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Why the Homeless are Especially Vulnerable During the COVID-19 Outbreak

March 30, 2020 By Lisa Melchior

This post is written by Michelle Quezada, Evaluation Assistant at The Measurement Group. Homelessness is a huge issue here in Los Angeles County, and many of the programs we evaluate provide services to this extremely vulnerable population. Thanks Michelle for this contribution.

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The coronavirus is quickly spreading, and although the U.S. government has advised social distancing and self-isolating to slow the spread, these measures will not completely eliminate the disease. Slowing the spread of the virus is critical – COVID-19 has become a pandemic and does not discriminate against age, race, or sex, making everyone susceptible. Nonetheless, the elderly, those with compromised immune systems or individuals who have chronic illnesses such as diabetes, heart or lung disease are considered to be at a higher risk of developing more severe complications related to the infection.

In an effort to reduce transmission of the disease, health officials at the Centers for Disease Control and Prevention (CDC) recommend that very specific actions be taken for protection – including staying at least a six feet distance from others; frequently washing your hands for at least 20 seconds with soap and water; avoiding touching your eyes, nose, and mouth; wearing a face mask if you are feeling unwell; and to disinfect frequently touched surfaces throughout the day (How to Protect Yourself). This begs the important question – what about those who are homeless?

For those who experience chronic homelessness, the recommended precautions outlined by the CDC are not so feasible. The homeless population face significant challenges of inadequate medical care and clear lack of basic hygiene necessities.  A large number of these individuals also experience serious underlying health conditions including behavioral health disorders that can greatly impair their daily functioning. The lack of access to necessary supplies to help in the fight against COVID-19 such as antibacterial soap, hand sanitizer, facemasks and disinfectant wipes can be especially damaging for those without stable housing, who are not only left to fend for themselves without shelter and in close proximity to others, but without the basic needs required to slow the transmission of the coronavirus.

What’s more, those infected with COVID-19 may experience symptoms anywhere from 2 to 14 days after exposure, if even at all. There have been reports of confirmed cases of COVID-19 in which individuals have remained asymptomatic. The issue is, several people infected with the disease may not know they are carriers and continue spreading and transmitting the disease to others. This means, that those within the homeless population are especially susceptible, considering they spend the overwhelming majority of their time in close proximity to others, who may not have access to medical care, COVID-19 testing, facemasks to wear when they are feeling ill, or the resources needed to properly wash and sanitize their hands frequently. This population is also at higher risk for developing more severe cases of COVID-19 and associated complications due to preexisting conditions.

As of March 24, there have been 2,365 cases of COVID-19 in California, with 50,206 cases in the U.S. (Coronavirus Live Updates). However, these numbers only include confirmed cases. California Governor Gavin Newsom noted that as many as 60,000 of the 100,000 plus homeless may be infected with the virus over the next several weeks. To increase hygiene opportunities among those without stable housing, the Los Angeles City Council has begun implementing safety measures including mobile showers and portable toilets (How to Prevent Coronavirus from Ravaging Homeless Encampments). Most importantly, Newsom has announced immediate plans to take over 42 city recreation centers, converting these spaces into emergency shelters, making 6,000 beds available (How to Prevent Coronavirus from Ravaging Homeless Encampments). These measures are not without challenges – how does this fit with the CDC’s very specific guidelines calling for people to stay at least 6 feet apart to reduce transmission? These are valid concerns, but the city has committed individuals will remain at a safe distance in compliance with the CDC by keeping occupancy at these facilities low. Inevitably, these measures pose health risks but it seems more beneficial to have the detection and sanitation opportunities these temporary housing solutions have to offer.

The magnitude of COVID-19’s impact has proved that on a global scale, we were ill-prepared for a pandemic, but the homeless population is especially vulnerable considering their lack of fundamental resources and access to healthcare. If even one person becomes infected with COVID-19 within a homeless community filled with housing tents, a domino effect becomes imminent considering how easily the virus spreads. While California is making strong efforts to aid homeless communities during this time, these strides are not without challenges.

Filed Under: Uncategorized Tagged With: behavioral health, coronavirus, COVID-19, homelessness, mental health, substance abuse, The Measurement Group

Evaluation, Pandemics, and Running a Small Business

March 25, 2020 By Lisa Melchior

Greetings from my home office! The last few weeks have brought unprecedented change to our world. We plan to re-launch this blog and share posts on a variety of topics related to our evaluation work, the programs we work with, the populations they serve, as well as assorted random thoughts about who knows what.

The AEA365 blog posted recently about the role of evaluation during a pandemic. Among other things, the piece stressed flexibility and responsiveness. I can’t agree more. I’d also stress keeping communication going in these difficult times.With the help of IT Support Clayton it is easier. Our work is primarily with community-based health, behavioral health, and social service providers. They are having to re-design their services on the spot – working to maintain connections and support for their clients while keeping their staff safe and healthy.  Because community programs are focused on responding to the crisis, addressing evaluation concerns isn’t necessarily their highest priority. We are reaching out to our clients to let them know we are here for them and offering whatever support we can. And, it’s an opportunity to check in and evaluate whether we need to adjust our evaluation designs or implementations. For example, are our evaluation protocols working given new modes of service delivery? Do we need to adapt any of our procedures?

In terms of running this small business, we are fortunate – we can continue to do our work remotely without much interruption. But the logistics bring some challenges. Being able to just bounce something off one another takes a bit of planning (picking up the phone or messaging), rather than just walking across the hall in the office. On the plus side, though, we get to work surrounded by family and furry companions.

 

Be well,

Lisa

 

Filed Under: Program Evaluation, Uncategorized Tagged With: behavioral health, COVID-19, Lisa Melchior, Program Evaluation, The Measurement Group, TMG

New Post on AEA365 Blog: Lessons Learned in Evaluating Cross-Systems Programs

August 21, 2017 By Lisa Melchior

Credit/Copyright Attribution: Belight/Shutterstock

It’s Behavioral Health week on the American Evaluation Association’s AEA365 blog, and I had the opportunity to contribute today’s post on lessons learned in evaluating cross-systems programs. I’m grateful for the opportunity to share some of our experiences. It was an interesting exercise to think about how our work has taken a systems approach over the years.

 

Filed Under: Program Evaluation Tagged With: aea365, american evaluation association, behavioral health, Lisa Melchior, systems of care, The Measurement Group

Evaluation of Programs for Children & Youth

January 2, 2017 By Lisa Melchior

The Measurement Group works with a range of programs that address the needs of children, youth, and families.

  • TMG evaluates programs designed to increase access to quality services.
  • TMG works with programs addressing a variety of medical, social, and support needs of children, youth, and families.
  • TMG evaluates workforce development programs that aim to increase service provider knowledge and skills.
  • TMG evaluations document the processes of innovative service models so that successful programs can be replicated.
  • TMG evaluations measure outcomes at the individual, family, program, and systems levels.
  • TMG evaluations document the implementation of best practices in services for children, youth, and families.

Selected Examples

Partnership for Families provides child abuse prevention services to families at risk in the West Service Planning Area (SPA 5) of Los Angeles County (funded initially by First 5 LA, and subsequently by the Los Angeles County Department of Children and Family Services).

PROTOTYPES, through the Effective Adolescent Treatment Initiative, provided an evidence-based substance abuse treatment model for adolescents (funded by CSAT).

Health Initiatives for Youth in San Francisco developed and implemented a youth-based HIV education and prevention model (funded by HRSA).

Filed Under: Content Area Tagged With: adolescent, behavioral health, children, Program Evaluation, The Measurement Group, youth

Evaluation of Programs for Older Adults

January 2, 2017 By Lisa Melchior

The Measurement Group works with a range of programs that address the needs of an aging population.

  • TMG evaluates programs designed to increase access to quality care for all groups of older adults.
  • TMG works with programs addressing medical, social, and support needs of the elderly.
  • TMG evaluates workforce development programs that increase the number and skills of providers working with older adults.
  • TMG evaluations document the processes of innovative service models so that successful programs can be replicated.
  • TMG evaluations measure outcomes at the individual, program, and systems levels.
  • TMG evaluations document the implementation of best practices in services for older adults.

Selected Examples

The Archstone Foundation, through its Elder Abuse & Neglect Initiative, funded projects throughout California to develop, implement, and disseminate strategies for providing services to identify, prevent, and minimize the impact of elder abuse and neglect.

Two initiatives of the Hartford Institute at New York University, Resourcefully Enhancing Aging in Specialty Nursing and Nurse Competence in Aging, work with specialty nurse associations to improve nursing competencies in caring for older adults.

The Hartford Gerontological Nursing Initiative used a variety of strategies to increase the supply of geriatric nurses and the quality of care they provide by enhancing geriatric nursing training programs (funded by the John A. Hartford Foundation).

Filed Under: Content Area Tagged With: aging, behavioral health, gerontology, health, Program Evaluation, The Measurement Group

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