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Dealing with COVID-19 from within the Service System for Persons Experiencing Homelessnes

Key Lessons from King County Washington


Background and purpose of this document

King County, which includes Seattle, was hit by COVID-19 in the nation’s first wave. Planning for the health needs of the county’s unhoused population began immediately, on/around March 1. They shared their strategic framework and collaborative approach on a HUD webinar on 03/10/2020.


I believe that the planning approaches they are using provide important guidance for those of us working to craft local COVID-19 responses.

What follows is an attempt at distilling “key lessons learned,” offered here for consideration in supporting those planning efforts. These reflections are mine, not those of King County, although they have read this and thanked me for sharing their information.


King County’s Guiding Principles for COVID-19 Planning

One key statement of purpose they articulated reads:

“Slow the spread by keeping or getting people in the right level of sub-hospital care (so hospitals can keep providing care to those who need it).”

Several principles underlie King County’s strategies aimed at achieving this objective. Among these are:


  1. “De-intensify”

  • Remove highly vulnerable people from the general population, relocating them to motels and other places that are less congested than congregate shelters

  • Expand/retool spaces in and near shelters to add space between beds (trying to optimize existing staffing)

  • Identify and prioritize modifications at shelters and day programs heavily used by older individuals


2. Build out an infrastructure of isolation/quarantine (“I/Q”) units and congregate recovery centers, to preserve access to hospital beds for those in greatest medical need. Keep expanding and don’t stop.

3. Centralize support functions. King County created an on-line cleaning-supply request system designed for staff to drive to a central warehouse and pick up pre-packed cartons. They also contracted with a nonprofit catering organization (that employs formerly homeless staff) capable of providing up to 1,800 meals per day. Together, these strategies maximize space for occupancy by people. They also accelerate and streamline critical routine processes and limit contact.



Additional Strategies

King County leaders described several additional approaches, including:


  • Intentionally simplify guidance materials for community members and staff. Actively work to make materials clear and user-oriented.

  • Communicate often and consistently with stakeholders. Establish “meeting rhythms” (although be prepared to shift them). Hold regular calls for logical collaborative groups and send weekly email updates.

  • Use technology wisely. They centralized communication about individuals needing care, working through a single Call Center. Use data analytics and mapping tools where these make sense.

  • Start your planning with an understanding of “what is.” King County swiftly conducted a Shelter Assessment and Inventory to understand current shelter practices as well as surveying options and limitations of existing facilities for different kinds of adaptation, e.g., converting unused space to less-congested living spaces.


Work and plan collaboratively. King County’s COVID-19 Response Team includes:


  • Public Health – Seattle/King County (they lead the effort, with active CDC input)

  • City and County Departments of Community and Human Services

  • Facilities Management Division

  • Healthcare for the Homeless Network

  • METRO government

  • Community partners and providers


* * *

Staff from the partner entities are co-located, and work closely and collaboratively. They have made it clear that the strong scaffolding they built has already and will continue to evolve to serve a widening group of persons at risk.


There is no guarantee that what King County’s leaders thought even 10 days ago, when this webinar was recorded, still holds true. Nonetheless it is crucial that these leaders, as well as the rest of us, iteratively examine the results of their efforts. Illuminating their underlying values and operational strategies – and checking back to see how things are playing out – can provide tangible information for other communities to build on.


Judy Perlman has a background as a practitioner, convener and HUD Technical Assistance consultant on homelessness and homeless systems in greater Boston and nationally.

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