When Vermont's online registration form for home delivery of free rapid COVID-19 tests went live on January 12, then crashed due to overwhelming demand, Jess Horner was too busy to log on and compulsively hit refresh. Horner is the program director at John Graham Housing & Services in Vergennes, and with nearly a third of her 12-person staff out due to illness or exposure to COVID-19, she was scrambling to meet the immediate needs of John Graham's 100 or so clients, most of whom are unhoused.
By the time she tried to sign up for the rapid testing kits, all 350,000 had been claimed.
"I am so burned-out from COVID," said Horner, who manages the 25-bed John W. Graham Emergency Shelter in addition to coordinating outreach for clients living in motels and on the streets. The pandemic, she said, has added a new layer of logistical complexity to her work. "Our clients call us for everything," Horner said. "We help them problem-solve around food and housing issues, and COVID testing has become part of our case management duties."
Yet Horner and others from organizations that serve the homeless feel that the state has overlooked them and their clients in the recent push to distribute rapid antigen tests. While Gov. Phil Scott's administration has dispatched hundreds of thousands of testing kits to schools, childcare centers and individual addresses, it had not created any mechanism to get tests to the more than 2,000 Vermonters spending the winter in motels and shelters until the end of last week.
Last Friday, about six weeks after the highly transmissible Omicron variant arrived in Vermont, the Department of Health began allowing shelters to request rapid testing kits. The department expects to distribute 30,000 tests in the next two to three weeks — half of which will go directly to shelters, said Agency of Human Services spokesperson Will Terry. The other half will be distributed to service providers who work with "vulnerable Vermonters," including those living in motels.
At-home tests can quickly identify infections, a critical advantage in slowing the spread of the Omicron variant — particularly in shelters, where people have little control over their risk of exposure.
The health department does not know how many people housed in motels and shelters have COVID-19, according to a spokesperson, and the data it has collected on shelter outbreaks is too limited to provide an accurate picture of the prevalence of COVID-19 within the population as a whole. Meanwhile, the only quarantine facility in the state for unhoused Vermonters who contract the virus is the 30-room Ho-Hum Motel in South Burlington.
"This is a massive equity issue and a massive disability rights issue," said anti-poverty advocate Brenda Siegel. Her 28-day vigil on the steps of the Vermont Statehouse last fall helped push officials to reinstate a federally funded motel voucher program that had housed virtually all Vermonters in need of shelter, before officials enacted new guidelines last July to restrict the number of people who would qualify.
Now, anyone below a certain income threshold experiencing homelessness is eligible for a room until March 1. According to the Department for Children and Families, which oversees the program, 1,775 adults and 490 children are living in motels across the state.
In recent weeks, the state and federal governments have tried to get more tests into the public's hands by mailing them directly to residential addresses and requiring insurers to cover the cost of the kits. But for unhoused Vermonters, those measures didn't make much difference, because distribution was limited to one bundle of kits per street address — thus excluding most people in shelters and motels.
Some got lucky; Josh Lisenby, who lives at the John Graham shelter in Vergennes, managed to sign up for rapid tests through the state website using the shelter's address.
"I'm not sure if I was the first one to sign up and if my doing that prevented someone else from getting them," he said. When he tried to get tests mailed to the shelter through the United States Postal Service-administered federal program, he got an error message saying the address he had entered was a business.
"My real concern is, why hasn't the state sent cases of tests to shelters and motels just to have on hand?" Lisenby said. "When you get to the shelter, they give you a little care package with a toothbrush, toothpaste, shampoo, stuff like that. It would be really nice to get a rapid test in there, too."
Lisenby doesn't have a car, so whenever he wants to get tested for COVID-19, he has to take two different buses to the site in Middlebury — an undertaking, he said, that can eat up half the day. And if he were sick, he would risk exposing his fellow passengers. "When you're homeless, you're always asking yourself whether the thing you're going to do is worth the danger to yourself and others," Lisenby said.
Nor is purchasing a testing kit — even when one can be found in a store — a feasible option. At roughly $25 for a box of two rapid tests, the kits are out of reach for most Vermonters earning less than $24,000 a year, the income cutoff for the motel voucher program. And those without health insurance can't submit their receipts for reimbursement.
Joe McCaffrey, who has been living at the Days Inn in Colchester since November, said the motel has no rapid tests to offer voucher guests who can't afford to buy them. He's disappointed, he said, with the lack of direct outreach from the state.
"A lot of people here need a knock on their door, whether it's because they're not internet-savvy enough to be informed or because they have a lot of other issues besides being homeless," McCaffrey said. "But there's been no activity whatsoever from the state since I got here, in terms of getting tests to people, and this is a pretty big motel. If it's not happening here, I don't know where it's happening."
Sarah Phillips, director of DCF's Office of Economic Opportunity, acknowledged these frustrations. "I absolutely agree, and the administration agrees, that we need to address this issue," said Phillips, who works with the health department to coordinate the pandemic response to Vermonters living in shelters and motels. "It is an equity issue at some level. You couldn't log in to the rapid test request and ask for more than two [at a single address], so what does that mean for folks living in congregate settings?"
Throughout the pandemic, she said, her agency has offered to support organizations that work with people housed in motels and shelters. "If shelters can get rapid tests and they need some funding to support that, we're happy to have those conversations," she said. "But there are challenges around the supply chain impacting the state as a whole, and I think that's well understood."
In December, Rick DeAngelis, the executive director of Good Samaritan Haven in Barre, used grant funding from DCF to help cover the cost of 500 rapid tests for his organization, which manages three shelters and serves some 250 people living in motels throughout Washington County. If DeAngelis hadn't had the foresight to stock up, he probably would be in trouble now: At the beginning of the month, a field supervisor from the Agency of Human Services came to one of Good Samaritan's shelters and dropped off 34 rapid tests for the facility.
Other than that, DeAngelis said, the state had not provided any testing supplies; in fact, he said, several Washington County agencies that work with the homeless, including a day shelter in Montpelier that had to close this week due to staff COVID-19 infections, have recently asked him to share some of his tests.
But DeAngelis is most concerned about motel residents, who are even less likely to be in contact with service providers who can help them get medical care. "There are no on-site services right now in Washington County, and we've got the second-largest number of people in motels in the state," he said. "What are those people doing if they think they have COVID?"
DeAngelis said he has enough rapid tests on hand for the roughly 50 people housed in Good Samaritan's three shelters, but with case counts creeping up — over the past two weeks, six people in the shelters have tested positive — he worries that his staff won't be able to respond quickly enough.
"If there was a SWAT team that came in and said, 'We're going to take care of this. We're going to do the testing, and if somebody is positive, we'll figure out where they go,' that would really help," said DeAngelis.
When someone in a shelter tests positive, the protocol is to transfer them to the Ho-Hum Motel in South Burlington. Since early January, the Ho-Hum has been consistently at or near capacity, according to a spokesperson for the Champlain Housing Trust, the nonprofit that manages the motel's day-to-day operations.
Phillips, the Office of Economic Opportunity director, said the state has no immediate plans to add additional quarantine capacity in motels. The Ho-Hum is ideal, she said, because of its proximity to other social and medical services, including the Community Health Centers of Burlington, which provide clinical support by phone to Ho-Hum residents who ask for it. "It's not just a roof," said Phillips.
Two weekends ago, subzero temperatures froze some pipes at the Ho-Hum, rendering 10 of the rooms uninhabitable. All but two of the displaced residents were relocated to empty rooms on the premises that weren't being used for the quarantine program. By last Friday, plumbers had managed to engineer a temporary solution so that people could return.
Recently, one of DeAngelis' clients refused to go to the Ho-Hum after he was told that he would have to share a room; in another instance, DeAngelis had to pay for two motel rooms for Good Samaritan residents who tested positive, because he couldn't immediately arrange their transportation to the Ho-Hum.
"It's overwhelming," said DeAngelis. "In some ways, it's been much harder to manage the situation than last year. The more we test, the more cases we're going to find. What are we going to do about them?"
Correction, January, 26 2022: This story has been updated to clarify Will Terry's role in the Agency of Human Services.