The board this week unanimously approved a proposal to call homelessness a public health disaster and advise local governments to do whatever is necessary to get people inside.

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The King County Board of Health is urging local governments to use emergency homeless shelters in anticipation of the quickly approaching cold weather.

The board of health this week unanimously approved board member Bill Daniell’s proposal to call homelessness a public health disaster and advise local governments to do whatever is necessary to get people inside.

The board’s action doesn’t prescribe how jurisdictions should act, nor does it require them to take action. But it endorsed Daniell’s idea to prioritize getting people into shelter before winter, and then shift to more long-term efforts.

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“We recognize that in trying to shelter thousands of people in the span of months, one might use lower-quality or resourced shelter at first,” said Daniell, a physician who teaches at the University of Washington’s School of Public Health.

“But we stress the need to maintain and enhance that shelter over time. In a hurricane they might put out tents quickly to serve people, but once the hurricane and flood is gone, they move into a next phase and build shelter or have trailers or barracks.”

King County and Seattle declared states of emergency for homelessness three years ago, but the number of unsheltered people in the county rose from 3,772 in 2015 to 6,320 in the 2018 Point in Time count. Deaths of homeless people also increased. A record 169 people were identified as homeless at their time of death last year, and half died outdoors, although the total is likely an underestimate.

Disease outbreaks among homeless populations have continued, including a recently discovered cluster of HIV. Eleven people, described as heterosexuals, drug users, and recently homeless, have now been diagnosed in sanctioned and unsanctioned encampments in North Seattle, Patty Hayes, director of Public Health – Seattle & King County, said at the board meeting.

Hayes said her department tested more than 97 people in the three weeks before the meeting. The public health department has been testing at sites in North Seattle, including at Licton Springs Village and Aurora Commons, and officials hope to expand testing in the coming weeks, public health spokesman James Apa said in an email.

Despite the health board’s recommendation, some King County staff cast doubt on the impact of the action.

Carina Elsenboss, preparedness director for the public health agency, said she doesn’t think local governments will actually use emergency planning for homelessness, especially if it would mean using resources reserved for disasters.

The first focus during disasters is on saving lives and sheltering people in schools and other public facilities, Elsenboss said. But emergency responders always have demobilizing in their minds. They hand response back to the agencies that would normally provide services as soon as they can, moving from the response to the recovery stage.

“What were seeing with homelessness is that it’s a longer-duration event. We’ve been working on it for a while,” Elsenboss said. “It looks more like what we think about when we transition to recovery.”

King County human-services director Adrienne Quinn said the most effective way to get people out of homelessness is to address the root causes, and not just shelter them.

“It’s as if the hurricane continues every single day,” said Quinn, who announced her resignation this week. “Shelter does provide an emergency life-saving mechanism, but it doesn’t always save people’s lives.”

Seattle City Councilmember Teresa Mosqueda said she was initially concerned about Daniell’s proposal. But she said that because there aren’t enough resources for a long-term solution to homeless before winter, she supports the short-term shelter emphasis endorsed by the board on Thursday.

“My concern is that we are not responding to this crisis with the emergency it requires,” Mosqueda said. “I agree that this is not the answer, but it’s a critical interim measure.”

Daniell said he hopes officials will agree to the ambitious goal of getting everyone inside before the cold, and that the exact methods can be worked out after, looking at what’s been done elsewhere.

Mass sheltering has been used in other regions, such as San Diego, which used FEMA-style emergency tents after a hepatitis A outbreak, and Tacoma, which used 70-foot-long tents as emergency shelters. Seattle and King County Healthcare for the Homeless Network staff are concerned that poorly planned large shelters could exacerbate health issues among homeless populations, according to a Board of Health staff report.

But the organization has planning and checklist resources for temporary sanctioned homeless encampments that could be distributed to local jurisdictions.