On March 18, a new Building Bridges blog series was launched to share solutions from other communities and highlight key interventions in response to the COVID-19 pandemic. Last week’s blog post focused on how communities are exploring options to transform gains in temporary housing capacity during the response to COVID-19 into permanent housing stock following the pandemic.

In response to COVID-19, organizations have pivoted to ensure that people at risk of or currently experiencing homelessness can continue to receive the supportive services they need. Supportive services can include a range of interventions such as case management; housing search assistance; budget and credit counseling; medication management; mental health and/or substance use counseling; or other therapeutic services. Generally speaking, supportive services are designed to help households obtain and sustain permanent housing; and may be needed from a few weeks to years. Coupled with rental assistance, supportive services are a critical component of the work to address housing instability and homelessness.

This new Building Bridges series looks at community responses to COVID-19 using a prospicient lens: What short-term, community responses can become long-term, systemic solutions?  Which immediate interventions can effectively and efficiently address the structural issues that lead to housing instability and homelessness? What “new thing” can evolve into “business as usual?” And what is needed to create healthy, stable communities permanently?

This week’s blog post is dedicated to how communities are continuing to provide supportive services during the response to COVID-19 and how some of these changes can be transformed into permanent solutions.

THE CURRENT STATE OF SUPPORTIVE TELESERVICES

To protect the health and well-being of both the people providing and receiving services, organizations have turned to telecommunications to close the gaps created by new social distancing requirements. Below are two major categories where telecommunications have been used to provide services in response to COVID-19:

Telehealth meetings

Prior to COVID-19, supportive services were generally provided through in-person meetings, including in an office or at the client’s home. An individual housing/homelessness service-related case manager or counselor might have supported as many as 30 households at any given time. With this high frequency of interaction comes the increased potential for transmission of the novel coronavirus, especially among populations that are likely to have underlying medical conditions.

The Health Resources Services Administration defines “telehealth” as the “use of electronic information and telecommunications technologies to support long-distance clinical health care; patient and professional health-related education; public health; and health administration…Telehealth can also refer to remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services.”

Whether conducted in-person or virtually, supportive services are designed to “meet a client where they are.” When meetings occurred in-person, this might mean accommodating client schedules and varying meeting locations. In virtual terms, telecommunication is the method to meet the client where and how they are: by phone, computer, text, or some combination. The National Alliance to End Homelessness (NAEH) recently released a webinar for providers on how to support people remotely in housing programs. The webinar recommended that housing providers recalibrate caseloads, prioritizing client contact based upon factors like vulnerability to COVID-19 and risk of housing instability. Similar recalibrations should occur with case plan goals.  If the client is in housing, these shifts should include proactive conversations with landlords. Additional tools and resources are available via this link to the COVID-19 Hub .

Virtual webinars and groups

In addition to one-to-one meetings, other types of meetings (including trainings and webinars) for clients and staff have shifted to virtual settings. Clinical group settings have also taken place online.  In response to COVID-19, Mental Health America published multiple online resources including: building resiliency; coping with anxiety and depression; and meditation and mindfulness. In Charlotte-Mecklenburg, Promise Resource Network, which provides peer support services, has shifted supportive services online with different options available for clients each day (Click here for the link to their May 3 – May 10 virtual schedule). As schedules for virtual offerings continue to be made available, the Charlotte-Mecklenburg Housing & Homelessness COVID-19 Hub will share them via “Local Information & Resources.” If your organization is offering a schedule of virtual events, please send it by way of the contact information at the bottom of COVID-19 Hub webpage.

LONG TERM VIEW ON TELECOMMUNICATIONS & SUPPORTIVE SERVICES

While the shift to telehealth has been driven by the need to protect public health, there are other benefits for organizations and communities to consider as they contemplate a “phased re-entry” when it comes to supportive services. Telehealth allows for greater flexibility in scheduling meetings. For example, when a work schedule is not confined to physical office hours, a case manager automatically has more variability to meet their client “where they are” when it is convenient for both parties. Telecommunication reduces or eliminates altogether the need to commute to a specific place, which saves organizations dollars in both mileage reimbursement and in a case manager’s time. Time spent commuting can be reallocated to other, less client-facing matters such as documentation. In addition, virtual groups and webinars remove transportation as barrier to attendance for clients.

It is important to note the limitations of telecommunication. For example, access to the device, itself, as well as internet connectivity and/or plan minutes can also pose a barrier, especially for households that have limited resources. In addition, some funders require that housing case managers conduct a minimum number of in-home meetings as a visual “check” on the housing unit. This “check” is intended to identify early red flags before they might become a problem that could negatively impact a lease. As organizations consider what supportive services look like in the weeks and months ahead, these limitations should be considered appropriately and addressed. Some communities are allocating resources to ensure ongoing connectivity with clients – from added phone minutes to low- or no-cost devices.

SO, WHAT

This blog post highlights yet another short-term solution that can easily become a long-term strategy to address the pre-existing conditions of housing instability and homelessness.

At its best, telecommunication can empower clients and staff by allowing them the space to balance competing priorities related to all aspects of their lives. Such an orientation is not only good for promoting housing stability, but also overall health and well-being. This can also result in improved employee morale and increases in staff retention.

An ongoing shift to telecommunication, including telehealth, is not limited to the field of housing and homelessness services. This trend is also occurring across other service sectors and workplace settings. Organizations are adapting daily to changing circumstances; what might have once been considered undesirable or impossible is now realized as productive.

As communities shift to planning for future re-entry operations, they must consider all aspects of client interaction along the housing continuum: from coordinated entry, to emergency shelter, to housing inspections, and other supportive services. They must ask questions like: How does telecommunication as it currently exists prevent or facilitate access to resources? Under which circumstances, and for which purposes, should telehealth become the “new normal” in supportive services? And, vice versa – under what conditions is/was an in-person meeting really necessary? How can any gains in efficiency be reallocated for maximum efficacy?

Future posts in this series will continue to focus on this important shift from short-term intervention to long-term implementation. Check back here each week to find out more.

To access COVID-19-related news and resources related to housing instability and homelessness, visit the new Charlotte-Mecklenburg Hub for Housing Information related to COVID-19.