PURPOSE: To develop partnerships and resources to identify problems and find solutions for our homeless and housing crisis

(MSCC) Posted: June 24, 2020

HOMELESS AND HOUSING MEETING RECAP FOR May 5, 2020

This was our first Zoom Homeless and Housing meeting. If there were any concerns we missed, please forward. It’s our purpose to provide a space for networking and sharing of ideas. 

If any content below is mischaracterized or needs more clarity please let us know. And don’t forget to check out the announcements from our partners at the end of this recap!

CHAIR (May 5, 2020 meeting):Sharon Jasprizza, Midtown South Community Council, MSCC

POLICY COMMITTEE’S REPORT FOR May 5, 2020, 8:30AM MEETING

This was our second Zoom Policy Committee meeting. The prior 8:30am Policy Meeting’s hour was spent discussing shelter policies, Medical Respite beds, and transitioning for active society with COVID-19.

Daniel Pinchinson, Chelsea Ryan Clinic said that, the use of hotels were done quickly to isolate people and provide public health personnel a place to stay. The city moved quickly for safe spaces during the COVID crisis; this process is needed beyond COVID, to develop medical respite beds to save hospital beds. (Please see Addendum B for details)… 

SPEAKER(S) 

The guest speakers during this past May 7, 2020 Homeless and Housing meeting were: 

• Erica Strang, LCSW, Director, Manhattan Outreach Consortium (MOC), discussed conditions, changes, actions, supply (food, PPE) shortages
• Michelle Mays, RN, New York Project Coordinator for Doctors Without Borders (DWB)/Médecins Sans Frontières (MSF) discussed their outdoor shower program and its needs (see Addendum E: Michelle Mays’s Email)
• Dan Pinchinson, Chelsea Ryan Clinic discussed health services during COVID-19
• Relish Caterers: Lenise Dazzel-Harris, Catering & Event Specialist; David Woods, Managing Director/Director Business Development discussed their food service operation 

SHELTER, OUTREACH, RESOURCES, AND CARE DURING COVID-19

• Erica Strang (MOC), said COVID has changed the routined for the street homeless and outreach for them
• Portable Restroom facilities are available at 126 and Park Ave, Ferry Terminal, Penn Station between 7th and 8th Avenue (?) Rosevelt and 50th Street (?)
• Haven drop-in opened in the Bronx (NEED ADDRESS) and is accepting people with poor ADL  (CLARIFY)
• People who are vulnerable to COVID, but not experiencing symptoms, need to be housed and prioritized with their Reasonable Accommodation Request
• Thought the Wellness checks were a good idea, we need it now, with added inquiries such as: how is your accommodations, medical, and mental health, and do you have PPE, clothing…
• Masks and sanitizing solution is distributed (SOMEWHERE)
• Erica introduced the showers and Doctors Without Borders

Michelle Mays, RN, New York Project Coordinator for Doctors Without Borders (the famously known for providing global medical aid where it is needed most, has come to town) talked about their showering facilities at St. John the Baptist Church’s parking lot, 213 W 30th Street. 

• People who are homeless can shower between 12-4pm, on Monday through Saturday, and receive towel, soap, hygiene kit, mask, sanitizer, water, socks, list of soup kitchens, and more. They are closed during heavy rain.
• April 22nd was the first day of operation, they’ve served 250 people at the time of this meeting
• Their maximum capacity for service is 48 people 
• Michelle is asking for clothes and laundry support for their current shower and hygiene offerings mentioned above
• The hand washing station is rudimentary

John Mudd spoke about MSCC’s ongoing Laundry for Kids program that partners with a laundromat in Midtown Manhattan. MSCC could integrate their program with DWB needs.

Lauren Curatolo, Midtown Community Court will reach out to support DWB

Meryl Hulse, NYDIS, initiated a new clothes drive in 2017 and has access to clothing and will contact Michelle.

Daniel offered healthcare and asked the member to send people to his clinic.

645 10th Avenue, btw 45 and 46th Avenue

• They see all age groups
• The clinic can’t test for COVID yet
• call before you come, but walk-ins are welcomed regardless of the ability to pay
• The clinic can help individuals apply for medicate
• The customer are screen upon entering
• Hours of operation are M-F 8:30am to 4:30pm,
• Primary care, emergency dental, optical, mental health, etc.
• Thanked Senator Holman for the PPE equipment
• They are following the Governors recommendation of having the 90 day supply
• Mt. Sinai is to send people who non-COVID to local clinics to lessen patient workload

Daniel, What is the process to get at risk people who are homeless or unstably housed into isolation shelter.

Erica said she would inform Daniel of the process of moving people from street to shelter.

Laurie spoke , said that NYC Councilman’s Wellness check program is about connecting seniors with resources. There’s been a massive amounts of food deliveries. Masks will distributed with the food deliveries. The Mayor has made available 25 mil for community resources.

Relish Caterers: Lenise Dazzel-Harris, Catering & Event Specialist; David Woods, Managing spoke of their operation:

• They are a small business providing 10,000 hot meals and pantry items, which has helped 6,000 families and currently serves 14,000 people
• They have the capacity to do a lot more
• Their goal is to be good community partners
• David Woods referred to the Episcopal Charities at St Thomas Church where he is a member and have lots of contact who may help DWB and the MSCC’s work

Tamara is a Adaptive design, which design and adapts everyday items (furniture, etc.) for people with disabilities within midtown.

John Mudd spoke generally, briefly and positive about Corey Johnson’s vision of how we may open up the NYC for business. 

Laurence Frommer says that the Northwell Urgent Care center (like the one on W 23rd Street) are testing for COVID.

Andrew Bonfranseco, Housing Works, there is not a lot of suicidal assessment done in shelters and isolation wards. This is something we should examine.

If a client has a disability, what are their rights?

Charisma White asked, are people moving into apartments? Britt answered that, leasing is still happening but different depending on the service providers, virtual viewing and lease signing are being done.

Cassie Dessalines, Director, Living Room and Safe Haven, BronxWorks, commented by 5/4/202 email:

Thanks so much for checking in. Things have been absolutely chaotic. I, myself had Covid and was out for 2 1/2 weeks so I was not able to contact NYLAG yet.  Its on my list of things to do. As far as DHS policy we are doing our best to keep up. Things are changing rapidly and it seems like by the time we get some solid direction it changes. I would be happy to comment on our experience in the Living Room as I am pretty sure the challenges we are facing are universal. If I was to break out the main issues we are having it would be:

1.)  Lack of space to properly isolate people with symptoms while they wait for a bed at the isolation shelter.

2.)  Wait time to get a bed at the isolation shelter is extending from hours to days.

3.)  Resistance of clients who refuse isolation and or safe practices (ie social distancing, wearing masks, etc)

4.)  Staff shortages

5.)  Social distancing in Drop In Centers is inherently difficult.  (With this DHS is starting to freeze Safe Haven beds and move older individuals into those beds from the DIC which is on one hand very helpful but also creates a handful of other issues.)

5min

CITY’S PROPOSED NEW RULE (ISP)

DHS’s ISP, Income Saving Program mandate for shelter residents. Further information and links are provided in the Objections and Suggestions to the ISP Rule, see google docs link

• Updates: No initiation during COVID
• We asked for more ISP testimonials and additional savings options

MEDICAL RESPITE BEDS

Medical Respite Bed Advocacy Plan (see Addendum B: Medical Respite Bed Advocacy Plan). Hiring a bookkeeper to chart out costs among several medical respite bed facilities.

The Chelsea Ryan Clinic would be a good example of costs.

RESPITE BEDS

Non Medical Respite Bed Policy Recommendations: No update due tot COVID-19

PUBLIC CONCERNS: POLICE AND COMMUNITY

• Sargent Suzanne Ransome from Community Affairs Outreach Unit attended our meeting
• Marni asked about unemployment delays
  • Laurie suggest to reach out to Senator Hoylman’s office because of their effectiveness
  • Emily suggest to reach out to the Depart of labor, delay from 1-2 weeks, a system has improved for people who were previously unemployed and the now COVID unemployed

Marni asked about rental cancelation 

Laurence suggested to check with Housing Conservation Coordinators HCC

Marni is drafting an email and sending it to John Mudd to forward to HCC

ADDITIONAL WORKS IN PROGRESS

The following items include programs and projects that this committee has undertaken:

• Street Sheets (Volunteers to vet contacts)
• CB4 is strategizing with community partners concerning dispenser issues (representatives?)
• APTs (No updates)
• Workshops 
• Laundry For Kids: raised $4,546.00, served 315 kids, raising funding goal to 8,000 to cover next year

ACTION LIST

Review(see Addendum F: Actionable Items)

ANNOUNCEMENTS

• Please support our  Go Fund me campaigns: Laundry for Kids and Street Sheets

ADDENDUM A: ACCUMULATIVE ACTIONS

A discussion is needed at our 8:30am Homeless and Housing Policy meeting to outline the studied and unstudied issues, and how best to progress them. Discussions should include team development for furthering planning, statistics, finance, procurement, and actions.

ACTIONS

Listed from more recent, to later items. 

• Outreach and police monitoring for 8th Avenue around 34th and 35th Streets
• Communication with precinct  
• Voucher: Additional information and discussion needed
• Daycare resources, discussion and development
• SOI: Speaker to discuss department’s policy and actions
• Comunilife: Establishing relationships with other homeless services, particularly Urban Pathways
• DHS’s General Welfare Committee held a hearing in September 2019 on medical respites; Erin Drinkwater suggests that we look at the testimony and transcripts of that hearing 
• DHS is to provided information about institutional referrals & process for hospital discharges
• DHS with the Medical Director’s office are having ongoing conversations to find the nexus in which to operate among DHS, hospitals, and providers
• DHS is looking for ways to:
  • Reduce cyclical returns to emergency rooms
  • Transition people to medically appropriate shelters when needed
  • Source stable housing for people after discharge
  • Improve communication between the agency and the hospitals about people’s health status and expected discharge dates for timely transition to housing options
• Operating systems: CARES, Home, Street Smart needs more study
• Diversion Plan: The Committee thought it best to further seek further perspectives from enforcement (particularly from the Transit Dept. as they issue the summonses), courts, social services, and civilians (those who receive the summonses)
• Income Savings (ISP) Mandate: We’re waiting for your supportive or contrary comments (pro or con) and saving options for the Objections and Suggestions proposal
• Medical Respite Bed Facility: execute Advocacy Plan
• Non Medical Respite Bed Policy Recommendations:Cassie Dessalines (BronxWorks) and Reggie Miller (NYDIS/ESN) are preparing another draft to discuss with the principal respite bed providers
• Oversight
• Shelter Policies
• Social Workers embedded: School, Hospitals
• Affordable Housing / AirBnB / Deregulation 
• Vouchers: The committee’s researching and taking testimonials. 
• The committee wants to hear from independent landlords about barrier and reluctance to the voucher program
• Outreach / social workers embedded in the hospital emergency room (good), and to a much lesser degree during a patient’s respite period (not so good)
• Mapping medical pathways from recovery to stable housing
• Workshops development
• Hotel participation: Allen Oster, CB4 and MSCC, to organize a meeting with the hotel industry to discuss how they may participate
• Erica (CUCS)/MTS: follow up with outreach in the 8th Avenue (between 34th and 35th Street)
• Erik Botcher, NYC Councilman Corey Johnson’s office, suggests having a conversation between the person who was hampered by bureaucratic systems and DHS/HRA to troubleshoot and find where the breakdown occurred. Others with similar problems could be invited too (SUS’s client)
• Erin suggests watching for legislation and budgeting (that may not cover enough programs/assistance) to come from Albany: Liz Kruger’s Housing Stability bill, supporting increases of City and State voucher participation, and assistance for undocumented citizens (Federal provides only emergency assistance)

ADDENDUM B: POLICY COMMITTEE’S RECAP

(Sub-committee of Homeless and Housing Committee) 

Policy COMMITTEE’S MEETING Recap

When: May 5, 2020

Time: 8:30-9:30am

Where: Via video Conference using ZOOM.US 

Join Zoom Meeting

COMMITTEE’S PURPOSE

Review policies and their oversight, determine actions, suggest and lobby for change!

TOPICS

This was our second Zoom Policy Committee meeting. The prior 8:30am Policy Meeting’s hour was spent discussing shelter policies, Medical Respite beds, and transitioning for active society with COVID-19. 

RECAP

Shelter, Outreach, and Client Care Policies

John Mudd gave an outline of two case studies: A shelter mishandling of a client’s property and poor healthcare treatment of another client care who contracted COVID-19 in separate shelter. 

Is there a common policy among DHS manage shelters and nonprofits? Is this a worthwhile action to pursue? The consensus was yes.

Community wellness check…

Britt Melewski, Breaking Ground says, his work is not about oversight but moving people into housing, but agrees and advocacy arm is needed. 

Community wellness check (which automatically is an oversight arm) would best be use for people using stabilization beds where there is minimal staff care.

Shannon Luchs, talked wellness check are done twice daily seven days by case managers, and when not available, operating staff carries the task forward.

John Mudd asked for testimonials of clients issues within the shelter system; what are the DHS and nonprofit shelter policies?

John outlined aa case where someone is be Bianka, Christena

Metha Balasquides, Outreach Team for Trinity Church, Wall Street, has been informed of two cases where people have been asked to take people’s things away. Metha contacted shelters, cases were not denied, but no one followed up from the shelter.  

Medical Respite Advocacy Plan

Andrew Bonfrancesco, any advocacy is great, especially an outside advocate is needed. Andrew, in response to COVID19, outlined further how a medical respite bed facility could be used as a hub to direct an infectious persons to the right care (hospitals, quarantine, etc.). These Medical Respites can be used as a screening site to enter the shelter system.

• City quickly found sites to isolate infected people
  • This was effective for COVID-19
  • How do we transfer this process to medical respite beds
    • Need to pitch Medical Respite beds during this time

Isolation means a place to stay, but we need trained nursing staff given the trauma this community is undergoing.

Daniel, the use of hotel were done quickly to isolate people and provide public health personnel a place to stay. The city moved quickly for safe spaces during the COVID crisis; this process is needed beyond COVID, for non COVID needs such as medical respite beds to save hospital beds.

Cassie Dessalines, Director of the Living Room and Safe Haven, BronxWorks, commented on a 5/5/20 email: So sorry I missed this morning.  Speaking of DHS policy there is a huge initiative to move older and vulnerable clients out of the Drop In Center and into Safe Haven beds.  This was done very quickly and between yesterday and this morning I had to find, inform, convince, pack and transport twenty of our most vulnerable clients to another site.  We are still finishing up.  Again, I really had planned to be on the call but alas duty calls.  

Metha Balasquides, Outreach Team for Trinity Church, Wall Street, population in lower Manhattan, it is challenging to find shelter. His staff does not want people on the church site because of the COVID threat, but they are providing meals at the church gate.

Action

Research needs to be done to understand the process used to transition hotels into isolation wards and shelters. Sharon and John are to write up a pitch of the above ask to appropriate agencies (see Cassie’s email above and Andrew and Daniels discussion above).

Transitioning for Active Society with COVID-19

Janet Reid, Community Affairs Bureau, sent email wanting to know your thoughts as to the needs and specific assistance your community will require when New York City reopens after the pandemic ban is lifted. 

Britt from a staffing perspective, it is important to engage folks in the field when working out the need and processes when reopening NYC. Test everyone is important, we’re still in crisis, we need to know who can safely go back to work.

John Mudd was in agreement, every life has value, and needs to be considered when getting back to business. We need widespread testing and a vaccine. 

Dan, “New normal is a better way, normal is not possible.† This has been intense drama for everyone. Social distancing has to be maintained. Shelters have to be a priority going forward.

Meryl Hulse, NYDIS, is raising funds for long term needs, COVID-19 hotline info@nydis.org 

Action / Planning List

Position open for someone to list actions and monitor it.

Cassie Dessalines, Bronx Works, will follow up with NYLAG about statistics and legal and legislation progress. 

John Mudd will email the NYLAG proposal to Britt Melewski from Breaking Ground, and David Ward from Trinity Church. 

Emailed on Monday, April 20, 2020 NYLAG’s Report explaining the effectiveness of a Medical Respite model: Homeless New Yorkers Need a Safe Place to Recuperate-Not the Streets

Britt Melewski and Maria Vasquez from SUS will gather testimonials speaking to the medical respite needs.

John Mudd and Sharon Jasprizza are emailing all our participants for testimonials.

Dr. Andy Coyle, Mt. Sinai, as a guest speaker at a future meeting, to be followed up.

To review Advocacy Plan see attached Addendum D: Medical Respite Bed Advocacy Plan.

Prioritizing Our Action List

The policy committee is reviewing the Action List to determine each line item’s next steps. The below line items were discussed thus far:

• Voucher: Additional information and discussion needed: Perspectives between social services and City Agency
• Daycare resources, discussion and development: Ye to be discussed
• SOI: Organize speaker to discuss department’s policy and actions
  • And possibly the Human Rights Council
• Comunilife: Establishing relationships with other homeless services, particularly Urban Pathways to be facilitated by Homeless and Housing Committee
• DHS’s General Welfare Committee held a hearing in September 2019 on medical respites; Erin Drinkwater suggests that we look at the testimony and transcripts of that hearing : Needs to be added to the May 5, 202, Policy meeting Agenda

AOB

• Andrew Bonfrancesco: Shelters cleanliness, gloves, masks, protocols, Several People have
• contracted COVID-19 medical respite for recovery 
  • Follow up: Sent email 4.8.20 to NYC Council and DHS representatives alert them of possible widespread problem
  • We also suggested in the above email to inquire with all DHS shelter needs
• The committee is to reach out to all shelters for a wellness and needs check

FURTHER PLANNING

• Review the rest of the action list
• New study focus
• New Policy focus
• Review Voucher policies and oversight 
• Review systems
• Adding policies concerning chronicity to our task list
• Assign someone to notate further planning

ADDENDUM C: BOSTON MASSACHUSETTS MEDICAL RESPITE BED

MASSACHUSETTS / Barbara McInnis House 

Agency: Boston Health Care for the Homeless Program
Address: Jean Yawkey Place, 780 Albany Street, Boston, MA 02118 Contact: Sarah Ciambrone, Executive Director, Barbara McInnis House Phone: (857) 654-1701
E-mail: sciambrone@bhchp.org / Website: www.bhchp.org 

Description / Established 1993

Since 1988, medical respite care has been an essential component of the continuum of healthcare services provided by the Boston Health Care for the Homeless Program (BHCHP). Originating as shelter-based medical beds, medical respite care for men and women is now provided in one freestanding facility, the 104-bed Barbara McInnis House which is housed in the top three floors of Jean Yawkey Place on Albany Street in Boston and located across the street from Boston Medical Center. 

Jean Yawkey Place is home not only to the medical respite program but also the dental program, a busy pharmacy and ambulatory clinic, and administration for Boston Health Care for the Homeless Program. 

The McInnis House provides care to men and to women, and provides comprehensive medical, nursing, behavioral, dental, and case management services in an environment sensitive to the needs of homeless adults. 

The McInnis House offers three meals per day that are served in the dining room. Patients recuperate in private, semi-private or two to six bedrooms. The program admits patients 24 hours per day, seven days a week from hospitals, shelters, emergency departments, outpatient clinics, and directly from the street by referral from the BHCHP Street Team. 

Operating agency: Boston Health Care for the Homeless Program (HCH) 

Facility type: Stand-alone / Number of respite beds: 104

Hours of operation: Admissions office – Monday thru Friday, 8am-4:30pm Average length of stay: approx. 12 days 

Admission Criteria 

• Primary medical problem 

• Psychiatrically stable 

• Independent in Activities of Daily Living 

• In need of short-term recuperative care 

• If on methadone, must be enrolled in methadone maintenance program 

• Disclosure of known communicable disease, including TB, VRE and MRSA 

ADDENDUM D: MEDICAL RESPITE ADVOCACY PLAN FOR NYC

MEDICAL RESPITE BED ADVOCACY PLAN

There is no question that we need medical respite beds in New York City. Many of our service providers will attest to this. People suffering homelessness are deprived of complete recovery alternatives after leaving an emergency room. People are mostly cared for by family or visiting nurses after returning home to ensure successful recovery. People who are homeless do hot have access to aftercare, and hospitals are reluctant to house people beyond their needed emergency care. As one Mount Sinai doctor said, “We’re not a Holiday Inn.†

A medical respite bed facility can be a pipeline from the hospitals to health, medical, social, and other services, which can lead to housing opportunities. 

This four-step plan is to encourage the development of medical respite beds in NYC. This is a plan in progress, not without flexibility, and is open to suggestions.

Step #1 (Began November 2019) Mission:

Describes our mission (the encouragement of medical respite beds) and suggests the following pathways to complete that mission:

• Encourage medical respite bed funding through the city budget
• Ask the city to fund a pilot project to study the financial and clinical outcomes
• Encourage the network of providers to develop medical respite beds

A press release describing the committees’ intentions, emphasizing the forthcoming presentations, and encouraging attendance could be prudent.

Step #2 (March 2020) Information Gathering:

This step requires a tremendous amount of information gathering affirming the necessity, sustainability, and capital to develop a respite bed facility. Fortunately there are successful examples and developers who are willing to guide this endeavor. The information gathering should include, but not be limited to:  

• Statistics outlining success in other states
• Costs difference between emergency care and respite bed facilities
• Developmental and operational cost analysis
  • Daniel Muwamba, Deputy Chief Financial Officer, Boston Health Care for the Homeless Program is already working on financial details of the Barbara McInnes House and Stacey KirkPatrick facilities
• Short documentaries and testimonials speaking to medical respite needs
• Video and PowerPoint presentations affirming the medical respite beds necessity and benefits:
  • Andy Coyle, M.D., Assistant Professor of Medicine and Medical Education, Associate Program Director for Ambulatory Care, Internal Medicine Residency Program, Icahn School of Medicine at Mount Sinai, has shared a great deal of knowledge during a conference call and with his PowerPoint presentation, using data from March 2019, and he is willing to further support our endeavors: 

I can pull updated data if there is an opportunity to speak to a group…I can also share more of our outcomes data for the respite as we have it.

• Comunilife’s Rosa Gil, DSW, President and CEO, has contracts with Monte, Bronx Lab and a few Medicaid Managed Care plans for medical respite bed care
• David Munson, Barbara McInnes House, has shared details of his operation and as with Dr. Coyle, is willing to support our endeavors
• BronxWorks, is partnering with One City Respite Program, to lower the cost of emergency room use, to provide longer care for persons without a residence, and to enable a pathway to better health and housing stability (an interim step towards medical respite beds?)
• Insurance Companies: Health First, United Healthcare, MetroPlus, Amida Care
• DHS, Outreach services, and NYDIS: How can medical respite beds benefit?

The video presentations should educate, speak to the need, and empower others to advocate for medical respite facilities. 

Step #3 (July, August 2020) Administrative, Proposal Development, and Marketing: 

This step collates the work from Steps 1 & 2, fills in the gaps, and tailors it to the needs of client and state for a finalized proposal to encourage the development of medical respite beds. This step serves the final presentation and marketing needs, and also encourages support and participation. 

Step #4 (September, October 2020) Advocating for Development:

This is the culmination of discussions, meetings, research, discoveries, proposals and presentations to gather the support from nonprofits, city agencies, governing bodies, medical institutions, and humanitarian developers to realize the building of medical respite beds.