Community-based organizations (CBOs) are essential to supporting homeless populations during disasters, yet little is known about their preparedness and ability to support their vulnerable clients. This qualitative study evaluated the perceptions of Los Angeles nonprofit homeless residential service providers regarding the likely impacts of a disaster on their clients and operations, the barriers they face in disaster planning, and their suggested solutions to facilitate preparedness within their sector. Twelve semistructured interviews were conducted with executive staff and emergency planners from six organizations serving people experiencing homelessness. Respondents reported significant barriers to both postdisaster services and collaboration with emergency management. They indicated both a need for and interest in technical assistance and training to develop their disaster capabilities. These concerns suggest that a multisector effort, including homeless-service organizations, their funders, ...

Context: People experiencing homelessness are often the first and most severely affected group during disasters. Nonetheless, communities across the United States have frequently failed to adequately address the needs of homeless populations in disaster planning, response, and recovery. Communities must build multisector collaborative relationships and ensure that homeless service providers are adequately resourced. However, constraints in funding and staffing, combined with a lack of guidance about how to achieve an integrated approach to disaster planning for people experiencing homelessness, have hindered communities' ability to accomplish these goals. Program: The US Department of Veterans Affairs, the US Department of Health and Human Services, and the US Department of Housing and Urban Development created an interagency workgroup to identify resources to help communities address the disaster needs of homeless populations. This workgroup created a toolkit to address this gap: Disaster Preparedness to Promote Community Resilience. This article describes the development of the toolkit. The toolkit is divided into 3 sections: Section 1 provides guidance to homeless service providers and government entities in identifying collaborative relationships to ensure that services are available to address homeless populations' disaster needs. Section 2 offers nonprofit homeless service providers guidance in creating their disaster response plans. Section 3 aims to ensure that public health officials and health care systems have the capacity to provide health care to homeless populations during disasters. Implementation: Efforts are under way to develop a disaster preparedness training manual to assist nonprofit homeless service organizations. Discussion: Homeless service providers are vital partners in disaster response. Integrating them into emergency management and ensuring that they are adequately prepared for disasters will effectively enable them to contribute their unique skill sets to community disaster recovery.

People experiencing homelessness during the 2017–2018 California wildfires faced significant risks of disruption. Homeless service organizations (HSOs) are an essential safety net for this population. To learn about how HSOs performed during the wildfires, this study interviewed U.S. Department of Veterans Affairs (VA) staff overseeing HSOs providing transitional housing under the VA's Grant and Per Diem (GPD) program to Veterans experiencing homelessness. We employed a comparative case study approach exploring GPD organizations' disaster response actions, including evacuating Veterans from wildfire‐affected areas or taking in disaster‐displaced Veterans. This article presents three themes in the GPD organizations' disaster response: (1) Organizations benefitted from close collaboration and communication with the VA during the disaster, creating a safety net to ensure Veterans' well‐being and enact rapid re‐housing to prevent homelessness; (2) Organization staff performed heroically under stressful disaster conditions; and (3) Organizations benefitted from the written disaster plans that VA requires them to create, but were not as well‐prepared for wildfires as they had been for earthquakes. As emergent threats such as the COVID‐19 pandemic, wildfires, and a very active 2020 hurricane season amplify the importance of mitigating risks, comprehensive disaster planning is needed to ensure the safety and support of people experiencing homelessness.

Sufficient uptake of the COVID-19 vaccine is key to slowing the spread of the coronavirus among the most vulnerable in society, including individuals experiencing homelessness. However, COVID-19 vaccination rates among the Veteran homeless population are currently unknown. This study examines the COVID-19 vaccination rate among homeless Veterans who receive care at the U.S. Department of Veterans Affairs (VA), and the factors that are associated with vaccine uptake. Using VA administrative and clinical data, bivariate and multivariate analyses were conducted to identify the sociodemographic, health-related, and healthcare and housing services utilization factors that influenced COVID-19 vaccine uptake during the first eight months of the vaccine rollout (December 2020–August 2021). Of the 83,528 Veterans experiencing homelessness included in the study, 45.8% were vaccinated for COVID-19. Non-white, older Veterans (65+), females, those who received the seasonal flu vaccine, and Veterans with multiple comorbidities and mental health conditions were more likely to be vaccinated. There was a strong association between COVID-19 vaccination and Veterans who utilized VA healthcare and housing services. VA healthcare and homeless service providers are particularly well-positioned to provide trusted information and overcome access barriers for homeless Veterans to receive the COVID-19 vaccine.

Little is known about COVID-19 vaccine hesitancy and acceptance among individuals experiencing homelessness, despite their higher risk for morbidity and mortality from SARS-CoV-2. This study examines COVID-19 vaccination attitudes and uptake among U.S. military Veterans experiencing homelessness enrolled in transitional housing programs funded by the U.S. Department of Veterans Affairs (VA). Telephone interviews were conducted with 20 Veterans in California, Florida, Iowa, Kentucky, and Massachusetts, USA (January–April 2021). A rapid analysis approach was used to identify and enumerate commonly occurring themes. Although 60% of interviewed Veterans either received the COVID-19 vaccine or were willing to do so, one-third expressed hesitancy to get vaccinated. COVID-19 vaccination attitudes (e.g., belief that the vaccines were inadequately tested), military experience, beliefs about influenza and other vaccines, and sources of information emerged as influential factors for COVID-19 vaccination uptake or hesitancy. Veterans in VA-funded homeless transitional housing programs are generally willing to be vaccinated. However, a substantial minority is reluctant to take the vaccine due to concerns about the COVID-19 vaccine and distrust of authority. Recommendations for increasing uptake include utilizing Veteran peers, homeless service providers, and healthcare providers as trusted messengers to improve confidence in the vaccine.

Community-based organizations (CBOs) are critical to supporting homeless individuals during disasters. However, CBOs often have difficulty engaging in preparedness planning, and are often unable to prioritize business continuity planning. This qualitative study evaluated disaster preparedness at six Los Angeles nonprofit homeless residential service providers using a tiered maturity model that organized preparedness into three progressively advanced steps: (1) life safety, (2) continuity of operations planning (COOP), and (3) collaborative relationships. Twelve semistructured interviews were conducted with executive staff and emergency planners from the six organizations. Respondents reported being very prepared in implementing life safety measures, such as having evacuation plans and vital life safety supplies. However, plans for continuity of operations tended to be limited. These organizations lacked written protocols for prioritizing among services or triaging limited staff and resources. Collaborative partnerships with peer organizations in disaster planning were extremely rare. These concerns underscore the importance of external support and guidance for CBO preparedness to enable them to plan for service continuity and connect with partners to build a more resilient safety net.