COVID-19: Response Plan for People Experiencing Homelessness Public Summary Please be aware that this description is current as of April 20, 2020, and may be updated as community planning evolves and we respond to emerging needs and resource availability. The Mayor’s Office of Homeless Services (MOHS) has developed this COVID-19 Response Plan to mitigate risk for individuals experiencing homelessness. MOHS, in partnership with homeless service providers and public and private agencies, will implement a range of prevention and response strategies to support individuals who are at particularly high risk of contracting communicable diseases and unable to self-isolate at home. To date, MOHS is committed to the following critical interventions: 1. Emergency Shelter Assessments and Testing On March 20th, 2020, MOHS released guidance to the primary public emergency shelters. MOHS implemented this protocol to proactively identify potential COVID infections in emergency shelter environments as quickly as possible. It provides a process and resources for emergency shelters and congregate homeless service progrms to assess residents for symptoms consistent with COVID, consult with a health care provider, receive a referral for testing, and be transported to an isolation site, including:  Shelter Client Triage Screening Tool: The emergency shelters will use this tool to proactively screen all shelter residents for symptoms consistent with COVID-19.  Telephonic Screening: After a positive initial screening, shelters will connect with a health provider to conduct a secondary telephonic screening.  COVID-19 Testing and Isolation: If the screening is positive, the individual will be referred for COVID testing and provided with transportation. 2. Hospital Discharge Practices On March 17, 2020, MOHS released interim guidance for hospitals to ensure the proactive assessment of housing status upon discharge, prevent unsafe reentry into congregate living environments and unsheltered locations, and provide a safe alternative for isolation. Depending on the scenario, it includes discharge protocols to assess housing status and facilitate transfer to an isolation site or an emergency shelter bed as follows:  Discharge Protocol for Patients with Suspected or Confirmed COVID-19: For patients being discharged who are pending COVID-19 test results or are a confirmed case, before discharge, hospitals should complete a Housing Environment Screen to determine whether or not the individual will be able to selfisolate at home.  Discharge Protocol for Patients Experiencing Homelessness when COVID-19 is NOT Suspected: For patients being discharged from the hospital who are experiencing homeless when COVID-19 is NOT suspected, the hospital may coordinate discharge to an emergency shelter by contacting the Mayor’s Office of Homeless Services. 3. Isolation Sites Baltimore City has secured an isolation site to provide individuals experiencing homelessness and others unable to self-isolate with a safe alternative while awaiting test results and/or recovering from a COVID infection. Individuals identified through the COVID-related protocols are provided with transportation to a designated isolation site. Upon arrival, MOHS staff are completing an intake process with each person and maintain ongoing contact with each individual to assess ongoing needs during the isolation process. The City of Baltimore will continue to evaluate community need and the availability of resources and modify isolation sites and supportive services. Screening, Testing, and Isolation Process Map Emergency Shelter Assessment Emergency shelter provider completes screening tool with residents Negative Hospital Testing Hospital completes screening tool with patients prior to discharge Positive COVID Ruled Out Consultation with health care provider or referral to the hospital No Further Action Negative No Further Action COVID suspected of confirmed Transportation to the isolation site. Call MOHS for shelter access Positive Individual is referred for testing at a dedicated site or the hospital Transportation to the isolation site. ISOLATION SITE Individual arrives at isolation site. MOHS staff completes intake and assigns for regular check-ins. Negative 4. Expanded Capacity for Social Distancing in Shelters Return to Shelter Positive Remain in isolation until medically cleared. MOHS recognizes that with our emergency shelters filled to near capacity, the risk of communicable diseases spreading through this population is exceedingly high and there is no way to allow for shelter residents to practice the recommended level of social distancing.   Social Distancing Shelter Site: Starting on April 6th, 2020, MOHS activated an alternative social distancing shelter that will operate temporarily, at least until the COVID-19 health emergency has been contained. All Monument Street Shelter residents and some Pinderhughes Shelter residents were transferred to this location. Social Distancing Hotels: Starting the week of April 6th, 2020, MOHS relocated over 150 of the most vulnerable shelter residents to hotel rooms. During this initial phase, priority was given to individuals over the age of 62 and/or those with chronic health conditions. 5. Outreach to People Experiencing Unsheltered Homelessness Homeless outreach teams have shifted to tactical operations to ensure individuals experiencing street homelessness are provided with critical supplies, including hygiene products, water, food, and guidance on COVID and available community resources. Additional Planning MOHS has released interim guidance and local and national resources to all homeless service providers and community partners. Many service providers have modified hours and services to mitigate the risk of exposure to staff and individuals experiencing homelessness. Comprehensive updates will be provided on a weekly basis and are made available on the MOHS website. MOHS will continue to pursue additional opportunities to expand capacity within and beyond emergency shelters and provide updates as they are available.