Local organizations step up as President denies, deflects, and dissembles on COVID-19

NEIGHBORHOOD FAMILY PRACTICE, AREA CHURCHES WORK TO EXPAND COVID-19 EDUCATION & TESTING TO BLACK AND BROWN COMMUNITIES

By R. T. Andrews

Neighborhood Family Practice Community Health
Center, on Franklin Blvd. in Cleveland's Detroit-
Shoreway neighborhood, one of seven NFP centers.

With President Donald Trump desperately trying force an economic recovery by browbeating federal health officials, threatening to withhold federal funding for school districts that do not re-open in normal fashion, and lying daily to the American people about the extent of the crisis and his administration’s half-hearted, disjointed, and ineffective responses to the COVID-19 pandemic, the black and brown people who are proving to be at higher risk can take some comfort in the knowledge that some of the community organizations that serve them are taking matters into their own hands.

COLOR OF HEALTH INITIATIVE

Last month the Greater Cleveland Congregations (GCC) launched a community-based campaign to test thousands across Cleveland and Cuyahoga County to contain the spread of COVID-19, with an emphasis on African American populations and other at-risk groups.

The campaign, known as the Color of Health Initiative, has recruited 18 congregations that will serve as sites for free testing through a partnership with the Cuyahoga County Board of Health and MetroHealth Systems. The Initiative is being co-chaired by GCC members and Cleveland pastors, Rev. Jawanza Karriem Colvin, Olivet Institutional Baptist Church; Rev. Ronald Maxwell, Affinity Missionary Baptist Church; and Rev. James Quincy, Lee Road Baptist Church.

Public health research and experts have pointed out the disproportionate impact COVID-19 has had on the poor and communities of color, exposing the inequities and injustices that GCC has been building power to correct since its founding. "There is an intersecting point between where race, poverty and this virus meet and it is ground zero for the worst of this pandemic," says Rev. Colvin. "We aim to meet it head-on."

HEALTH NETWORK ON WESTSIDE

Similar work is underway by the Neighborhood Family Practice (NFP), which has been providing outreach and education about the virus and expanding COVID-19 testing capabilities to minority populations via partnerships with other organizations.

NFP  is a community medical practice providing primary care, women’s health and midwifery services, behavioral health, dental and case management appointments to more than 19,000 patients annually at its combined locations. It has a network of seven community health centers — six on the city’s west side, and another in Lakewood — serving a diverse population of more than 19,000 patients annually.

“There are serious barriers to accessing COVID-19 testing among the African American/Black, Hispanic/Latino and refugee populations. It is our obligation as a federally qualified community health center to create systems that are equitable and accessible to all Clevelanders,” says Jean Polster, RN, MS, NFP’s president and CEO.

Polster’s comments echo findings by the Greater Cleveland Congregations organization. GCC members visited 46 drug stores operated by CVS, Rite Aid and Walgreens within Cleveland city limits and found only two operating COVID-19 testing sites.

According to the Centers for Disease Control, long-standing systemic health and social inequities have put some members of racial and ethnic minority groups at increased risk of getting COVID-19 or experiencing severe illness, regardless of age. Among some racial and ethnic minority groups, including non-Hispanic black persons, Hispanics and Latinos, evidence points to higher rates of hospitalization or death from COVID-19 than among non-Hispanic white persons. As of June 12, 2020, age-adjusted hospitalization rates are highest among non-Hispanic American Indian or Alaska Native and non-Hispanic black persons, followed by Hispanic or Latino persons.

“For the past several weeks, NFP has been offering testing — at no cost to those tested — at our West 117^th Community Health Center. To date, we’ve conducted more than 500 tests,” says Polster. “We recently added testing capabilities at our Detroit Shoreway location as well and hope to expand testing to other locations in the near future.”

AWARENESS AND EDUCATION CAMPAIGNS

In addition to testing, NFP is reaching out to leaders of other community organizations, starting with those serving the Hispanic/Latino community, with the goal of working together to help reduce COVID-19 related illness and death in that population. NFP is inviting organization leaders to participate in a video conference (to be conducted at 11 am on Wednesday, July 15) in which information on health guidance, testing and more will be shared.

NFP is also launching a COVID-19 awareness and education advertising campaign that will target African American/Black, Hispanic/Latino, refugee and white low income households (less than $50,000), as well as populations with existing chronic health conditions including diabetes, hypertension and obesity. Ads will run on networks targeting these populations like BET, OWN, TBS, VH1, Galavision, Telemundo, Discovery Spanish, ESPN Deportes, and more. Non-skippable ads will also run on other platforms including Xbox, Roku, Kindle Fire and PlayStation, along with other platforms to reach those who don’t watch traditional television, but instead stream it on their iPads and mobile devices.

“The campaign will use a combination of video on television and smart phones, with messaging focused around community outreach, education on testing awareness and testing locations,” says Polster. “As we see COVID-19 cases continue to rise, it’s more important than ever that we do all we can to get information out and make testing available to these at-risk and underserved populations in our community.”

Meanwhile, GCC is also conducting a community-wide survey of its member congregations and the surrounding communities as research for organizing people to ensure public and private resources are directed toward the individuals and families most adversely affected by the virus and the socio-economic impact on households. "Much of the world has demonstrated that the resources and expertise exist to not simply slow the virus, but suppress it," says Rev. Maxwell. "We must act together now to ensure that those resources are brought to bear within communities facing the greatest threat." 

The survey will enable persons across the city and county to provide first-person feedback on their experience with the virus and its implications on their social stability and financial well-being. GCC plans to utilize this information to identify strategies and action steps that will serve as effective tools to support affected individuals and families who may be subject to financial and social disruption due to exposure to COVID-19.

In addition, the survey will provide important on-the-

Rev. James Quincy
Lee Road Baptist Church

ground data that will be used in meetings with state and local public officials to improve the COVID-19 response in public policy, public health and public dollars. "Our community is in dire need of support to overcome the negative economic, emotional and physical effects of COVID-19," says Rev. Quincy. "We are working to deliver critical support."

• • •• • •

CVS, Rite Aid Walgreens shun COVID testing where it is most needed

GCC calls out CVS, Rite Aid and Walgreens over COVID test sites

46 Cleveland stores visited; only two offer testing

By R. T. Andrews

While the COVID-19 pandemic continues to wreak havoc with the nation’s health, economy, and ways of life, it is also illustrating many of the underlying and enduring ways in which systemic racism operates in America.

Greater Cleveland Congregations, the largest community power organization in Northeast Ohio, yesterday called out the country’s three biggest pharmacy chains — CVS, Rite Aid and Walgreens — on their failure to provide broader COVID-19 testing within the city of Cleveland. 

In a news release, GCC reported that its members visited local neighborhood drugstores to assess the availability of COVID-19 testing within their communities. According to their survey, only two of 46 drug stores visited offered testing for the virus.

"We visited ten Rite Aid stores in Greater Cleveland and discovered it is offering only one testing site within the city of Cleveland while offering several testing sites in suburbs surrounding Cleveland," says DeAnna DeForest, member of Elizabeth Baptist Church. GCC visited nine Walgreens stores in Cleveland and surrounding suburbs and found it only offered testing in one store within Cleveland.

"We visited 27 CVS sites in the Greater Cleveland area and were dismayed to have discovered that while CVS offers testing in several suburbs, it is not offering any testing site within the Cleveland city limits," says DeForest.

Color of Health Initiative

GCC recently announced its Color of Health Initiative, which has recruited 17 congregations as sites for free testing through Cuyahoga County. The initiative will bring testing into less affluent urban neighborhoods in a focused and sustained effort. 

"We are pleased with our efforts but realize that if testing is going to be effective, we must increase both capacity and availability," says Rev. James Quincy of Lee Road Baptist Church. "It is an affront that these stores have made testing readily available in the suburbs, but not in the city, where the virus is having a devastating and deadly impact."

"This is the definition of structural racism – bias built into the systems and institutions of our society to the detriment of particular racial groups," says Rev. Ronald Maxwell of Affinity Missionary Baptist Church in Cleveland. "These structures have too long resulted in the loss of life, whether from inequality within our justice system, toxic environmental conditions, the lack of access to healthy foods or, in this case, available health care."

 GCC is asking CVS, Rite Aid and Walgreens to meet with GCC and do the following to create access for people living in urban areas to accessible and available testing:

• Increase testing sites in urban neighborhoods that are predominantly Black, Brown and lower income.

• Give $5M to Cuyahoga County to pay for more tests until there is a vaccine

• Hand out free PPE (personal protective equipment) to people that come into the store for testing

"The presence of these stores within our communities is appreciated and testifies to the fact they find value within our communities," says Rev. Jawanza Karriem Colvin of Olivet Institutional Baptist Church in Cleveland. "This crisis offers an excellent opportunity to demonstrate that they equally value the lives of individuals living in our communities."

• • •• • •

Lead tests for children plummet in Cleveland

Advocates worry about long-term fallout 

This story is provided by ideastream as part of special community coverage of COVID-19 and funded by Third Federal Foundation and University Settlement.

By Rachel Dissell

CLEVELAND, Ohio — State shutdown orders meant to prevent the spread of the novel coronavirus have created a double-whammy of lead poisoning risk for young children in Cleveland. 

Many of these children are spending more time in homes with potential lead hazards, and fewer are getting tested to see if they’ve been exposed to the toxin. 

Tests for lead have plummeted by almost half compared with previous years in Cleveland and across Ohio, driven mostly by a dip in March, when most pediatricians’ offices and labs were closed to non-emergency visits because of the pandemic. 

State health data shows a slight uptick in the percentage of Cleveland children tested who have elevated levels of lead in their blood.

The setback couldn’t have come at a worse time, local lead-safety advocates say. For the past year, they have been working to prevent children from being poisoned in their homes, rolling out a new strategy that includes city-mandated lead inspections in rentals and new grants and loans for hazard cleanup. 

Testing children for lead is the main way to identify lead hazards that can continue to do damage. The tests also allow parents to get help recognizing developmental delays or behavioral issues linked to exposure to the toxin, which can cause irreversible damage to a child’s brain. 

The pandemic-related drop in testing means that fewer lead-exposed children will receive help from state-supported early intervention programs, which are now offered automatically when a child’s blood test shows exposure.

It also means that public health authorities won’t receive as many referrals to investigate potential lead hazards in homes, which are triggered by a high lead test. That could result in prolonged exposure for children to lead dust or paint chips. 

“I worry about children who are at home, playing on porches full of lead paint or in the dirt nearby,” said Patricia Barnes, executive director of the Ohio Healthy Homes Network and co-chair of the Ohio Lead Free Kids Coalition, which advocates statewide for policies to eliminate childhood lead poisoning. 

An Ohio Department of Health spokeswoman said that while test rates have dipped across Ohio during the pandemic, other “lead belt” states fared even worse. 

Tests in Ohio have picked up in recent weeks as more parents schedule routine well-child visits, said state lead poisoning prevention advocates. 

“There is nothing we are doing to make up on the missed testing,” ODH spokeswoman Rachel Feeley wrote in an email.

“This is something the (Centers for Disease Control and Prevention) is tracking, as it is a national occurrence,” she wrote. “We will continue to monitor the situation and follow CDC guidance on the matter.”

Testing setback

“I feel like we’re almost starting over again,” Kathy Schoch, nurse case manager for Cuyahoga County’s lead-poisoning prevention program, said about the interruption in testing. 

Schoch and others have wrestled with improving lead testing for years. 

Only one in five Medicaid-eligible children entering kindergarten in Cleveland public schools from 2011 to 2016 had federally recommended tests for lead poisoning at both ages 1 and 2, according to research released last year by Case Western Reserve University and Invest in Children, a county early childhood initiative. 

The study also showed that even a “high dose” of 18 months or more of high-quality preschool education failed to help most lead-poisoned children catch up with their peers. 

As lead testing stalled in the spring, so did new referrals to Ohio’s Early Intervention program, said Karen Mintzer, director of Bright Beginnings, formerly known as Help Me Grow. 

The Early Intervention program, run through the Ohio Department of Developmental Disabilities, can assess children for developmental delays linked to lead exposure.

Referrals to the program from Cuyahoga County also dropped to zero at one point, but have since rebounded, Mintzer said. 

Any child younger than 3 with lead in their blood at levels of five micrograms per deciliter or higher is automatically referred.

Safer than the grocery store

When the MetroHealth System resumed well-child visits in late April, many parents were reluctant to bring their children to the doctor’s office or a lab because of fears about the virus, said Dr. Abdulla Ghori, vice chair of Pediatrics at MetroHealth Medical Center.

There has been a slight uptick in visits in the past few weeks, he said. 

In terms of risk, “coming to the hospital is better than going to the grocery store,” Ghori said. “And certainly much safer than [attending] a birthday party.”

Ghori, also a professor of pediatrics at Case Western Reserve University, said it is difficult to increase the rate of lead testing in part because testing practices vary by location and even by facility within a single health system. 

Sometimes blood can be drawn in the doctor’s office. Other times, parents have to wait at a lab at a different location, which can be impractical for families with limited time and resources. 

At MetroHealth, Ghori said, about a quarter of lab orders for lead tests aren’t ever completed. 

While long-term solutions continue to be debated, Ghori said MetroHealth took the step of “bulk ordering” lead tests for any children who need them, rather than having doctors order the test individually during visits.

The orders will automatically show up in the mail or on electronic medical records for parents, he said. 

Ghori said that’s good, but even better would be free, accessible blood-drawing locations in the city. 

Ghori said he understands the focus on catching up on immunizations for children under 2, especially immunizations against highly contagious and dangerous diseases such as measles. Immunizations are often needed to enroll in day care or school. 

That doesn’t mean lead testing should be an afterthought, though.

Both are important, Ghori said, but he worries people will de-emphasize lead testing. That, he said, would have dangerous long-term consequences. 

“People should not be forgetting this silent disease, which could be getting worse during this lockdown, and the consequences that it could have,” he said.

• • •• • •

Ways to limit exposure to lead dust in your home

·    Much of the lead dust that enters homes comes in from outside via the dirt on shoes and feet and on pets’ paws. Remove shoes when entering the home and clean your pets’ paws if they spend time in bare dirt outside.

·    Put a stiff, outdoor door mat outside the door to trap dust and dirt before it gets in the house.

·    If you have any bare patches of dirt around the edges of your home or driveway, cover it with at least six inches of mulch.

·    Check window sills and doorways for chipped and peeling paint, especially at the level where your child’s hands reach, and in areas of high friction. Wipe or vacuum out window sills and doorways. If you can’t repaint chipped areas, cover with contact paper or duct tape.

·    Mop hard-surface floors frequently using the two-bucket method, if possible. Fill bucket #1 with warm water and a household cleaner. Fill bucket #2 with clean water. Dip the mop into bucket #1 and clean the floor. Then dip the mop into bucket #2 to rinse and squeeze before returning it to the cleaning solution. Dispose of the dirty water by pouring it down the toilet.

·    Vacuum carpeted surfaces at least once a week. Use a HEPA-filter vacuum followed by a steam cleaner, if possible.

·    Wear gloves when cleaning to avoid getting lead dust or paint under fingernails and transferring it to children.

·    Wash your children’s hands frequently with soap and water, especially before meals. Hand sanitizer will not remove lead from hands.

• • •• • •

Police Reform or Change?

problematic police behavior is less the result of a few “bad apples”, more often the result of policies and practices.

By Wornie Reed

Among the subtle lessons being taught during the great demonstrations over the murder of George Floyd — and others — is the difference between liberal approaches and progressive approaches.

Hundreds of thousands of Americans, white and black, see policing as seriously problematic. Liberals tend to think that institutions in America are structured just fine with a need for mending here and there. Many liberals in traditional fashion tend to believe policing in America is okay, but a few problems have developed that require tinkering around the edges.

Progressives tend to see some institutions as problematic in their structures and functions. Thus, there are calls for defunding police departments — meaning different things to many people. Many view the police’s current duties as too broad, involved in areas that require other types of expertise, like mental health and domestic violence. 

But others see the remaining functions of policing as problematic, especially in the case of race and policing in America.

Racial discrimination was done not so much by individuals but by institutions in society … if those institutions have not changed their policies and practices, they are still discriminating by race.

The utility of discussing racism as an attribute of institutions becomes apparent when we explain that it was permissible and legal to discriminate against African Americans not long ago. Racial discrimination was done not so much by individuals but by institutions in society — through their policies and practices. And if those institutions have not changed their policies and practices, they are still discriminating by race.

Legislation, known as Black Codes, was enacted in the independent states and commonwealths following the Revolutionary War to institutionalize and legalize the customs and practices on which slavery rested before the founding of the nation.

According to Wintersmith’s 1974 book, Police and the Black Community,  the relationship between the black community and the police started with the enforcement of the Black Codes. He asserts that few counties in the slave states did not have a local police patrol known as “patterollers,” whose primary responsibility was to contain the slaves and enforce the Black Codes.

According to Wintersmith, these patterollers (patrollers) were usually poor, young whites, who did not own slaves but whose favorite sport was Negro catching, watching, and intimidating. After the Civil War, these Black Codes were subsumed under Jim Crow and the legal doctrine of segregation. Police officers were the principal agents of the violent repression of black Americans.

And after the Jim Crow era ended, some policing practices changed, but the basic functions did not. Quite simply, law enforcement protects white communities and polices black communities. And there is almost a direct line from that fact to today’s police using excessive force against African Americans.

Over surveillance of black communities has undoubtedly led to racial profiling, which is the precipitating event in many police-black citizen encounters involving excessive use of force.

A colleague, Ronnie Dunn, and I demonstrated in our book, Racial Profiling: Causes & Consequences, that contrary to widespread belief, problematic police behavior is not necessarily the result of a few “bad apples.” It is usually the result of policies and practices.

Consequently, better training of police officers will not bring much change. The structure and function of police departments need changing, or at least their policies and practices.

Two weeks after George Floyd’s death, 16 state legislatures had introduced, amended, or passed 159 bills and resolutions related to policing. That suggests many officials knew something was racially wrong with policing beforehand. And they wanted to demonstrate that at least they were doing something about it. 

While I accept all reform as useful, much of it we must classify as necessary but not sufficient to solve the problem of police killing black folks.

Better training of police officers will not bring much change. The structure and function of police departments need changing, or at least their policies and practices.

At least three states have passed legislation reforming policing. The state of Colorado passed a sweeping police accountability bill. Among other things, it limits the use of deadly force, requires the use and public release of videos if police misconduct is alleged, and requires the collection and reporting of data on police-citizen encounters.

New York repealed the infamous Section 50-a of the NY Civil Rights Law, which had kept records of police misconduct as confidential personnel matters. Other provisions of laws passed in New York and Iowa address such things as banning chokeholds.

Much of the legislation passed and or discussed across the country does not address many of the things that shield police from prosecution for misconduct —and encourages misconduct — like qualified immunity, police unions, state law enforcement bill of rights laws and the absurd “reasonableness” doctrine from Graham v Connor, [490 US 386 (1989)].

• • •• • • 

Wornie Reed is Professor of Sociology and Africana Studies and Director of the Race and Social Policy Research Center at Virginia Tech University. Previously he developed and directed the Urban Child Research Center in the Maxine Goodman Levin College of Urban Affairs at Cleveland State University (1991-2001), where he was also Professor of Sociology and Urban Studies (1991-2004). He was Adjunct Professor at the Case Western Reserve University School of Medicine (2003-4). Professor Reed served a three-year term (1990-92) as President of the National Congress of Black Faculty, and he is past president of the national Association of Black Sociologists (2000-01).

This column first appeared online at What the Data Say and is shared here by permission.

Hotel opens doors to homeless

This story was done in partnership with The Cleveland Street Chronicle. This story appears in the June/July issue being distributed by badged vendors at the West Side Market and other areas in downtown Cleveland and the east side.

Some of city’s homeless find refuge in hotel during pandemic

by Ginger Christ and Rachel Dissell

 

Abel Currie, 63, sits in his hotel room in May. It's been a relief to him to have space to quarantine safely as he searches for a permanent apartment.

A cherry-colored 10-speed rests inside the door of room 123 at a hotel* on the west side. It’s overturned, forks facing the ceiling, a deflated front tire slung over a pedal. Abel Currie has crisscrossed Cleveland on the vintage bike, sometimes on a shady park trail, other times packing a lunch and heading to the lakefront. Lately, his rides have been an escape from the stresses of the coronavirus pandemic, which have created chaos, especially for those experiencing homelessness. Currie, 63, hasn’t had his own place in nearly a year, since he lost his job at the Euclid Beach Laundromat when business slowed down. But for the last few months, he’s had a bed of his own, and a television that blares old Westerns.

This hotel is home to more than 50 unsheltered individuals—those who are uncomfortable going through the county’s shelter system because of trauma or concerns about confidentiality. “I’m loving it. It’s 100% better than where I was. It’s like having my own place,” said Currie, a U.S. Air Force veteran who grew up on Cleveland's west side.

As Covid-19 swept into Cleveland earlier this spring, advocates started looking for safe havens for those who live on the streets. Could they stay in emptied out college dorm rooms? What about vacant hotels? The task became more urgent in mid-March as public spaces like libraries, restaurants, and drop-in centers shuttered under state orders to prevent the virus’s spread. That left few places for unsheltered homeless people to use the bathroom, wash up, or charge a phone. At the same time, the nonprofit Metanoia Project, which provides shelter during the winter months for those living on the streets, was preparing to shut down early.

“It’s tough enough being homeless, then Covid-19 made it harder,” Currie said.

A safety strategy

Early on, Cuyahoga County and Cleveland officials and other community partners, who work to reduce homelessness in the county, made emergency plans that prioritized lowering the number of people in shelters, considered high-risk “congregate” settings by public health officials at the local and national level. They encouraged newcomers and those in the shelters to move in with friends or family and provided gift cards to assist with food costs.

The county paid to move people staying in crowded shelters or who were deemed at-risk for Covid-19 into a handful of area hotels. Anyone who tested positive for the virus was isolated in a separate hotel. The Cleveland/Cuyahoga Office of Homeless Services’ focus was “reducing the concentration of the nearly 600 men and women who were sleeping in congregate settings as quickly as possible,” officials said in an email.

That left out the more than 200 people sleeping on Cleveland’s streets, many of whom had used shuttered drop-in centers for essential needs. The Northeast Ohio Coalition for the Homeless (NEOCH) started planning for a larger homeless encampment, gathering up more than 50 tents and other supplies.

“We had people with no place to go,” said Chris Knestrick, executive director of NEOCH, which supports The Cleveland Street Chronicle.

Knestrick said he asked Ruth Gillett, who heads the Office of Homeless Services, if the county would support hotels if NEOCH helped raise the money. He said she declined. “If they want to sleep outside, let them sleep outside,” she told him.

County officials said, “conversations took place with outreach workers” about individuals who were unsheltered and considered at lower risk of getting the virus. In their view, the unsheltered homeless people were “already pretty self-isolated and were not likely to have traveled on an airplane or have participated in the kinds of group gatherings that promoted transmission.”

Knestrick wasn’t opposed to an encampment, he said, at least in theory, and at the time the U.S. Centers for Disease Control and Prevention had put out interim guidelines for existing encampments, though the public health agency recommended temporary individual housing, if possible. Currie was one of the people, rounded up in a parking lot, ready to sleep in the valley. He’d slept outside before, in the dead of winter. At least he’d have a tent, he figured.

Down Carter Road, near a bend in the Cuyahoga River, not far from the Centennial Lake Link Trail, Knestrick and some others scouted out a spot. The weather was still in the 40s, it had been raining, and dense fog shrouded the city. “We would have floated away down there,” Currie recalled thinking. But what choice was there?

Knestrick said he looked around and thought about how many in the encampment would be older or would have health problems that made them more at risk for complications from the virus—and death. “This is wrong of us,” he thought. “This is unethical and immoral for us to allow this to take place.”

Instead, Knestrick rented 25 rooms at the hotel. NEOCH didn’t have the money to pay for the rooms, he said, but he put out a call for help.

A new routine

Paula Miller, who has been a Catholic Worker for
two decades, uses a hotel room as her office as she
coordinates hospitality and outreach efforts for about
50 unsheltered people staying at the hotel for
Northeast Ohio Coalition for the Homeless.

A little more than two months later, Paula Miller sits in a first-floor room; a hotel bed is her desk. Curls of her blonde hair peek out from under a ball cap as she updates a handwritten log passed from shift to shift by the workers hired to staff the hotel and assist the residents. Miller, a member of the Catholic Worker community, moved into the hotel with the first wave of residents, helping out along with two others, Dawn Vought and Jean Kosmac. After aiding refugees on the Mexican border in Arizona for nine months, Miller knew the importance of providing basic needs and dignity to those facing hard times.

The hotel team now has a routine that includes daily health screenings, including temperature checks for residents, distribution of meals (provided by West Side Catholic Center, Bishop Cosgrove Center, and St. Augustine), helping residents track down government stimulus checks, and filling out housing applications. Doctors from MetroHealth Medical Center come once a week to tend to medical needs, and FrontLine Services case workers visit the hotel to provide support and mental health services. 

The first few weeks there was a lot to figure out about how to run what essentially became a transitional housing program overnight, all while facing a global pandemic, Miller said. For instance, out of fear of transmission, it wasn’t safe for the hotel housekeepers to come into the rooms each day to clean. So the team had to assemble cleaning kits for residents, some of whom had been living outdoors for a while, to wipe and disinfect surfaces and take out their trash.

And many of the unsheltered homeless who moved in were anxious, Miller said, because their routines were disrupted. The places they frequented for a meal, the people they checked in with, along what is often called “the trail” on the near West Side, all had shut down or disappeared.

“What people lost was their sense of community: the volunteers, the organizations, the services,” and the personal, spiritual, and mental connection it provided, she said. “That is just as vital to wellbeing as the physical stuff.”

There’s been turnover. As expected, for some unhoused people, living in a hotel was too big of a change. “They weren’t used to being indoors. Some people had been outdoors so long they didn’t know how to act,” Currie said. The hotel, he said, was “like a prison to some of them.”

One resident had a mental health episode and had to be hospitalized. Another scraped up money to rent a room, where he had a small party – and then was asked to leave. Miller said NEOCH lucked out with the hotel management, which has worked closely with them, even as they remain open to the public. The hotel manager, Sarah Dontenville, said she’s taken a “figure it out as you go” approach. The 30-year-old was weeks into the job when coronavirus started to hit Ohio. As other hotels emptied out, hers filled up.

There’s been a few tough moments, Dontenville said, but she’s had those moments in her life too. At one point, years ago, she was in the same spot as some of her hotel guests, struggling with addiction with nowhere to go. “I want to see people get help,” she said. “I’m that kind of person that just cares about people.”

For Brandon S., who grew up in the western suburbs of Cleveland, the hotel gave him a roof over his head for the first time in months. “This is a blessing,” the 31-year-old said. “It’s a huge peace of mind. It keeps you out of the elements.”

His hours had recently been cut at a job in litigation support he had held for 11 years, and he could no longer afford his apartment. He tried the shelter system but felt unsafe after having his belongings stolen, and instead chose to sleep outside during the winter months. Then, during the pandemic, a lot of the public showers he had relied on were shut down. “It's been a struggle to say the least,” Brandon said. “I didn't want to be out in the streets in February and March.”

From a public health stance, the use of hotels seems to have prevented large outbreaks of the virus in shelters by reducing the populations by more than 65% at the men’s shelter and by 58% at the women’s shelter. As of June 5, MetroHealth had screened more than 650 shelter and hotel residents for the virus, with 3.5% or a little more than 20 people, testing positive. None showed symptoms of Covid-19. At the hotel, only one person tested positive, and was moved to a different hotel to quarantine.

A wide variation in testing doesn’t allow for comparison between cities, and most states are not separately tracking Covid-19 infections among populations of people experiencing homelessness. One screening effort found more than a third of the residents in one large Boston shelter tested positive for the virus, though many had not developed symptoms.

In California, which has a large population of sheltered and unsheltered residents, some large counties recorded relatively few cases. As of June, however, some California cities had recorded outbreaks: Los Angeles had 455 infections and 13 deaths; San Francisco had 167 — about 6% of the city’s total infections, according to the The Mercury News in San Jose.

Meeting people where they are

After Knestrick’s big risk, the Community West Foundation, the Greater Cleveland COVID-19 Rapid Response Fund, and a host of private donors stepped up to help cover the cost of the hotel rooms through June. The cost of the rooms and staffing the hotel with outreach workers is about $40,000 a month, Knestrick said. When NEOCH’s money ran out, the county agreed to pick up the cost of those rooms as well though its contract with Lutheran Metropolitan Ministry (LMM), supporting more than 200 rooms in total, with a capacity to house more than 380 people, depending on need. The U.S. Department of Veterans Affairs has also paid for some of the rooms.

The hotel has offered a glimpse of what having a transitional housing environment could offer for people who might not be able to adjust from going to a shelter straight to an apartment. It was out of necessity, Miller said, that they created what is basically a low-barrier “meet people where they are” transitional-housing setting, much different from a more bureaucratic or structured setting. But she noticed that people have started to work on their future plans, whether they are getting into a rehabilitation program or finding permanent housing.

“I think people just feel supported for who they are,” Miller said. “Just accepting them and loving them. I mean, we just love them so much.”

Miller said she sees value in having a middle step between the streets and permanent housing. “Not only is this a good transitional place for people to just kind of land,” Miller said, it is good training for maintaining your own space. “Really basic stuff that might be obvious to us, but if you are not used to that, and there are a lot of our folks who are not, there’s a learning curve, and they get to practice that.”

Shelter settings, because of the number of people housed, tend to have a focus on rules, which can be necessary to keep people safe, Miller said. Smaller communal settings allow time to develop relationships. Miller said she and the other staff at the hotel know each person staying in each room. That allows people the space to open up, and to think about their paths forward, instead of just where their next meal will be coming from, she said.

“There's the physical space,” Miller said “but then there's the emotional space. And that's what we're able to provide. In a way, that has made this a unique setting because we’ve become a family and a community. You can’t put that into your guidelines. It’s just developed over time.”

The question is whether what was an emergency decision to use the hotel has opened the door for a new possibility to address the needs of people who traditionally have been resistant to shelter, instead of relying on the shelter-to-permanent housing system.

“No one really knew what we were doing here,” Miller said. “This is a unique moment in time and an opportunity to create something pretty special and use it to our fullest advantage to our folks as part of our overall goal at NEOCH to end homelessness, but also to really create a model that could be replicated or continued.”

County officials said they tried using transitional housing from 1989 through 2009 but were unable to reduce homelessness in the area or connect people with permanent housing using that approach. Officials hope to ramp up rapid rehousing assistance to people currently staying in hotels to keep shelter numbers low. “We know that hotels will not be available forever,” a county spokeswoman stated in an email.

The plan currently is for NEOCH to transition out of running the hotel—its staffing was never meant to be permanent—and to focus on its outreach to unsheltered homeless. The county has agreed to pick up the costs of the hotel rooms and staffing through the end of October and has arranged for LMM to manage the hotel.

Looking ahead – and back

Despite everything, the hotel doesn’t solve all of Currie’s problems. “It’s helped me greatly,” he said. “I’m not stressed out as to where I’m going to lay my head tomorrow.”

But he still has a list of things to do: find a job and an apartment, hopefully on the near west or east side near bus lines and bike trails. “It’s just hard with this Covid thing. A lot of things are closed,” Currie said. “It’s hard to look ahead.”

He also has some old scars to heal, scars that date back to 1974, the year his older brother was shot and killed. Looking back, that was when 16-year-old Currie started to disconnect from his friends and from the world. He graduated from high school early. He drank and partied, eventually entering the Air Force. “I was just losing myself, I guess,” he said. “I didn’t want to face reality, so to speak.”

It took Currie many years to realize he was traumatized and didn’t know it. Now, in the midst of a global pandemic, he’s had some time – and space – to reflect.

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 * Hotel is unnamed for reasons of confidentiality.