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HomeMy WebLinkAboutachch-covid-response-36x48-presentation-2022-nhchc1 1 2 7 10 14 11 27 9 5 13 17 10 13 9 17 8 9 14 14 10 27 21 10 7 6 4 5 1 2 8 13 3 14 21 28 48 33 24 33 37 51 50 36 15 24 12 6 13 10 14 8 3 11 5 4 5 7 2 3 1 3 7 10 14 35 33 34 45 40 31 29 26 27 13 16 14 14 10 6 4 6 1 5 5 5 13 10 40 209 232 163 100 74 43 32 16 10 6 3 6 3 4 3 2 3 20 50 100 150 200 Convening a Community of Care to Respond to the COVID-19 Crisis Alameda County Health Care for the Homeless Program (ACHCH) and the roles of Health Center-County-and-Community Emergency Coordination David Modersbach ACHCH; Sabrina Fuentes ACHCH CCAB/HIV Education and Prevention Project of Alameda County (HEPPAC), ACHCH Staff Convene and Communicate: Alameda County Homeless Services Providers COVID- 19 Community Call March 13, 2020: ACHCH convened what turned out to be first of two+ years of weekly COVID Community Calls:An AM call for shelter and congregate housing providers;a PM call for outreach and street providers. Each call includes up to 100 participants from over 130 different agencies, including community providers, advocates and volunteers. Early calls served to unite providers who were able to share fears of unknown, share experiences & build community, trust, and common purpose. Written Guidance Create webpage, compile guidance, update frequently March 10 2020-present: We listened and responded to the questions raised by providers in weekly meetings. Kudos to Seattle King County from whose great work we all borrowed liberally – You’re the best! HCH Health Center READINESS HCH Health Center READINESS Persistent Precarity and Everyday Disasters Based on our roles in previous emergency responses, when COVID-19 began, ACHCH leveraged existing trusted relationships with a wide variety of community providers, and supplies stockpiled for wildfire disasters to support an immediate response.This build upon work ACHCH shared in a 2019 NHCHC national conference workshop. Distribute Supplies ACHCH converted meeting rooms into a Supplies Center for open distribution of needed supplies to hundreds of shelter and outreach partners March 2020-present: ACHCH accessed and distributed needed supplies widely to homeless providers, who in turn created regional informal distribution networks. ACHCH was able to support this effort through administrative staff pivoting to perform stock and supplies distribution roles. As a result, our community distributed tens of thousands of hand sanitizer, surgical masks, N95, thermometers, gowns, face shields, gloves, wipes, pulse oximeters, etc. Providers felt a strong sense of relief and support having these essential resources. Crucial support was provided by Direct Relief and Americares programs & County Emergency Operations Center. Isolation and Quarantine (I&Q)hotel service delivery model ACHCH staff worked to develop I&Q hotel capacity March 2020: ACHCH staff worked with county partners to help develop innovative I&Q hotel system geared towards the needs of people experiencing homelessness.ACHCH pharmacist created innovative supports for people with alcohol or opiate dependencies. Isolation and Quarantine Develop I&Q Policies and Procedures Handbook April 2020: ACHCH staff worked with local and national providers to develop comprehensive I&Q policies and procedures and a handbook. This handbook was shared nationally and used by countless localities across the country. Rapid Response ACHCH adopted a one-suspected-case threshold for initiating Rapid Response, in shelter and street settings May 2020-Present: Early on, ACHCH decided to carry out a “one-suspected-case” trigger for a rapid response to outbreaks in shelters. We constantly updated community providers on our response protocols and outbreak status in weekly meetings. This is still the ACHCH outbreak definition. To date, ACHCH has led 450 Rapid Responses, with testing, tracing, and surveillance, at 340 shelters and 110 street sites, in coordination with shelter, provider, outreach and public health partners. Environmental Scan ACHCH developed & shared a Google Form for community and County providers to assess outbreak settings April 2020-March 2021: Environmental Scan was a shared document that dozens of community, outreach, Street Health and City staff used to clearly understand the settings of street-based COVID outbreaks (without PHI) and coor- dinate outreach, meals, water, tents, and hygiene supplies (port-a-potty and wash station) to support people who opted to isolate/quarantine in place. Training to Build Community Skills ACHCH led regular online trainings for community providers. September 2020-present: ACHCH identified topics with community input, and scheduled monthly skills-building trainings, using HRSA COVID funds to bring trainers and experts to lead community providers through a variety of topics. Many topics were “non-COVID” to reduce burnout and increase space for community learning on topics such as harm reduction, trauma informed care and anti-racism practices Support CDC Encampment Guidance Preventing further spread of COVID among unsheltered ACHCH played roles mediating community concerns around encampment sweeps during COVID outbreaks, to ensure that CDC guidelines were respected, working with advocates, Cities and County to provide housing, testing and support for camp residents threatened with sweeps. Initiate Vaccination Efforts Prioritize homeless services providers in rollout December 2020-February 2021:With the first release of COVID-19 vaccine in Dec 2020, ACHCH advocated for shelter and outreach providers to be deemed “essential health workers” to access vaccines. We were able to quickly vaccinate over 1000 frontline providers. Providers felt immediate support and in turn demonstrated their vaccine-willingness to the clients they served. Community Care Vaccination Sites Easy-Access regular vaccine/testing March 2021-present: In addition to providing regular, on-site vaccinations at shelter and congregate homeless settings, ACHCH establishes a fixed schedule of Community Care sites which are supported by partnering community providers and are easily accessible for people in nearby camps and shelter locations. OMICRON SURGE! All-hands-on-deck to maintain a containment vs. mitigation strategy. January 2022: The huge surge of Omicron tested our ability to “contain” infections through providing I&Q for everyone who was infected, symptomatic or close contact. I&Q leads were able to expand to over 400 beds, ACHCH had daily contact with dozens of shelters and outreach providers and had twice-daily huddles with I&Q, public health, and ACHCH leads to monitor and strategize. In the end we did NOT have to leave shelter providers to deal alone with the surge, which occurred in most localities nationwide. Distribution of Rapid Home Test Kits ACHCH distributed over 100,000 rapid test kits to 113 shelter and services sites between January-February 2022 December-February 2022: ACHCH procured rapid test kits through HRSA and large regional health system donations (Stanford Health), trained community providers on their use, used our community distribution network to quickly ensure that all shelter, congregate setting and outreach providers had access to sufficient test kits on an ongoing basis. This enabled ACHCH to stop providing testing and focus on vaccinations and shelter environments and health. Readiness and Initial Response Isolation and Quarantine Testing and Rapid Response Sustain Community Response Isolation and Quarantine Train and Fully Involve Community Partners for Referral April 2020: ACHCH staff developed online trainings and materials to ensure that 300+ community organizations could quickly refer homeless COVID+ or symptomatic persons to I&Q hotels to limit transmission of disease. Shelter Decompression and Safer Ground ACHCH worked with shelter providers to decompress and identify high-risk residents April 2020: ACHCH led street outreach providers in identifying and communicating with high-risk street/encampment residents to refer into Safer Ground hotels.We led shelter providers in identifying high-risk shelter residents, testing and “airlifting” some 500 persons to Safer Ground within a few days. To date over 2400 people have utilized Safer Ground housing. Street-based Water and Encampment Supplies distribution Community providers able to access bottled water, tents, food and hygiene supplies April 2020-present: ACHCH convened a community of providers to access bottled water (initially Americares- provided), solar chargers and tents (Direct Relief) World Central Kitchen meals, supplies including PPE and hygiene supplies, and city-provided port-a-potties. Street Response Mapping Project: ACHCH and networks of community outreach providers to map encampments and needs March-September 2020: ACHCH convenes mapping project with daily input of formal and informal outreach providers throughout County. This helped to coordinate outreach efforts, assess needs at sites, and reduce duplication of efforts. More than 200 encampment sites were mapped and updated regularly. This map was not shared with enforcement officials. Recovery and Readiness Honor Our Heroes GG Greenhouse Community Hero Awards December 2020-present:It is critical to acknowledge individual heroes that make our community efforts successful. Beginning Winter 2020, ACHCH honored heroes selected by the community in the name of GG Greenhouse, one of the founders of ACHCH and the National Health Care for the Homeless Council. Flu Vaccination Campaign Working with community providers to avoid Double Trouble October 2020-21: Based on our earlier role in Hepatitis A outbreak response, ACHCH leveraged trusting relationships and communication with a wide variety of community providers to carry out successful flu vaccination efforts in shelters and street settings in Fall/Winter of 2020 and 2021. Hire/Train Vaccine Ambassadors People with lived experience play a huge role in improving Vaccine uptake February 2022-Present: ACHCH participates in NHCHC /CDC/NAACHO Vaccine Ambassador program, hiring and training four people with lived experience to join ACHCH team and provide direct information and support to people in shelters and streets who are considering whether or not to vaccinate. Anti-Viral COVID Treatment ACHCH led Test-to-Treat among homeless community and providers February 2022-present: ACHCH procured supplies of HRSA antiviral COVID treatment and ensured that Test-to-Treat procedures were made available to outreach, testing, shelter and I&Q providers. We trained community providers in TTT and supported creation of community-wide TTT protocols. ACHCH would like to salute all of our community partners who worked successfully to protect and support the thousands of people experiencing homelessness throughout Alameda County during the COVID pandemic of 2020-2022: HIV Education and Prevention Program of Alameda County HEPPAC, 2 de Febrero, Abode Services, Alameda County Network of Mental Health Clients, Alameda Health System, Alameda Point Collaborative, Bay Area Legal Aid, Bay Area Community Health, Bay Area Community Services, Berkeley Food & Housing Project, Berkeley Free Clinic, Berkeley Mental Health, Berkeley Outreach Coalition, Building Futures for Women and Children, Building Opportunities for Self-Sufficiency , C.U.R.A.,Inc., CAL-PEP, Cardea Health, CAREavan Program, City of Fremont, Cities of Alameda, Albany, Oakland, Berkeley, Emeryville, Fremont, Hayward, Union City, Livermore, Newark, San Leandro, Pleasanton, Dublin, CityServe Tri-Valley, City Team Ministries, Covenant House, Dine and Connect, Dorothy Day House, East Oakland Collective, East Oakland Community Project, East Bay Community Law Center, El Chante, Family Bridges, Feed My Sheep, FESCO, First Presbyterian, Five Keys, Fred Finch, Global Communications Services GCEA, Hayward St Vincent de Paul, Homebase, Homeless Action Center, House of Prayer Everywhere Urban Missions Outreach, Harrison Alter MD, Horizons Inc., Housing Consortium of the East Bay, Lake Merritt Lodge, La Familia, Lifelong Medical Care, Love and Justice in the Streets, Manna, Melissa Moore, Men of Valor, Men/Women on the Way, NEED, Oakland Catholic Worker, Oakland HAWG, Off the Street Ministries, Office of Homeless Care and Coordination Housing Support Program, Operation Dignity, Operation Dignity , Project Pride, Punks With Lunch, ROOTS Community Health, Ruby's Place, Salvation Army Emergency Family Emergency Shelter, SAVE, Second Chance Recovery, Seventh Step Foundation Inc., Shiloh Domestic Violence Shelter, South Hayward Parish, Street Level Health Project,St. Mary's Center, St. Vincent de Paul Oakland, Swords to Ploughshares, Talia Rubin, The Village, Tiburcio Vasquez Health Center, Tri-Valley Haven, Turning Point and Rising Oaks, Umoja Health, Unity Within the Community, Village of Love, Volunteers of America, Women's Daytime Drop in Center, Youth Spirit Artworks, YEAH Isolation and Quarantine Hotels Involve Community Partners April 2020: Community providers reviewed and improved I&Q FAQs and info materials for people referred to I&Q. Harm Reduction providers HEPPAC set up naloxone and OD prevention kiosks and supplies throughout hotels. County AC3 “Fellows” with lived experience provided contact and support services to folks in Safer Ground hotels to reduce isolation. Rapid Response COVID Testing Team ACHCH/Public Health Testing Teams provided PCR testing to any site with outbreaks or high risk July 2020-March 2022: With HRSA COVID funding, ACHCH was able to create teams to carry out outbreak response and surveillance testing, providing over 15,000 tests to people and staff in shelter and street settings. Improving Shelter Environments Efforts to improve ventilation, infection control and healthier built environments at homeless congregate sites. April 2022 -ACHCH earmarked HRSA COVID/Capital Improvement funds to partner with Alameda County Public Health and Healthy Homes Department to develop toolkits, training and on-site assessments for shelters. ACHCH will provide HEPA air filter machines, recommendations and resources towards improving shelter environments. ACHCH Health Center READINESS Building Climate and Community Resilience ACHCH will maintain our close trusted relationships with community providers through regular meetings, trainings, advocacy and efforts to better prepare and respond to the inevitable disasters and emergencies we face in times of climate and COVID-19 uncertainty. Addressing Vaccine Hesitancy Partnering with community providers listen and learn May 2021-Present: ACHCH carried out focus groups and dedicated a lot of time in our weekly meetings to listen to people experiencing homelessness to listen and learn about vaccine hesitancy. Our Consumer/Community Advisory Board produced valuable input around key issues such as low-barrier access, choice of vaccine, education, and incentives, which have become standards in ACHCH vaccination efforts. Regional Homeless Coordination ACHCH Regional Coordinators December 2020-present:ACHCH was able to bring on highly-skilled providers to serve as Regional Coordinators in five zones of Alameda County, to serve as leads to shelter, outreach, city and homeless services providers in their areas. They built effective communication and trust between community and the ACHCH program and County. Partnering to Support People at Risk Resources and Partnerships to protect the broader community ACHCH partnerships extended beyond homeless provider networks. We partnered in many comm unity-wide efforts and initiatives to support pop- ulations such as people exiting criminal justice, immigrant/day laborer, substance users, and Black & African- American communities in Oakland. Homeless Health Centers are uniquely situated to lead effective regional disaster/emergency response to protect and meet the needs of people experiencing homelessness.HCH providers can serve to bridge gaps between shelter & services providers, community members, advocates, patients and vulnerable populations with health department, City, County, State and Federal responders, building trust and developing innovative networks for delivery of care, guidance and supplies, while supporting the strengths and resilience of homeless providers and people experiencing homelessness.Of critical importance is development of trusted relationships, and a sense of collective effort that includes all members of the continuum of clients and community services providers. These trusting relationships are not “planned” --they emerge from ongoing efforts and engagement in response to the persistent precarity and everyday disasters that confront people experiencing homelessness. In this poster Alameda County HCH traces the development of our collective COVID-19 response in Alameda County.Alongside the curve of cases over the last two years, we highlight some of the key elements of ACHCH’s work in partnership with local government and community partners. Vaccination Efforts I&Q and Safer Ground as Housing Demonstrate effectiveness of I&Q and COVID Safer Ground Housing as a way of ending homelessness June 2020-Present: ACHCH staff frequently shared the successes seen in our I&Q and Safer Ground COVID hotels. To date 1,400 formerly homeless residents have left Safer Ground hotels into permanent housing, and providers have celebrated these successes with us along the way. Chronology of Alameda County Homeless COVID Cases Among People Experiencing Homelessness by Week/Month 2020-2022 International Seafarers Vaccination ACHCH partners with community providers to vaccinate international seafarers for fun July 2021: Local advocates and unions informed ACHCH that international seafarers at Port of Oakland found it impossible to get vaccinated. We took our services on board their ships to provide vaccinations, and helped other ports initiate seafarer vaccinations.