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State campaign getting vaccine to the homeless

Trusted shelters are pivotal by Ginny Monk | April 5, 2021 at 7:11 a.m.
Ronald Gilbert (left) receives a shot of Johnson & Johnson coronavirus vaccine from Sedley Tomlinson, a section chief with the Arkansas Department of Health, on Thursday, April 1, 2021 at the Little Rock Compassion Center. (Arkansas Democrat-Gazette/Staci Vandagriff)

A line of people shuffling forward to get their vaccines stretches through the room where those staying at the shelter typically play board games or cheer on their favorite sports teams to pass the time.

"Do you think I'll have side effects?" one man asks another as they sit, waiting 15 minutes after the dose.

"Can I get it if I have cancer?" Ralph Greer, 60, says to a couple of people in line in front of him, holding a stack of paperwork bearing the U.S. Centers for Disease Control and Prevention logo.

Greer has lung cancer, and although he is from Magnolia, he didn't have transportation to travel back and forth for treatments. So he wound up staying at the Little Rock Compassion Center, an emergency homeless shelter. He got his covid-19 vaccine Thursday morning.

"I'll try anything one time," he said of the shot. He feels similarly about his cancer treatments, and says that while he wants to live as long as he can, "when it's my time, it's my time."

He hopes to go back to live with his sister after his treatments and maybe buy a house one day. He used to have a landscaping business, work he loves. He says he designed the flower beds in front of the Compassion Center.

"This is where you come to get on your feet," he said of the center.

Greer is one of about 114 people experiencing homelessness who had been vaccinated as of Thursday. That's close to 5% of the state's homeless population, which is 2,336, according to the 2020 count.

Shelter workers and residents became eligible under Phase 1C of Arkansas' vaccine rollout. Shelters and the Arkansas Department of Health last week boosted efforts to vaccinate the state's homeless population.

Floyd White, 58, another man staying at the shelter who got vaccinated, said he was "half-half" between relieved about the prospect of immunity to covid-19 and worried about the shot. He found out about the opportunity that day.

A former cook, White became homeless after his wife of 19 years died in 1998. He's been on the streets and in hotels on and off ever since.

"I'm feeling fine," he said, waiting his 15 minutes in the lobby after the shot.

He said he hoped he wouldn't have side effects -- he was scheduled to work at the center's thrift shop as a cashier later that day. He said one of the workers suggested he take Tylenol, but he wasn't sure where he could get some.

There were at least two events in Little Rock on Thursday morning.

At the first, 10 people got their first dose of vaccine at the Salvation Army Central Arkansas Command. The shelter provided breakfast and partnered with Kavanaugh Pharmacy to provide the shots. They'll have another event later this month to provide first and second doses to anyone who shows up, said Maj. Bill Mockabee, Central Arkansas area commander.

The second event was a part of a Health Department program launched last summer called Operation Compassion. It provided covid-19 testing and contact tracing for people experiencing homelessness and is transitioning to doling out vaccines.

"They are part of the larger society and they have unique challenges because of their livelihood and their safety and concerns," said Dr. Appathurai Balamurugan, the department's deputy chief medical officer and state chronic disease director. "Either sheltered or unsheltered, it is the greater society's responsibility to take care of this most vulnerable population.

"If part of us are not good, everyone is not good."

Balamurugan said vaccinating the homeless is a priority for the state department because many people experiencing homelessness live in congregate settings such as shelters or camps and that population often has pre-existing health conditions, in part because of lack of access to health care.

He said there have been several covid-19 outbreaks among the homeless population over the past year.

The program is giving out one-dose Johnson & Johnson vaccines because it may be difficult to schedule follow-up appointments for people experiencing homelessness who have limited access to transportation, Balamurugan said.

The one-dose shots have simplified the process of vaccinating those experiencing homelessness, said Katie League, covid-19 project manager at the National Health Care for the Homeless Council, a Nashville-based research and advocacy group.

The practice of delivering vaccines to the homeless through providers in "smaller, more targeted settings" is one of several best-practice recommendations the council sent to governors, state and local health agencies and covid-19 response leaders in late February encouraging them to prioritize this population.

League added that although each state labeled its phases of vaccine rollout differently, many states placed the homeless in roughly the equivalent of Arkansas' 1B category -- the phase after health care workers. Not every state explicitly wrote about the homeless in their policies, but included shelters in congregate settings.

In some states, it was unclear what that meant for the unsheltered homeless, who live in camps, on the streets or in places not meant for human habitation, League said. Arkansas is one of a few states in which more than half of its homeless population is unsheltered, according to a 2020 report from the U.S. Department of Housing and Urban Development.

"The sad reality is many of our community don't live that long," League said. "So they were not eligible because they did not meet the age criteria, although they had many health complexities."

It's tough to compare states based on the percentage of their homeless populations that have been vaccinated because of differences in the speed and method of the rollouts. But working with providers who already have relationships with people experiencing homelessness is key, she said.

"People do not always accept services immediately," League said. "They have been mistreated by systems. ... We know that homelessness is a systemic issue, it is not a personal issue."

The University of Arkansas for Medical Sciences gave out 39 vaccines to people experiencing homelessness at the Jericho Way Day Resource Center on March 22, said Mandy Davis, the center's director.

Davis hopes to set up more events with any pharmacies willing to bring shots to the facility, she said.

"For the people that we serve, the guests, our friends, it's been devastating. There's no equity in a pandemic," Davis said. "This was a step for them and for us, the people that serve them every day, to give them a chance."

Casey Kidd, president of the Arkansas Greater Balance of State Continuum of Care, said that in her area, she's not aware of many plans to distribute vaccines, although she planned to talk with the health department. She added that The HUB, a homeless resource center in Jonesboro, was working on a distribution plan.

The continuum is a consortium of service providers across the state that work together to serve people experiencing homelessness. It covers the most counties of any continuum of care in Arkansas.

The Community Clinic in Northwest Arkansas is utilizing its mobile health clinic, which offers a range of medical testing and consultations, to vaccinate clients. The clinic rotates weekly between four locations where people experiencing homelessness or who were recently housed can access services, said Amanda Echegoyen, the clinic's chief operating officer.

Like the health department, her organization doesn't require identification in order for people to get vaccinated, an issue that providers have said could be a barrier for the homeless.

"Our goal is to provide accessible health care," Echegoyen said. "For the populations experiencing homelessness, accessible means going to them."

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