHS will develop protocols for the use of the decompression shelter.
       Once a person leaves the decompression shelter, they will be unable to return.

    2. The Concord Cold Weather Shelter will be asked to reopen and take 10 peoplewithout COVID symptoms or exposure to COVID-19 while in other shelters to assist with the reduction. If the Concord Shelter agrees, BHS will enter into a contract with the Concord Cold Weather Shelter during the State of Emergency.

    3. Shelters will continue to work within their municipality to identify alternatives for local decompression, such as, but not limited to: motels/hotels, churches, or other space available in the community. BHS and Housing Action NH will work with the shelters to identify funding for this through a combination of BHS and Housing Action NH funds.

  3. In an effort to comply with the Stay at Home orders, shelters should provide day services, such as, but not limited to: tenant 101 classes, budgeting, treatment, and case management; encouraging people to remain in the shelter. Shelters that are under contract with BHS can apply to BHS for additional funding to cover these costs.

  4. For those remaining in the shelter, social distancing must occur. If a shelter needs to make temporary modifications for this to occur, funds can be made available through Housing Action NH.

  5. The BHS will provide additional dollars to support additional staffing needs to shelters. A plan must be submitted and approved by BHS before funds will be committed.

  6. The BHS has the following formal mechanisms to provide guidance to the shelters:

    1. Calls twice weekly with all shelters to address systemic concerns, share best practice, and resources.

    2. Weekly calls with individual shelters to address shelter-specific needs and guidance.

    3. Based on these calls, BHS will provide a summary of Frequently Asked Questions (FAQ) to be posted on the DHHS website and the COVID-19 website as well as sharing broadly via e-mail with stakeholders and providers.

  7. BHS follows and provides guidance from the Center for Disease Control for the following protocols:

a. Screening

b. Cleaning

c. US Interagency Council on Homelessness Resources 

d. Facility Recommendations- Please refer to the CDC guidance here.

  1. For questions regarding a specific person’s medical condition, please contact their Medical Provider. If the person does not have an assigned Medical Provider, please work with their Managed Care Organization (MCO) for assistance. If you suspect a person may have symptoms of COVID-19, based on the screening conducted, you can contact Convenient MD for telehealth services. For shelters that do not have a partnership with a medical practice, they may want to establish one with a local provider; funds may be available through Housing Action NH for this.

  2. Personal Protective Equipment can be requested from local public health partners like the city/town health officer, the city/town Emergency Management Director, or the regional Public Health Network. If local resources are depleted, PPE requests can be made through the State Emergency Operations Center (Emergency Support Function 8 – Health & Medical) at 603.271.2231. For questions and guidance regarding PPE, the COVID-19 website has the most current information.

Reduction of Community Spread for Unsheltered Individuals:

The following guidance is given to communities and providers in an effort to mitigate community spread. The Department encourages providers to work closely with the municipality in which they operate as well as with other organizations. Based on preliminary data from the Point in Time (PIT) Survey in January, there are approximately 182 people who are unsheltered in the state. It is best if people remain in their home communities close to available services.

  1. Outreach workers should encourage people to not share tents and practice hygiene that mitigates the spread of COVID-19. Outreach workers will have additional tents in an effort to reduce the sharing of tents and have materials available that will assist to mitigate the spread of COVID. Funds can be made available through Housing Action NH.

  2. Due to the closure of many public buildings, there is a lack of restrooms for clean sanitation. Community Providers should work with their city/town officials regarding the temporary use of facilities and if not available, rent portable toilets and showers. Funds are available through Housing Action NH.

  3. In an effort to promote hand-washing, portable hand washing stations can be purchased or rented. A provider should work with their city/town to ensure placement. Funds can be made available through Housing Action NH.

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4. Other options that the shelter, outreach teams, or other providers determine may mitigate the risk of exposure and community spread. Please contact BHS and Housing Action New Hampshire for guidance. Funds can be made available through Housing Action NH.

Quarantine/Isolation for Individuals Diagnosed or Suspected to have COVID-19

When an individual who is homeless or staying in a shelter is recommended to self-monitor quarantine or isolate after a clinical assessment and assistance is needed to identify resources to meet that recommendation, the medical provider or shelter manager may call the state’s EOC at 271-2231. The EOC will contact the Quarantine Assessment Team Lead (QATL) for Tier 3 people. QATL will contact the hospital or shelter to determine next steps.

Process:

  1. Call comes to EOC.

  2. EOC refers call to QATL

  3. QATL contacts referral source to assess status and needs of the individual.

  4. If state supported quarantine/isolation is indicated, the QATL Lead:

    1. Identifies and activates the appropriate site.
    2. Arranges for transportation to the site.
    3. Arranges staffing for the site.
    4. Contacts person’s current community supports, if indicated.
    5. Notifies Bureau of Housing Supports (BHS), Melissa Hatfield and/or Mandy Reagan, of the admittance.
      1. The Quarantine Assessment Team will do an assessment of the individual to identify needs.
      2. It is not anticipated that BHS housing supports/services will be required upon admission. Initial focus will be on stabilization and nutrition/medical/behavioral supports.
      3. Plan will be developed person by person, day by day, based on what is presented.
      4. BHS will review to determine what services/supports the person may be receiving and work with the EOC to develop an individualized plan for the person.
 

For typical Housing calls that go to 211, if a COVID calls comes in, 211 will reach out to the EOC. No change of the typical process.

EOC is only handling calls for individuals who are experiencing homelessness and have clinical assessments with referrals for self-monitoring, quarantine, or isolation.