The COVID pandemic brought to light many long-standing health disparities that exist along racial and socioeconomic lines. As essential services were scaled back and stretched thin, at-risk populations became even more vulnerable to illness, job loss and homelessness. The latter group is particularly vulnerable to the threat of COVID, as homeless persons experience a lack of stable housing that is often compounded by joblessness, chronic health issues and transportation barriers that make it difficult, if not impossible, to access health care.

Once the FDA issued emergency use authorization for the COVID vaccine, case managers and directors of agencies that serve the homeless knew they needed to find a way to bring the vaccine to their clients. Among those searching for a vaccine partner was Laura Sabino, executive director of The Lake County Haven — known in the community as “The Haven” — a local social service agency dedicated to helping homeless women and children lead safe, stable and independent lives.

“It was such a blur — it was a crisis for the agency just like everyone else during the pandemic. It was new territory for us and other homeless service providers,” Ms. Sabino said. “I was on a mission to do everything that could possibly be done to help our clients stay safe. Their safety was the primary focus for me all year. So when the vaccines came out, I was really trying to get the vaccine available on site.”

The Haven serves approximately 30 residents a night in group housing and apartments. Residents include women and children. Some of the women are pregnant. The children range in age from newborns to teenagers. Keeping everyone sheltered, fed and healthy at The Haven is mission critical, and Ms. Sabino said that partnerships are key to making that happen.

“Most of our women couldn’t just hop in their car to go get a COVID test or get a vaccine. And a lot of those services, when they were first available, were drive-thru only, and that doesn’t work for someone without a car.”

“We don’t do it alone. We need partners like Â鶹ӰÒô. The Haven can’t also be a medical facility, so the fact that (the) Care Coach said, ‘We can bring services to you’ is huge,” she said. “People from Â鶹ӰÒô support us in other ways, too. We have a meal program where people can sign up to cook meals and bring them to the house for our residents, and I know we’ve had employees and students from Â鶹ӰÒô do that for us.

“It’s important that we offer as many services as possible on site because of where we are geographically located,” Ms. Sabino added, pointing out that The Haven is in central Lake County, and a lot of essential services are located along the northeastern corridor. “A lot of our clients don’t have cars. Public transportation is limited in parts of the county, or a client might not feel safe taking public transportation.”

This was particularly problematic when it came to accessing the COVID vaccine. “Most of our women couldn’t just hop in their car to go get a COVID test or get a vaccine,” Ms. Sabino said. “And a lot of those services, when they were first available, were drive-thru only, and that doesn’t work for someone without a car.”

Â鶹ӰÒô’s Care Coach visited The Haven throughout the pandemic to conduct testing for the agency’s residents and staff. When Ms. Sabino received a call from the Care Coach team offering to bring vaccines to the shelter, she didn’t hesitate.

“Our relationship regarding the pandemic started with the testing, and then (Â鶹ӰÒô) said, ‘We’re going to have access to the vaccine — would that be helpful for The Haven?’ and I jumped at the opportunity,” Ms. Sabino said. “We are so grateful to have been able to receive the vaccine, as many of our residents fall into at-risk health categories.”

A QR code with a link to a Spanish website allows patients to quickly receive information about the Moderna vaccine from their phone's web browser.

A variety of social, environmental and economic factors known as social determinants of health (SDOH) can negatively impact a person’s quality of life. The Centers for Disease Control and Prevention defines SDOH as “conditions in the places where people live, learn, work and play that affect a wide range of health risks and outcomes.” The COVID pandemic has exacerbated the effects of these factors, particularly for persons of color.

Housing instability isn’t the only SDOH affecting the homeless population — there’s also economic instability due to job loss or lack of skills needed for gainful employment, and lack of access to health care that results in chronic health conditions like diabetes, commonly undiagnosed or untreated in vulnerable populations.

The Care Coach can meet the homeless and medically underserved where they’re at and remove barriers to healthcare access. The university has a long-standing partnership with PADS Lake County, an agency that provides homeless individuals and families with safe emergency shelter and resources for housing. PADS has been a regular stop for the coach since Â鶹ӰÒô acquired the mobile unit from Lake Forest Hospital in 2011. For the past decade, the Care Coach has brought dedicated teams of medical professionals to PADS sites to conduct health screenings and provide health education.

“In my opinion, Rosalind Franklin University has been instrumental in bringing healthcare resources to our clients’ doorstep,” said Somya Sinha, healthcare case manager at PADS, which operates overnight shelters at rotating sites from October through April. “The nurse practitioners would come biweekly during shelter season and provide screening services like checking our clients’ blood pressure, blood glucose and cholesterol.”

According to Ms. Sinha, many PADS clients weren’t aware they had underlying health conditions until they received screenings from the Care Coach nurses. “This really helped us identify the clients, even among our younger population, who had high blood pressure. That’s not surprising given the stress of being homeless, which really contributes to ill health among the homeless population.”

“In my opinion, Rosalind Franklin University has been instrumental in bringing healthcare resources to our clients’ doorstep.”

Since the start of the pandemic, the focus has turned to COVID testing and vaccinations to help keep PADS residents safe from the virus. “It has been extremely useful to have the nurses come on site and vaccinate our clients,” said Ms. Sinha. Getting vaccinated isn’t mandatory for PADS clients, but they are strongly encouraged to do so.

“We see in some of our clients the same hesitancy as in communities across America,” Ms. Sinha said. “People who are homeless experience a lot of misinformation, which can spread very quickly. There is also the history of discrimination and abuse in medical care among different racial groups, which makes them hesitant to accept something so new like the COVID vaccine.”

Ms. Sinha added that the familiar faces on the Care Coach are a comfort to some clients who may be on the fence about the vaccine.

“They might not be as motivated to get it if they had to go to a vaccine site and wait several hours for the shot,” she said. “So when the Care Coach would come and make it so easy to get the shot, that was encouraging. They also saw the same people who had come to them before to do their health screenings. That familiarity provided a level of comfort in accepting the COVID vaccine and knowing it would be safe.”