When a COVID test comes back positive, the next step has become common knowledge: isolate at home. But for a person experiencing homelessness, isolation gets complicated. Then add severe illness due to pre-existing conditions, subzero temperatures, and no shelter in sight and the problem becomes untenable.
It’s a situation Billings’ homeless population may be facing more often since the low-barrier overnight shelter, Off the Streets, closed in January.
And since the closure, community organizations that once came together in a herculean effort to open various low-barrier options for quarantine and isolation for the homeless are now punting the responsibility around town.
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Off the Streets was, in part, developed to provide shelter for those experiencing homelessness and a COVID-19 infection, but the low-barrier option also provided a space for homeless people with a plethora of chronic medical conditions a place to sleep and shower. A catastrophic sewage leak, however, brought the services to an abrupt end on Jan. 4, 2022.
In the 24 days following the closure of Off the Streets, Yellowstone County’s COVID cases increased 571%. During the surge, Healthcare for the Homeless (HCH) was preforming about three to four COVID tests per day with about half coming back positive, said Pat Zellar, communications coordinator for RiverStone Health.
HCH has never been involved with sheltering the homeless, even during the pandemic. And the remaining shelters in town have policies that don’t allow for COVID-positive people to come inside.
The Montana Rescue Mission serves many homeless individuals in Billings, but did not respond to multiple attempts by The Billings Gazette for comment on this issue.
“Off the Streets was the community’s answer (to this),” said Cameron Cook, development director at St. Vincent de Paul. “No one has come together to figure out what the next thing will be.”
The primary solution now, albeit an unsustainable and inconsistent one, is to check them into a motel, which requires identification, funds, a credit card and someone willing to be liable for what happens in the room.
Finding an organization willing to take on the responsibility and a motel willing to house someone who is both homeless and COVID positive has been a challenge, according to multiple non-profits serving Billings’ homeless population.
And when motels are turning away people with COVID, “it raises an ethical quandary over how much should we encourage them to tell,” said Cook.
The Community Crisis Center, meant to serve those with immediate needs, works to connect people to services in town. So, when a symptomatic client stops at the Crisis Center, MarCee Neary, executive director of the facility, directs them to a testing site, usually the hospitals or HCH.
But when Neary has a COVID-positive person looking for shelter, she usually points them toward The Salvation Army.
Though The Salvation Army does provide emergency shelter when there are funds available, it’s not usually for people sick with COVID, said Lt. Felecia Pederson with the organization. Rather, funds for motels are reserved for people transitioning out of homelessness and the recipient is first assessed by a case worker.
Symptomatic clients are encouraged to go to HCH or to the hospitals.
Both St. Vincent Healthcare and Billings Clinic leadership teams emailed written statements that they are providing lodging vouchers when needed for COVID-positive people experiencing homelessness.
“This is only a temporary measure in response to an ongoing need that requires a community-wide solution,” said Zach Benoit, community relations coordinator for Billings Clinic.
But even with the help from the hospitals, not everyone is getting the resources they need.
Recent subzero temperatures brought a homeless woman sick with COVID to the St. Vincent de Paul doorstep, Cook said. The cold weather had exacerbated her already severe symptoms. Workers at St. Vincent de Paul helped her get to the hospital.
When a person experiencing homelessness can’t check into a shelter, it’s not uncommon for them to wander all night to stay warm and safe until services open again in the morning, meaning disclosing COVID symptoms or test results when being screened for entry isn’t has priority.
“One person who has no place to go (when they have COVID) has serious consequences for the community,” said Kari Boiter, past director of the Continuum of Care (COC) and now a community partnership liaison.
Limping calls the current situation “a patchwork of solutions.”
Many have looked to the COC to address the issue, but the organization doesn’t have the funding needed to carry on with a low-barrier shelter. Plus, COVID is here to stay and a more sustainable model is needed.
“The disconnect, if there is one, is, ‘is this a public health need or a need around homelessness?’” Boiter said, adding that infectious disease is just the tip of the iceberg.
Off the Streets brought to the surface the extent of the chronic health crisis. There aren’t programs in place for those still using substances, those with long term chronic health conditions, or disabilities. All these people arrived at Off the Streets when it was operating.
“There is a need to shelter people,” Boiter said. “Altogether we can solve this, but on an individual basis we can’t. We need to come together as a community to get it done.”