He sounded like a grandfather, but he had no grandkids. His voice, gruff and hardened from years living on and off the street, softened as they got to know each other. Him, a divorced, homeless father we’ll call John, with throbbing leg pains, calling from a motel room near the airport in Lafayette. Her, Donia H., a young woman of Iranian descent, calling from her parents’ house outside Atlanta. His leg pain sounded like complications from diabetes. And diabetes killed her uncle.
Signing up for Louisiana’s Medicaid program was just a checkbox on his food stamp application. And she could easily handle that over the phone.
“Well if it’s absolutely not a bother,” he said.
Now, several months later, John has Medicaid, a doctor, insulin, food stamps, a checking account and some money to put in it, Donia says. He’s in line to get a place to live through a rapid rehousing program funded by a federal grant. Living in a hotel wasn’t quite home. But it put him on the path to getting one — with Donia’s guidance from three states away.
Like hundreds of other unhoused people and families in Acadiana, John dialed his way to a hotel for shelter while coronavirus raged, connecting with housing advocates via 211. The hotel was part of a network of 19 hotels coordinated by the Acadiana Regional Coalition on Homelessness and Housing and funded by the federal government as emergency shelters during the pandemic. It was there he hooked up with Beacon Community Connections and his navigator, Donia H.
We agreed not to use Donia’s last name because of the sensitive nature of her work and privacy. “John” is a pseudonym for a real Beacon client we have tracked since July.
Based in Lafayette, Beacon Community Connections is a case management nonprofit that deploys “navigators” to help vulnerable people make their way through the social services system. Beacon normally works with hospital discharges, but during the pandemic, it surged, along with several other social service organizations, to meet needs wherever it could.
Paired with phone-based case management by Beacon and others, the ARCH-coordinated hotels offered a powerful, if intermediate, response that has implications for homelessness intervention beyond the pandemic — both for those working to prevent homelessness and those suffering in it. The ad hoc response laid the groundwork for a larger homelessness prevention and rehousing effort ARCH now calls Project Keystone.
“We’ve had police officers find people who were in the parks; they had been outside for years in some cases. Certainly months. [Now] they are in hotels and happily in hotels. And now we’re going to house them,” says Leigh Rachal, executive director of ARCH. “It’s been a dream to start that process from hotels. And this population has been willing to go to hotels when they were not willing to go to a shelter.”
The improvised solution, paid for in delayed and halting installments by the federal government through FEMA, created the stability that many bouncing in and out of homelessness needed to have a fighting chance to get on their feet.
Housing, research has shown, is healthcare. A 2009 study found that a Housing First approach — admitting the chronically unhoused in long-term housing without preconditions like sobriety — combined with supportive case management reduced hospital stays and improved overall health outcomes for a test population that had, on average, been unhoused for 30 months.
Within weeks of the pandemic’s first wave, thousands in Louisiana began looking for housing as the lockdown brutalized lower-income households. Acadiana’s 211 center alone clocked 2,307 calls for help with housing between March and the end of September. Around 8% of calls to 211 for health referrals also sought referrals for housing. And ARCH and other shelter providers took who they could until they ran out of room. The hotels proved a useful and safe alternative to a shelter floor during the pandemic. They also offered a better platform to help people long on the streets.
To be clear, the hotels are not Housing First. They are an improvement, perhaps, on the typical shelter — a band-aid, not a permanent solution. The upfront impact, hygiene, is itself powerful. Sleeping on the street wrecks human bodies quickly. Mosquito bites can get infected. Wounds fester and become septic. Teeth rot. ER visits are common. Few can get to primary care physicians or specialists to treat chronic disease. John’s diabetes was mostly left untreated. His call with Donia had raised that red flag. Now working with an ARCH case manager, he’s getting much-needed medical attention.
Almost 50% of the 456 people who entered the hotel shelter program operated by ARCH had no benefits at all. Even being temporarily stabilized proved crucial to closing those benefits gaps. Around 40% entered with access to food stamps. Now all but 8% have it. Only 35% entered with some kind of income — direct benefits, federal stimulus, social security or employment income. But that number climbed to 45% among the hotel population, including many who found jobs. All of that work was done by case managers operating remotely by phone.
There is no shortage of outreach programs for the unhoused. But the process of knowing what to apply for, how to apply for it and whether you qualify is complicated. John himself had been in and out of shelters for a year when he moved into his hotel room. Once there, his connection with Donia turned things around.
For John, applying for food assistance and Medicaid required at least a computer. That’s where Donia came in. She created a dummy email address for him and filled out the application online on his behalf with him over the phone. Of course, you can print and mail the application — if you have a printer and a mailing address and the money to buy postage.
“The thing that Beacon does is that we kind of step in as the middleman to help people decipher all of this, what we call, legalese,” Donia says. “So many people are applying for benefits; you cannot get through to any of these offices. You can’t call unemployment. You even try to call them, and you’ll be on hold for a couple of hours, and then the call will disconnect.”
Advocates in the region have historically struggled to get money for case managers to help more people. Funders and government agencies want to see the money go to direct services. Many have stepped in to fill that gap during the pandemic.
ARCH has relied on the generosity of hoteliers and their staff. Early on, the bookings were a boon to operators like Harvey Patel, whose motel on the Evangeline Thruway has hosted 56 households — both families and individuals — since April. Remembering the punishing poverty his grandparents came from in India, the young hotelier approached his partnership with ARCH as an act of service, eschewing the higher payments offered by the state to accommodate hurricane evacuees and utility workers.
“I’ve heard some nights that my grandfather just slept with water in his stomach,” Patel says. “I sleep good thinking that I’m helping all these people in this unprecedented time.”
Patel’s staff has been the de facto shelter staff. They didn’t just clean rooms. They called cabs for doctor’s appointments, sometimes paying the fare, faxed job applications, copied IDs and helped people with their taxes. Patel personally checks on a woman found living in a garbage dump. He watched one guest, blind in one eye, search and search for a job until landing a catering gig next door to save up for a new place to live.
While Patel’s experience has been largely positive — nothing stolen, little damage — many chronically homeless people are ill-suited to the independence afforded by the arrangement. Two people died in other hotels. Some with severe behavioral problems have been kicked out.
The ARCH hotels are on borrowed time. Over the summer, Louisiana Housing Corporation, the state go-between for the FEMA funds, asked regional housing coordinators like ARCH to stop admitting more people. Since then, 54 people have been tracked as unsheltered. There remains much more demand than supply.
Over the last few decades, markets and U.S. housing policy have underinvested in low-cost housing, says Urban Institute researcher Mary Cunningham. Lafayette, considered an inexpensive place to live, is short of the housing stock ARCH needs for its clientele. Vacant or underused hotels could offer a building block for jumpstarting single-occupancy housing.
“I think that what Covid did was provide a funding source to people, the providers on the ground. And there is no real clear adequate funding source to really fund [single room occupancy] or other alternative low-cost housing options,” Cunningham says. “And most of our homeless population in this country, a majority of the people who experience homelessness, are single adults who just need low-cost housing.”
Even with guaranteed funding, hotels are an incomplete solution.
Fortunately, federal funding came through in time for ARCH to fully launch Project Keystone with nine case managers. Rachal and her case managers are moving people into permanent housing, despite the short supply of affordable units. So far, they’ve re-located 50 households into stable housing, slowly chipping away at the one-time peak of 341. Only 12 of the 19 hotels are still being used by ARCH. Navigators with Beacon continue to help connect families and individuals with the remaining spectrum of needs — food, health, money, work. Everyone is working by phone.
John is still in the queue. He’s transitioned from Donia to an ARCH case manager who helped him apply for an apartment. That’s how it works with Beacon’s clients. Once they’re stable, they’re pretty much on their own. It’s been a while since Donia talked to John. She beams through the phone at how far he’s come and the fact that now he’s got a shot.
“So we got that for him, and he’s doing pretty well,” she says. “I’m pretty proud of him.”
Lifeline: COVID is made possible with help from founding sponsor LHC Group, supporting sponsor Oschner Lafayette General and Solutions Journalism Network