Rapid Creation of a Multiagency Alternate Care Site for COVID-19– Positive Individuals Experiencing Homelessness

Abstract

Cook County Health partnered with the Chicago Departments of Public Health and Family & Support Services and several dozen community-based organizations to rapidly establish a temporary medical respite shelter during the spring 2020 COVID-19 peak for individuals experiencing homelessness in Chicago and Cook County, Illinois. This program provided low-barrier isolation housing to medically complex adults until their safe return to congregate settings. We describe strategies used by the health care agency, which is not a Health Resource and Services Administration Health Care for the Homeless grantee, to provide medical services and care coordination.

A Scoping Review of the Health Impact of the COVID-19 Pandemic on Persons Experiencing Homelessness in North America and Europe

“…Two studies reported that those leaving non-congregate hotel accommodation were given support in finding permanent housing [ 58 , 99 ]; 83% of participants in the study by Aitken [ 99 ] found suitable alternative accommodation. An additional four studies reported those leaving medical care sites were supported with a discharge plan for housing [ 72 , 99 , 106 , 107 ]. However, a report by Barbu et al [ 94 ] noted that when some temporary accommodation supports eventually closed, some PEH to returned to rough sleeping.…”

“…Isolation or quarantine accommodation for PEH who were symptomatic, confirmed cases was noted in 44 articles. Of these, the majority reported that access to temporary facilities to safely isolate or quarantine was provided [ 34 , 35 , 36 , 39 , 40 , 42 , 43 , 45 , 47 , 49 , 50 , 51 , 54 , 55 , 56 , 69 , 72 , 74 , 75 , 80 , 94 , 97 , 98 , 99 , 101 , 107 ], with 15 specifically describing hotels converted for this purpose [ 12 , 21 , 33 , 40 , 41 , 46 , 53 , 58 , 73 , 86 , 99 , 100 , 106 , 108 , 109 ]. Fuchs et al [ 53 ] found that premature discontinuation of hotel isolation or quarantine was associated with experiencing unsheltered homelessness and requiring quarantine as a close contact.…”

“…Active substance use among PEH during the pandemic was noted in 36 studies [ 8 , 11 , 12 , 13 , 20 , 23 , 25 , 26 , 38 , 47 , 51 , 61 , 62 , 68 , 72 , 76 , 81 , 82 , 84 , 88 , 89 , 92 , 94 , 96 , 99 , 101 , 102 , 103 , 104 , 107 , 108 , 110 , 113 , 114 , 115 ]. Substances used included alcohol [ 8 , 13 , 23 , 25 , 26 , 47 , 61 , 62 , 68 , 72 , 82 , 84 , 88 , 89 , 94 , 99 , 101 , 102 , 108 , 110 …”

“…Many included studies discussed access to substance use treatment for PEH during the pandemic. Treatment was reported as available in 22 studies [ 8 , 12 , 20 , 23 , 25 , 26 , 51 , 58 , 65 , 72 , 85 , 88 , 93 , 97 , 99 , 101 , 102 , 105 , 107 , 108 , 113 ], and access or uptake was noted as improving in 12 studies [ 23 , 25 , 26 , 72 , 88 , 97 , 99 , 102 , 104 , 107 , 108 , 113 ]. Tucker et al [ 88 ] reported that 13% of young PEH (18–25 years old) in their study found substance use services easier to access since the onset of the pandemic.…”

“…Tucker et al [ 88 ] reported that 13% of young PEH (18–25 years old) in their study found substance use services easier to access since the onset of the pandemic. Nine studies noted that access to treatment improved within the context of accommodation services [ 23 , 26 , 58 , 72 , 99 , 101 , 104 , 107 , 108 ], five of which specifically noted that PEH initiated treatment for the first time within the service [ 23 , 72 , 99 , 101 , 108 ]. Participants in a study by Pixley et al [ 97 ] reported that PEH were more open and accepting to substance use treatment following the rollout of alternative services and improved housing standards in noncongregate sheltering.…”