Salt Lake homeless advocates are calling for a shelter serving the elderly and infirm. But will the state need to pressure cities to allow it?

Rudy, a 63-year-old man with a hernia and kidney and liver problems, said the pandemic has been a scary time for people experiencing homelessness.

He and his wife, who has cancer, have always avoided staying in congregate shelters because they didn’t want to be split up into men’s and women’s dormitories — as they would’ve had to do at the now-closed downtown Salt Lake City emergency shelter. Also, the couple didn’t like the constraints of staying in a facility.

Coronavirus added another layer of concern since he and his wife are both elderly and have health conditions that put them at higher risk of serious symptoms if they contract the disease in a crowded setting.

So they were both able to breathe a sigh of relief in 2020 when service providers found a spot for them in a temporary shelter, a converted hotel where homeless individuals most vulnerable to infection could stay socially distant in separate living quarters.

He and his wife finally had their own room — a space where they could relax and focus on their medical needs.

“It was great,” said Rudy, who asked to be identified by his first name only. “Just having that freedom, where you can walk around and cook what you want and get things done.”

Utah advocates say COVID-19 has thrown into sharp relief the need for separate shelter spaces for people who are older, chronically ill and frail. These individuals are more vulnerable to communicable diseases that can spread through crowded shelters, advocates say, and it’s difficult for people who are on oxygen tanks or who use wheelchairs to navigate through tight spaces in these settings.

The motel temporarily set up for vulnerable populations where Rudy and others stayed at the start of the pandemic gave providers a glimpse of what this type of shelter might look like.

“We really saw the value in that,” said Michelle Flynn, executive director of The Road Home, one of Salt Lake County’s primary homeless service providers. “We saw the needs of that population; it clarified them.”

In recent months, the Salt Lake Valley Coalition to End Homelessness has been looking for a hotel, motel or other building with separate living spaces that would lend itself to becoming a permanent center for high-needs individuals.

Their search for a solution has been fraught with challenges so far — not least of all because Salt Lake City has placed a moratorium through early April on new permanent shelters and other communities in the county have been reluctant to permit new facilities.

Providers are relying on temporary shelter to get through this winter, accommodating up to 150 people who are older or medically fragile in a converted Ramada on North Temple, but even that was difficult to open because of staffing shortages and political pushback.

In fact, local resistance to these new shelters has been such a persistent problem that a leader in the Coalition to End Homelessness wonders if top-down pressure from the state might ultimately be necessary to make progress.

A temporary stopgap

The Ramada at 1659 W. North Temple opened Jan. 18, and Flynn says providers have been working ever since then to identify individuals who would be most suited to fill its rooms.

So far, they’ve admitted to the facility about 70 people who are over the age of 65 or have serious medical conditions, she said.

Providers have been contacting older and frail individuals who are already in a shelter or through street outreach and letting them know the high-needs hotel might be an option for them, according to Flynn. The Fourth Street Clinic, which offers health services to individuals experiencing homelessness, is in charge of determining whether someone fits the definition of “medically fragile” and could be eligible for the Ramada.

“They are definitely looking at the chronic health diseases that most often lead to severe illness and hospitalization due to COVID,” she said. “But they’re also looking at other types of chronic issues that make living in a congregate shelter challenging.”

Even after these steps are complete, helping someone move over into the Ramada can take some time, she said.

Getting the facility up and running this winter was a challenge in and of itself.

The Salt Lake City Council approved the Ramada as a temporary shelter site in mid-November, well after many homeless advocates had wanted to identify overflow options for the winter. For the last several years, the city has been taking on the primary responsibility for providing additional temporary shelter beds to keep people off the streets in the cold months — and this time around, officials voiced exasperation that other communities aren’t doing more to pitch in.

“I am frustrated beyond belief. We are the ones and our residents are the ones that bear this burden,” Council Chair Amy Fowler said at the time. “It sometimes feels as if our compassion is taken advantage of.”

From there, labor shortages and slow hiring delayed providers for weeks, even as they hustled to get the facility open in time for the most bitterly cold months.

Jean Hill, co-chair of the Salt Lake Valley Coalition to End Homelessness, says the Ramada is helpful — but the greater need is to open a permanent high-needs facility so officials and providers aren’t scrambling every year to find overflow beds.

But that search comes with its own political and practical hurdles.

‘First investment’

Hill says the coalition has a “shortlist” of potential sites for a shelter specifically targeted to older or medically frail people.

To advance much further with the plan, though, providers will need the local approvals for a facility like this, and Hill has her doubts that one will step forward voluntarily.

“My fear is we’re going to need legislation to make that actually work,” she said. “Because getting through zoning processes in areas where no one really wants to see these facilities … we’ve experienced that many times.”

Oregon’s legislators last year passed a bill removing local land use barriers that made it difficult to open homeless shelters in the state, so Hill said her suggestion isn’t unprecedented.

Hill says advocates aren’t pushing Utah lawmakers to pass such a bill just yet — but they do want to pick a facility by sometime this summer and are hoping for a breakthrough soon in their conversations with Salt Lake County cities.

There’s a particular effort among providers to locate viable options outside of Salt Lake City, which accommodates two of the county’s three homeless resource centers and is also a hub for support services, she noted.

Flynn envisions a high-needs facility as a place focused on connecting clients with medical services and helping get them into a stable, safe living situation. Providers have already seen some success in transitioning people out of the temporary high-needs hotels and into housing.

Since Rudy and his wife left the temporary shelter, they’ve found a spot in the Magnolia, a new 65-unit permanent supportive housing complex run by The Road Home.

Others might be ready to move into more traditional housing or be better suited to shift into a skilled nursing center, Flynn said.

Hill and Flynn acknowledge that a facility for the elderly and frail wouldn’t be a cure-all and that some individuals might be frustrated about a new shelter option that’s narrowly targeted rather than available to a broader population.

Anthony Brown, who’s been sleeping in a tent beneath a Salt Lake City viaduct this winter, suffers hip pain so acute that he can barely walk sometimes. But because he’s only 53, he’s not sure he’ll qualify for a spot in the Ramada, and the admission process alone has brought him close to despair.

“They’ve just got me going through a whole bunch of hoops,” he said. “So much so that I just give up on it.”

However, providers say that the region’s affordable housing shortages and shelter bed deficits have left them doing triage.

“We do have to kind of go with, OK, who’s highest on the list of this could actually be fatal if we don’t do something quick,” Hill said. “It’s not a fun place for our providers to be in, to be trying to decide who needs something the most. … Because we’re talking about a very basic need, and everybody needs housing. Period.”

That’s why Hill is also pressing state lawmakers this year to devote $128 million to subsidized supportive housing for individuals experiencing homelessness and another $100 million for additional affordable housing in the state. Gov. Cox included that funding in his budget proposal for the year, and legislators are now considering the request.

“My biggest hope is that they are going to make that first investment,” she said of state leaders. “And understand that it is the first investment and not the only investment in that kind of housing we need.”