Response, Action and Wellness During a Pandemic

You may have seen my blog on Planning for a Pandemic from March 1. You can access that here. Now that we are in the midst of a pandemic, I offer the following thoughts to help you, your organization and community. To reiterate from my previous blog on this, this is NOT health advice. Use this information to have conversations with health professionals, funders, elected officials, and senior policy makers in your community.

Shelter Differently

Work with your local health professionals to develop a simple screening that can be applied at initial intake and every time a person returns to shelter if they leave. A similar screening may be applied at set intervals with guests of the shelter that have not left. Usually, the questions at this time pertain to whether or not the person has a dry cough and whether or not they feel feverish/ill.

How you configure your space matters more than ever right now, even if you are moving some sheltering to new spaces like conference rooms or convention centers. You want 37.7 square feet per person. Take the total square footage of the space and divide by 37.7 and that will tell you generally how many people you can shelter in that space. Within the shelter space, the sleeping areas should be configured to allow for separation between cots or bunks (distance of 2.5 feet is good when we are not in this situation, the more you can increase this, the better right now), and a head to toe configuration of arranging how people bunk down. 

If you are opening a new space for sheltering, aim for the following:

• A minimum of one (1) washroom that is barrier-free, fully accessible and designated gender-neutral

• A minimum of one (1) toilet for every fifteen (15) clients up to the first one-hundred (100) clients, and one (1) toilet for every thirty (30) clients thereafter. Urinals may replace up to half the number of required toilets in men’s bathrooms

• A minimum of one (1) washbasin for every fifteen (15) clients

• A minimum of one (1) soap dispenser within 0.6 m. (2 ft.) of each washbasin

• A minimum of one (1) shower for every twenty (20) clients.

How you staff and support people in shelter may also look different.  With staffing shortages as staff become sick or their loved ones do, you may be forced to look at skeleton crews and dedicated schedules for essential services, including janitorial work. Some shelters may find it better to adopt scheduling practices used by first responders such as “staffing in place” with longer shift rotations…like three days on, three days off. Naturally, the three days on will require staff to sleep in shifts in the place they are providing shelter in order to manage fatigue and maintain wellness.

Unless you set up your shelter intake process properly across your system, and you add shelter capacity, you can expect some people to start moving from one shelter location to another, especially if they think it offers the likes of a break in routine, better amenities, better food, or more relaxed rules. You actually want to put policies and procedures in place now that decreases the likelihood of people on the move in such a manner.

Also think of how people use your space when lines are involved. If you still have people that queue up for shelter access, bathroom use or meals, ensuring social distancing remains in place as best as possible when people are in line

If you are using a facility that was never designed to be a shelter, you should give some thought to air exchanges over the course of the hour and whether or not the number of air exchanges are sufficient for the volume of people in the facility. The more air exchanges per hour, the better.

Examine every single rule or policy that may, under other circumstances, result in the individual or family being asked to leave the shelter, if only for a brief period of time. Ask yourself at this point which of these are 100% essential at this period of time, in these unprecedented conditions. Removing or relaxing as many rules or policies as possible is not going to put already vulnerable people into, perhaps, a more vulnerable situation.

While we have no idea at this point when this will happen, if you expand capacity now you need to be putting some thought into how you will retract capacity later – if this is truly an interim measure. (In some communities this may permanently increase shelter capacity which may or may not be a good thing based upon a slew of variables.)

Quarantine Locations

Already in many communities there is a struggle to figure out where the best location will be to quarantine people who are homeless because of the virus. The best advice on this one is this: do not let the homeless services system become solely responsible for solving this potential need. Some within the health community have never been to a shelter or other homeless services facility and have zero idea that this is not a possibility or practice, unless there are fully health specialist-staffed, separate facilities just for homeless individuals and families to be quarantined. Only in rare circumstances with rare building configurations can I think of any shelter where establishing a quarantined wing may be possible. And even then, they will need people with greater health expertise to provide the human resources necessary.

Do Outreach Differently

If your community has expanded shelter accommodation or motel options, your outreach has likely moved from intensive supports to a desire to connect people that are unsheltered to the latest available emergency shelter options at this time.

If you do not have increased capacity, now is not the time to be spending precious time to try and thread the needle of having people compete for a single shelter space. Instead, focus on knowing where all encampments are. This will be critical for future contact tracking in some instances. Remember to maintain social distancing when engaging and use personal protective equipment to decrease health risks for you and your clients. With so many community services impacted, dropping off supplies so people can meet their basic needs is okay. If you are not gloved when doing so, consider leaving a plastic bag with disinfecting wipes for people to use when they receive the materials to they can wipe them clean.

Take the time to plan your outreach efforts. Prioritize who you want to reach based upon things like how vulnerable people are within different areas, as well as how mobile the people living within the encampment are. For example, a sequestered camp that has little to no interaction with the outside world may be served differently (less frequently) than a camp in a dense urban environment with lots of interaction with others.

There will be some people who were sheltered that choose to become unsheltered at this time if they deem it safer than the possibility of disease transmission within shelters. The outreach worker needs to use existing knowledge from HMIS when engaging these individuals and families rather than treating them as new individuals or families to be served. Continuity of service is better than repeating stuff that has already been done or is in the works to support the individuals or families.

Be very clear the purpose of your outreach at this time, and how the intention of the outreach may currently be different than if these were normal times. You don’t want to confuse people now or later.

Now May Be the Time When Some Sanctioned Encampments Make Sense

This is not the case for every community, but for some, centralizing outdoor camping opportunities (with appropriate spacing between tents) may make the most sense for ensuring there are hand-washing facilities, toilet facilities and food drop-off or preparation locations that are easier to serve and support. Unless your jurisdiction is special, remember that people cannot be forced to these locations, only encouraged to access them if required to take care of their needs.

Do Housing-Based Support Differently

There will be a natural tendency to move towards “checking in” with program participants as opposed to doing case management supports remotely.  We will have more on this in the not too distant future, but suffice to say we need to balance this. Yes, the immediate welfare of the people you are supporting in housing is paramount. But that does not mean we should abandon all previously constructed goals. There may be a need to examine goals, timelines and activities associated with them, but do not abandon them. Spend time figuring out if there are methods for staying in contact with program participants through phone calls or FaceTime or similar technologies. For those where technology is not an option, you may still need to provide them written information on how to contact you and how to be supported at this time. That can be mailed if necessary. Don’t think that because you have not heard from some individuals or families that all is okay in their world.  Professional responses to pandemics must recognize and respond to the impact of fear and anxiety on the mental wellness and housing stability of participants as well as the immediate needs for basic supplies and medical screening.

Harm Reduction and Supporting People Who Use Substances Can Look Differently and Presents Unique Challenges

Where, how and what people use when it comes to alcohol and other drugs can look quite differently during these times. If there is an appetite, now may be the time to institute a Managed Alcohol Program or Safer Consumption Site.

Here are some practical questions and thoughts to consider in your planning and actions at this time:

• How do people with dependency on alcohol or other drugs get access to their product of choice at this time? If we are practicing social distancing and decreasing community interaction, can we make alcohol or other drugs (or safe alternatives for detoxing or reduction) available to people where they are at rather than expecting people to go into the community?

• For people working on cessation or abstinence, how can they access supports at this time? There are online AA meetings, for example, but people may need access to technology to take advantage of this opportunity.

• As people’s product supply chain may change, they may not be as familiar with the product they are using or its potency. Encourage people to protect themselves by starting with smaller dosages first to reduce unintended overdoses.

• Alternate use methods may be the key to success for some to make what product is scarcely available last longer. Now may be the time for the conversation about alternative administration techniques such as booty bumping, for example.

• Using with a close friend may not be an option right now. Talking with people about how to plan the in-tox can become important so that people are safe, thinking about overdose prevention, and managing appropriate social distancing.

• Source of income like panhandling or sex work to afford substances will be on the decline. This will leave some in a state where a medical intervention may be required if they were dependent on a substance like alcohol that they cannot access right now. A number of others will be dope sick. Assisting staff on how to incorporate harm reduction conversations and resources in their interactions with participants will be essential.

Do Coordinated Entry Differently

Now is not the time to abandon coordinated entry, but it does require doing it differently. There will still be vacancies to be filled and many landlords have adapted their practices for lease signings and move-ins during this period of time. On the front end of coordinated entry, move to phone screening and diversion practices, as well as telephone-based triage and assessment whenever possible. Of all the horribleness of this current time, one silver lining is that you may be able to reach some very vulnerable people who otherwise are service adverse. You don’t want to miss this opportunity to get them included in your CES.

Compassion Fatigue Will Set in Quick Under Certain Conditions

You have likely felt the overwhelming need to ramp up service efforts differently in response to the identification of a global pandemic. It is important to recognize that this is the first wave. There are more waves to come. When you and others in your organization treat this event as a sprint rather than a marathon, you will feel the impacts much more acutely and staff become less effective. In terms of preparedness and endurance, remember that planning for a marathon – rather than a short, powerful sprint – is the best approach to maintain effectiveness and efficiency within the midst of a pandemic. Now is not the time to measure heroes by going above and beyond as fast as possible. Heroes now are those that can put a vision in place for how to manage each wave of impact (including wellness concerns, demands for service and compassion fatigue) and space out the impacts on staff across each wave with the use of evidence informed approaches.

Be Prepared for Stigma

The good news is that some people are talking favorably about intervening in the crisis of homelessness that previously had no interest in homelessness. However, should COVID-19 be found in the homeless population or if there is spread of COVID-19 within the homeless population, be prepared for considerable stigma against the homeless population. There is the possibility of wanting all homelessness driven out of town or have restrictions upon them that do not apply to the rest of the population. Being strategic regarding communication, policies and practices that impact neighbors experiencing homelessness must continue to be a priority in our work.

Collect and Respond to FAQs from Service Users and Staff

Provide sticky notes, a white board or a note pad for your service users and staff to ask their most pressing questions. Then prepare an evidence-informed response to those FAQs in an easily accessed location that promotes facts, not fears. If you don’t know the answers, ask experts who can answer them for you. There will continue to be different rumors and opinions, as well as updated and changing directives. Cut through the noise. Deliver the most up-to-date facts you can. You can probably safely assume that you and your organization have access to credible sources more than people without access to technology. 

Monitor and Reorder Supplies, Especially Food, Hand Sanitizer and PPE

Food security will potentially become an issue moving forward. If you provide meals on the site, starting figuring out your back-up plan if these meals or ingredients to prepare meals are sidelined in the not too distant future. You don’t want to be scrambling later to figure out how to feed people if this goes off the rails. The availability of more non-perishables will help tremendously in weathering the storm.

As for hand sanitizer and personal protective equipment (PPE), yes, health providers are sounding the alarm that these are already limited and in short supply. Better to get your order in the queue now for future supplies, rather than throwing your hands up. Also, you may want to begin researching alternate (and not as good or recommended) approaches to ensuring there is some protection in contact with program participants rather than no protective equipment.

Create an Electronic Wish List that Can Be Filled

Think of the stuff you NEED as an organization to keep running during this time. Create a wish list on Amazon, for example. Every outside person or organization that wants to help with homelessness during this time but cannot visit your organization to drop off supplies should be redirected to your wish list where delivery of the required items can be activated.  Many online retail sites are now offering free delivery on all orders so optimize this opportunity when possible.

Pandemic Planning and Services that Support People Who are Homeless

NOTE: This blog is intended to stimulate discussion in your local community regarding pandemic planning and the homelessness services sector. This blog is NOT medical advice. You should work with your local Public Health officials, or other local health officials to develop a community response to plan for a pandemic, should one occur. OrgCode Consulting, Inc. is not responsible for any misinterpretation or misuse of the contents of this blog.

During the SARS outbreak, I was working in homeless services sector in Toronto, and I recall how much work that went into planning for and responding to the possibility of a pandemic and its impact on homeless individuals and families in the community. I suspect that many of you reading this, have, are in the process of, or are just starting to think about pandemic planning in the event the coronavirus is declared a pandemic. The time is now to be planning and preparing.

People experiencing homelessness are presented with unique challenges in the event of a pandemic. Many who are homeless already have compromised health in some fashion. Many who are homeless have no choice but to be in congregate settings for sleeping, meals, and to get out of the elements, which can be perfect for the transmission of the disease from one person to another. People who are generally poor can also experience considerable stigma in the event of a pandemic. Here are some thoughts to help stimulate discussion in your community on pandemic planning and homelessness:

Expect the Work Force in the Homelessness Services Sector to be Impacted

Health experts have estimated that between 15-35% of the workforce will be unable to work because of illness, fear of contracting illness or because they are caring for their own families that become ill. Think about how, or if it is possible, to keep your homelessness services operating if there was that amount of loss to the workforce in the sector. Would you be able to deliver the same services in the same way? Would staff need to be, or expected to be, at the work site for longer periods of time, possibly including living on the premises for all or some of the pandemic to keep services going?

Consider the Density and Layout of Sleeping Spaces

Many homeless service providers try to maximize the use of whatever space they have to accommodate as many people as they can on a nightly basis. This may work against efforts to decrease spread of the illness. Furthermore, if you don’t already do so, you may want to consider reconfiguring sleeping space to maximize the distance between people and/or ensure sleeping arrangements are organized in a head-to-foot configuration.

Increase Attention About the Importance of Having Clean Hands

Now may be the time to put up posters reminding people about the importance of washing or sanitizing their hands on a regular basis. Even if you don’t normally make hand sanitizer available, you may want to start having it available near the entrance of your facility and reinforcing behavior to always sanitize at the time of building entry.

Early Detection and Screening Methods

At the time of intake, or re-claiming beds for existing guests, it may be advantageous to have a very simple screening about how people are feeling and to see if people have any of the symptoms that may be related to the illness.

Order Personal Protective Equipment for Staff

You may already have masks and gloves and even biohazard-type suits for rare situations. A pandemic would place considerable demand on whatever volume of personal protective equipment you already have on hand. It may already be difficult to get these resources in your community, so getting them ordered now – even if there is a backlog in having orders filled – may be better than waiting until the illness has taken root in your community.

Extra Supplies May be Needed

Now is the time to look at things like the volume of cleaning supplies your organization has on hand, things like hand soap and sanitizer, and food – to name a few. Not only may some items become scarce in the event of a pandemic, going out into the community to get these materials could present unnecessary risks. Preparedness experts often say that having an eight week supply of materials on hand is good planning.

A Seat at the Incident Command Center or a Separate Incident Command Center for Homelessness

While many Incident Command Centers do have members that focus specifically on vulnerable populations, depending on the size of the homeless population in your community it may be warranted to have a dedicated seat at the Command Center just for homelessness related issues. If that is not possible, consideration may be given to organizing and activating an Incident Command Center just for homelessness related incidents during a pandemic.

Map Out Locations of Encampments

Now is the time to start bringing together outreach workers, parks staff and law enforcement to ensure your community has a comprehensive map and understanding of where people are dwelling in unsheltered locations. This information may end up being critical for testing and tracking people impacted by the illness or impacting others with the illness. Even if you start with those encampments known to have two or more people it would be helpful. (As an aside, it is entirely possible that unsheltered homelessness will rise in the event of a pandemic as some homeless individuals and families may leave shelters and go outside if they perceive it to be safer than being in a congregate setting or a homelessness service provider needs to close during an outbreak.)

Expect Some Homelessness Services Protocols and Practices to Need to Change

There can be many changes that may need to be altered or suspended during a pandemic. Service restrictions may need to be relaxed to get more people access to services. Hours of operations may need to change. Queueing practices may need to be altered. If your community has a protocol for encampment abatement, that may need to be suspended during an outbreak.

Plan for Impacts of People Not Getting Access to Medications

Access to and supply chains of medication can be interrupted during a pandemic. Knowing that many people who are homeless live with chronic disease or mental illness where they rely upon medication, consider what is going to happen and how you can still effectively serve people who may lose access to their medications.

Some Homeless Individuals May Die

Death amongst those who are homeless can already have an emotional toll on others experiencing homelessness and the professionals and volunteers who engage with and support them. It is entirely possible there will be more deaths amongst those who are homeless during a pandemic. Your community will likely already be planning larger storage areas for people who die during an outbreak, but may not have thought about deaths amongst people experiencing homelessness.

Consolidating Services

It is possible that a pandemic will result in some homelessness services needing to close. If that were to occur, which services for people experiencing homelessness in your community are deemed critical operations? How could you redeploy staff to keep those critical operations going? Is there any part of the homeless services response that you would cease operating immediately if there was a pandemic?

Know How Privacy and Confidentiality May be Impacted

While this may vary from jurisdiction to jurisdiction, it is possible that consent and sharing of health information as we know it today would change in the event of a pandemic. A freer flow of health information may make all the difference for health professionals and the response to the pandemic.

Unique Challenges When Serving Families

Family service providers need to plan for the unique challenge of a parent(s) that become ill or pass away while their children remain healthy and need access to supports. Working with Child Welfare organizations now to plan ahead for this possibility is better than scrambling to figure out the response if/when this occurs.

Compassion Fatigue May Reach a New Level

Self-care and personal wellness may be difficult if there is large scale disease transmission within the homelessness services sector that frontline workers are responding to for a prolonged period of time. This can lead to impacts not during the pandemic, but may impact the workforce and long-term sustainability of the workforce after the illness is under control or has passed in the community.

Cross-train Now

Many people who work in the sector may be asked to do different jobs than they are accustomed to during an event such as this. Now is the time to make sure you have easy explanations of the tasks of essential jobs and to undertake cross-training. For example, you may want to ensure the Executive Management Team of your organization knows the ins and outs of specific frontline positions they may be asked to perform.

Impactful Outreach

At the recent National Alliance to End Homelessness conference in Oakland, CA I was pleased to provide a presentation on impactful outreach. You can download my presentation here. (Related to this, you can see the recent piece we put out on responding to unsheltered homelessness here, and you can read my thoughts on street outreach in The Book on Ending Homelessness by ordering it here.)

What is impactful outreach?

Impactful Outreach is a professional intervention that is structured, documented and strategic, to meet people where they are at - literally and circumstantially. Impactful Outreach is respectfully persistent in helping people achieve housing and exit homelessness through a process of assessing, understanding and addressing both immediate and housing needs.

The overarching objective of impactful outreach is to reduce and end unsheltered homelessness.

To achieve the overarching objective, impactful outreach shall:

• Be discerning regarding who they want to engage with and why, relative to the community’s priorities

• Know people by name

• Establish rapport

• Meet immediate needs without creating dependency and without enabling

• Focus on connecting people to housing through or outside of CES, and engaging in all processes associated with this (e.g., getting people paper ready)

• Develop strategies to effectively engage with people who do not wish to engage or struggle to engage

• Leverage strengths of various service providers beyond street outreach, within a systems context

• Drive decision-making through the use of data

The impact part is two-fold. For one, it impacts overall unsheltered homelessness by resulting in reductions in unsheltered homelessness in the community. For another, it impacts the lives of each person it touches by moving toward a solution to each person’s/family’s homelessness.

Impactful outreach, in some organizations and communities, disrupts the street outreach paradigm. The measure of effective outreach is not the number of contacts made or provision of goods. Rather, the measure of effective outreach is how many people have their homelessness ended as a result of the outreach intervention.

It must be noted that moving from contact-driven outreach to solution-driven outreach can be a tough sell for some existing outreach teams and for some communities as a whole. There isn’t a magical switch that gets flipped with existing street outreach workers to suddenly become solution-focused in their work. Quite often there is extensive training to be done, and processing of the new approach can require coaching. To be honest, not every outreach worker that currently does contact-driven outreach is able to make the switch to impactful outreach.

At the community level, the paradigm and practice shifts can come with pushback and hiccups along the way. No longer are street outreach workers pseudo-first responders or simply moving from location to location to encounter as many people experiencing homelessness as possible. Impactful outreach is a very targeted approach to street outreach that sees outreach workers engage with a smaller group of unsheltered persons intensely rather than a larger group of unsheltered persons peripherally. The outreach worker, in impactful outreach, is charged with the task of problem solving and getting all of the paperwork and/or documentation in order that will accelerate the unsheltered person in being able to access housing. While quite often housing access comes through Coordinated Entry in impactful outreach, there are some instances where the outreach worker can assist the unsheltered person/family access housing outside of Coordinated Entry-dedicated resources, especially when they have sufficient income.

As more and more communities see rises in unsheltered homelessness, they should examine their current street outreach services. If the way outreach is being delivered is not impactful, we miss the opportunity to impact unsheltered homelessness overall and the lives of many unsheltered persons/families that would benefit from an impactful approach to receiving services.

Police and Effective Responses to Homelessness

I have written about criminalization of homelessness and the likes of Salt Lake City’s Operation Rio Grande before. The ACLU of Utah has done a fantastic job analyzing Operation Rio Grande crime statistics (worth a read) and provides a cautionary tale for other communities that may be at their wits end on addressing street involved behavior and think that upping police engagement from an enforcement perspective is the way to get effective results. I also dedicate a chunk of The Book on Ending Homelessness to why criminalization approaches to homelessness do not and will not work.

So, what is the role of police in order to have an effective response to homelessness?

When it is positive, police can be one of the greatest resources in the work of ending homelessness.

When it is negative, police can be one of the greatest hindrances in the work of ending homelessness.

Analysis conducted by the California Policy Lab at UCLA using over 60,000 VI-SPDAT records from across the country show the unsheltered homeless population has, on average, more than 20 contacts with police in a six-month period. That level of contact should be a call to action to get the work right and positive, resulting in less homelessness because those who are homeless move to housing.

As one police officer who works on homeless outreach remarked to me, “The police are just as guilty as homeless service providers of confusing inputs and activity with outcomes and performance. The police love to quantify activity, usually as a measure of performance. As you can probably guess, it doesn't work very well. If I'm a police officer making loads of contacts (but not actually solving anything), then I'm a superstar. However, if I spend all day working with one client, resolving their challenges, then it is easy to view me as less-than-effective. The police are not good at measuring something they don't traditionally understand, such as homelessness. A case in point: I spent 4-1/2 years on one client. This is contrary to the usual police response model of rolling into a scene, with lights and sirens blaring, resolving a hostage crisis and delivering a baby, all before lunch. Officers in many busy agencies, such as mine, may handle 20-30 calls for service in a shift. The mindset is that calls for service are holding, and we need to clear this call to get to the next one. You cannot get into problem-solving mode if you are always in crisis-response mode. Also slowing down to the molasses-like pace of homeless bureaucracy is a giant leap for cops used to quantity.”

We need to acknowledge and respect that the police are open 24/7/365, and will respond to crisis, no matter what. The ever-expanding list of demands upon their time has increased from the traditional model of apprehending suspects and maintaining the peace, to fulfilling the role of taking on the societal issues that others will not, which can include homeless outreach worker. 

In some communities, police working in homeless outreach have become the only option for helping those that no else will. Their role is often a reflection of a community's (lack of) response to homelessness. In other words, the police fill the service gaps and voids left by others. In these types of communities, it seems to police that every agency wants to pick the low-hanging fruit but no one wants the difficult cases, leaving the police to assist the high-need, high-system utilizers (mostly the chronically homeless) that are not assisted by the more mainstream and popular service providers.

There are common features found amongst those police officers that are doing fantastic work in the pursuit of ending homelessness. Here is what I have found in exchanges and interviews with police that fall into this category:

They don’t see homelessness as a nuisance.

They see homelessness as a condition of housing. The problem to be solved, in the view of those that do it well, is not about getting businesses or members of the general public to be placated by moving people along or temporarily relocating people to jail. It is about trying to find a permanent solution to the person’s homelessness so that whatever “problem” was complained about by others is solved in the best way possible for the person who is homeless.

Effective police homeless outreach realizes that permanently solving an issue also results in reduced calls for service generated by high system utilizers; that getting people to move along solves nothing other than displacing people (and the “problem”) elsewhere.

They believe in Housing First.

Data and analytics changed the way policing occurs. Data and analytics changed the way homeless services occur. When there is an opportunity to provide education on what Housing First is and its practice, those police that believe in evidence-informed practice not only get behind Housing First, they become champions of it. A shock to some communities that have negative experiences with police and homelessness, is to learn that in some communities there are Housing First champions who are police officers.

Noted one of the cops that I engaged for this blog who is a Housing First advocate, “Housing solves homelessness; a concept that seems obvious. However, to the police, this seems counter-intuitive, almost an exercise in rewarding bad behavior. Many cops are conservative; we never had any training in harm reduction or trauma informed care. So, giving a chronically homeless client housing and wrap-around services is a foreign concept.” 

They get training on homelessness.

Many a police officer has shared with me that they didn’t get into policing to have to deal with homelessness. But because they do respond to homelessness issues (a lot in some communities) they start to assume that their experience makes them an expert. The best responses to homelessness by police, especially Homeless Outreach Teams established by a police department, are ones that realize they need training in homelessness if they are going to have a positive impact on homelessness.

They are effective, collaborative communicators.

When police are having a positive impact on homelessness, the officers involved tend to be collaborators with other homeless service providers and the CoC, and effective communicators with people who are experiencing homelessness. They attend meetings not because they have to, but because they see the benefits of being a partner and contributor. Police do not offer housing or homelessness specific services. As such, if they want a solution for someone who is homeless, they need to work with outside agencies. Police who do this work well collaborate with those service providers rather than making unreasonable demands of them.

They change the way the police conduct their business with people who are homeless.

Can the police help someone move from homelessness to housing? The answer is a resounding yes. It takes time like any other support provider, but it is possible, and it is happening in some jurisdictions. One of the common features in many of those places is that the police wear a completely different uniform so they are easily identified as doing something different from enforcement.

They separate engagement and support from enforcement.

Having police involved in the provision of support services does not grant a person who has committed infractions or offenses – homeless or otherwise – immune from enforcement. But having different police involved has been demonstrated to be helpful. You don’t want the person that was offering assistance today to be the person who is putting you in cuffs tomorrow, if it can at all be avoided.

As one cop put it, “I haven't written a ticket or made an arrest in almost 8 years (this makes me an ineffective officer if you utilize traditional performance metrics).”

They don’t try to lead a response they are not trained to lead.

When policing is effective at serving people who are homeless, the police want to work within the strategy that the community has already developed rather than creating their own or parallel process. The police don’t see themselves as above the system of care in these instances, but rather a partner in the system of care.

They respond to encampments differently.

Police that are working hard to have a positive impact on homelessness respond to encampments as part of a coordinated response to resolve without requiring enforcement if at all possible. This is remarkably different from those jurisdictions where enforcement happens without coordination with a service response.

One of the great examples of a police officer in the United States doing positive work to assist those who are homeless is Daniel McDonald in Tampa. His insights and knowledge of the issues of homelessness and panhandling are in such demand that in his time off he runs a consulting business (www.homelesspolice.com) dedicated to helping other police and elected officials better respond to matters of homelessness and panhandling other than a law and order approach. If the ideas in this blog captured your attention and may be of use to your local police response to homelessness, he is worth the time and energy to engage.

It is my hope that we can create more partnerships that are effective between police and service providers. We share a common interest in helping people who are homeless in not being homeless.

Giving Tuesday

For some non-profits, especially medium and large ones, Giving Tuesday is a day to make hay. Nothing wrong with putting money into the organization to help it achieve the mission it aspires to reaching. As one of the biggest philanthropic opportunities of the year, many a non-profit relies upon the generosity of donors on Giving Tuesday to give them the push and resources they need to do remarkable things. Many of those remarkable things only come about because the funding received is unrestricted in the sense that it is not tied to any government funding that may prescribe a certain type of program for a certain population is a certain way (though there is a place for that too).

Giving Tuesday also becomes a sensational example of poverty porn at its finest. By that, what I mean is, organization after organization will go to great lengths to demonstrate they serve the neediest of the neediest. At the same time, said organization will put out a success story or two to demonstrate how incredibly transformative a person or family life can be if only touched by said organization. 

Let's call bullshit when it is necessary.

Sample sizes of one (or two) shouldn't cut it when it comes to Giving Tuesday. Want to be an organization worthy of investment? Want to be a donor that makes a difference?  Stop focusing on outputs and start focusing on outcomes. This shouldn't be a contest of who serves more. If we want to focus on volume of service, needless to say there are oodles of organizations I could mention that see and "serve" lots of people but suck at making a difference in the lives of many if any of them. 

Focus on outcomes. Be an organization that demonstrates your work makes a difference. Be an informed donor. Look at the totality of the volume of households served and see what difference they made in not only accessing housing, but sustaining housing...or not only prepared for a job interview, but got a job and kept it...or not only signed up for assistance to become a better parent, but actually can demonstrate they are parenting better...or not only got access to emergency food assistance, but are now food secure...and so on.

We need great donors and we need great organizations. Thoughtful and results-oriented gets my vote every year. 

The Book on Ending Homelessness

Three years in the writing and over twenty years in the making, The Book on Ending Homelessness is now available here.

I have collected almost everything I have learned about ending homelessness over more than two decades of being immersed in the work from different angles – practitioner, funder, policy developer, researcher, consultant – and put it in one place. It was my intention to ensure there is something for everyone in the book, including frontline practitioners in the homelessness services sector, elected officials, and the general public.

I wrote the book for several reasons. After delivering a keynote address I would frequently get asked if I had a book. When providing policy advice to elected officials or senior public servants, I would often get asked if I had a book. Certain blog posts also resonate with people, and it had been suggested I take ideas from various blog posts and put them into a book. Finally, I wrote the book to take the pulse of my own knowledge on the subject of ending homelessness, and to evaluate what holes in information and practice I possess and take stock of that which I knew to be true and effective.

I have organized the book into six parts: 

1. Homelessness – What It Is and What It Isn't

2. Service Orientation

3. Emergency Services: Shelters, Outreach and Day Services

4. Supporting People that Have Been Homeless in Housing

5. Getting the Money and Policy Parts Right to Make Success Possible

6. Where We Go from Here

The Book on Ending Homelessness offers a range of solutions which I hope will stimulate discussion and encourage action-oriented dialogue on how to effectively respond to the crisis of homelessness. I want this book to help generate even more creative solutions to the ones that I propose. I don't claim to have all the answers or the only answers. Rather, I have endeavored to offer workable strategies, insights and approaches derived from my experience working with hundreds of communities throughout the United States, Canada, and Australia. I have drawn heavily from service providers and communities that have made reductions in homelessness and practiced and funded services in particular ways that have contributed to that result.

Homelessness is one of the most complex social issues of our time. The Book on Ending Homelessness leans into the complexity rather than shying away from it. The book does so in ways that are pragmatic rather than theoretical, firmly entrenched in the day to day realities of responding to homelessness and trying to ensure it is rare, brief and non-recurring.

I will have accomplished my objective with The Book on Ending Homelessness if it results in advancing the work of everyone involved in homelessness. The book, I hope, helps move the needle forward in ending homelessness. I appreciate, as I state at the beginning of the book, that ending homelessness is a bold, whacky, and somewhat preposterous idea to some, while being an entirely possible scenario for others. Perhaps the book can help convert some who think it is impossible to at least giving the idea a solid "maybe" moving forward, and at the same time, provide encouragement to those that already believe to keep going.

I am deeply indebted to the people that have taught me so much in this journey of working to end homelessness. Those partnerships and relationships over the years have made this book possible. Nonetheless, there is still more to learn. There is lots more to do. The work continues. I'd like to think the Book on Ending Homelessness will make the work a tad easier for those that practice in this field and those impacted by homelessness daily. Lastly, it is my hope that the book will help decrease and end homelessness one person, one family at a time.