A Qualitative Investigation into the Impact COVID-Era Telehealth Policies Had on Organizations Ability to Deliver Care to People Experiencing Houselessness in Seattle

Abstract

As Covid-19 swept through the nation, many businesses and organizations moved to a remote setting where possible. While each business and organization, without a doubt, struggled to adapt, those who worked with vulnerable populations were disproportionately affected. Organizations with the goal of providing and connecting houseless individuals with medical care, mental health treatment, and more needed to find creative means to continue to provide those much needed services from a safe distance. This report aims were descriptive in nature, and aimed to learn more about how these organizations continued to provide services, and what lessons they are taking forward. Data was collected through semi-structured interviews with organization leaders and service providers as well as data provided by various state organizations to provide a scale for the issues raised in these interviews. The interviewees, or stakeholders, had all interacted with houseless clients via telehealth, either directly providing care, or managing staff who did. All organizations operated mostly in the greater Seattle Area, with some edge cases or clients being from elsewhere in the region. All organizations had performed a number of in person services before switching to primarily telehealth during the COVID-19 pandemic. Analysis suggests that telehealth was helpful for interacting with the houseless community however there were some important caveats. Firstly, telehealth was often aided by clients being able to use physical spaces provided by these organizations as well as access devices capable of engaging with services providers remotely while clients were at the facility. Second, some clients did not respond well to telehealth services or were unable to engage with them in a meaningful way. Thirdly, there are some real concerns with confidentiality that should be better addressed for this type of service. There are unique challenges to providing telehealth services to those experiencing houselessness that must be addressed, however, it is very much worthwhile to extend policies that allow for telehealth to continue in its current state while these issues are addressed. More research must be done to further understand the impact of these policies and on telehealth’s efficacy in this context.