Wish I had seen this report a while ago . . . good stuff! We have a long way to go.
Here’s a summary of the major take-aways.
Three critically important elements to an effective regional or local approach to the prevention of injury and hypothermia:
• Knowledge – Accurate and timely information can be life saving for people experiencing homelessness, while a lack of information can be damaging or deadly. In many communities, elected officials and decision-makers hold and keep critical information across a broad range of public and private resources and services. Effective prevention strategies include a pre-approved plan for the gathering and dissemination of lifesaving information to all critical stakeholders, including those at risk on the streets.
• Networking – In cold weather, local elected officials and decision-makers are a critical first step to preventing hypothermia. Those in need must receive clear, consistent and repeated messages about the signs, symptoms and consequences of hypothermia, as well as emergency services that are being made available for them. Furthermore, the general public wants and needs to know how to help those in danger of hypothermia and
what responses are most appropriate. The public also needs to know who the decisionmakers are and what decisions are being made.
• Temporary Seasonal Shelter and Outreach – Appropriate approaches to the level, design and schedule of prevention resources, shelter and outreach, are critical to an effective response. The level of response must be timely and measured against the imminent and emerging concern of injury and hypothermia. The design must place the human cost of injury and death front and center. And, the schedule of emergency shelters and outreach services must be developed and available based solely on sound established prevention practices.
The National Coalition for the Homeless (NCH) interviewed homeless coalitions and shelters nationwide to gain an understanding of the cold-weather services offered in each area. Of the reporting parties that responded, thirty-eight have temperature-specific cut-offs for their winter services, twenty-seven are open every night between specific dates, and twelve have no cut-offs but base their decisions on judgment, need, and capacity. Thirty-four (54.0%) of the reporting parties are open only at night, even in the winter. Additionally, thirty-eight (76.0%) of the reporting parties admit people who are inebriated into their shelters, and twelve (24.0%) do not. Governments need to provide funding to ensure adequate winter services in their communities. In addition, every state and city should have a cold-weather response plan in place before the winter in case of extreme cold.
In order to protect their homeless citizens from extreme cold, cities must organize and fund a winter response plan that provides enough extra beds to accommodate the increased need of the season. Dr. O’Connell asserts that “all cities should have a plan well in place” before the cold weather arrives. Temperature cut-offs should be avoided, since the effectiveness of a shelter is decreased when the population it serves does not know, from night to night, whether the shelter will be open. If a temperature cut-off is necessary, due to financial or other reasons, the cut-off should be at least 40o F in order to prevent the most dangerous cases of hypothermia, according to Dr. O’Connell. If it is possible to keep services open every night during the winter, regardless of temperature, the winter season should be defined as October through April. This allows homeless people to find shelter during the transitions from fall to winter and from winter to spring, which Dr. O’Connell acknowledges is a very dangerous period for homeless people.
A comprehensive approach is necessary in order to make city-funded winter response plans as effective as possible. When a homeless population has nowhere to take refuge indoors, it is threatened by low daytime temperatures as well as nighttime cold. Winter services must be available throughout the day, and cities must have adequate space in day centers to accommodate people who would otherwise remain outside until nightfall. If there is no day center in an area, shelters in that area must open during the day, at least when the temperature falls below 40o F.
Additionally, winter services must be available to all homeless persons, without restrictions. Naturally, people who are violent, threatening, or exceedingly disruptive may be excluded from shelters for the safety of others. However, past bans and other restrictions should be waived on nights when the temperature is lower than 40o F. Most importantly, every city must make winter shelter space available for people who have been consuming alcohol or other drugs. The risk of developing hypothermia is greatly increased for those who have been using substances, especially alcohol. People who are inebriated must be allowed to spend the night indoors during cold weather. If needed, they may be separated from those who are sober, as long as they can remain safe and warm.
Local governments should play a large role in the improvement of winter homeless services. Every state and every major city should have a winter plan in place detailing options for shelters, day centers, and emergency transportation, as well as increased outreach and distribution of blankets and warm clothing. This plan should be revised yearly, before the start of the winter season. Additionally, the government should allocate funds to winter services if there is not enough shelter space to meet the nightly demand.
It must be understood that we do not write this report to criticize existing winter services that are imperfect due to funding or other circumstances out of their control. Limited services that cannot be open reliably or cannot accommodate everyone whose needs are certainly better than no services at all. However, all homeless service providers must be constantly trying to improve.
Homeless service providers and governments have the responsibility to protect their homeless citizens through state- and city-wide winter plans and increased shelter availability. An exemplary winter shelter would be open 24 hours each day between October 1 and April 30, regardless of temperature, as well as any other days during the year when the temperature falls below 40o F. It would also admit all homeless people,
regardless of sobriety status or past bans, unless they are violent or causing an extreme disturbance.
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