Metta Fund spoke with the executive directors of Metta Fund grantees to see how their priorities and programming has shifted in the midst of a global pandemic. Here’s what they shared with Metta Fund.

Homebridge, a nonprofit caregiver organization based in San Francisco, only saw one case of COVID-19 emerge this spring from their work done across 17 different hotel sites for 240 clients. This care and precision are a testament to the professionalism with which the staff has operated during the COVID-19 pandemic. How did Mark Burns, Executive Director of Homebridge, and his staff, pull this off, especially with such vulnerable clientele? The answer, in sum, is teamwork, organization, support from local government, and caring as much about the staff as their clientele.

Homebridge is known for investing in its “caregivers and supporting [their] clients with complex health, behavior, and social needs in overcoming barriers to accessing quality in-home care.” The population served is 70% older adults. One-third suffer from substance use issues and most live in single-room occupancies (SROs) in hotel-type housing. Because of drug use, mental health issues, or dementia, they are often isolated; this is where Homebridge comes in.

“Often, one of the closest relationships our clients have is the one with our homecare workers,” said Mark, “and our job is to keep them safely at home and out of the hospital or in nursing homes.” That job is complicated, as about two-thirds of Homebridge’s population have previously been homeless, adding an aspect of trauma into these relationships. “They are isolated as it is,” he said, “and it’s our homecare workers who check up on them and ask them if they’ve taken their medications, bus them to the mental health centers or clinics…these are the folks who find our clients when they’ve overdosed.”

During the pandemic Mark and his dedicated staff had to find a way to centralize their clients and continue serving their needs in a manner that was safe for both parties. Homebridge employs 300 homecare staff who are themselves a low-income workforce, “with their own experiences and their own backgrounds,” he said, “but they’re well trained in what it takes to handle these situations and are not fairly intimidated.”

Mark’s priority was not only to protect his clientele from getting sick, but also his staff, who fit a “high COVID profile, are predominantly women of color, and (many) come from multi-generational households with childcare issues — in sum, they are low-wage workers with high risk exposure,” he said, “so we had to manage both side during this pandemic.”

“We’ve been the only people coming in to check on people and check in with their world, helping with food delivery and health checks.” – Mark Burns

After losing 20% of their workforce once COVID-19 hit, Mark was worried, but over the past six months, there has only been one case of client-worker transmission, showing just how exposed both client and worker are and how careful they’ve been. “Fortunately,” Mark said, “about 20% of our client population decided they didn’t want anyone in their rooms, either, so we rejiggered all the schedules and reduced services and went bare bones.” After juggling schedules around, Mark and his team started doing wellness checks over the phone and introducing clients to their new homecare person if their regular person had left. Luckily, Homebridge had enough workforce capacity to continue serving critical client needs from house cleaning and cooking, to mobility assistance.

While pivoting so quickly could easily have caught Homebridge off guard, Mark actually leveraged the use of the homecare workers’ PPE (Personal Protective Equipment) to their advantage. Homebridge decided to engage in workforce development, acknowledging how much the homecare workers were having to shift and grow in their positions and responsibilities.

“We got them a $2 per hour raise, an official title change to ‘essential workers,’ and PPE, and most critically, we’re using technology for care plans and real-time communication,” said Mark. The team is now on a network together and in constant communication with one another and supervisors about ongoing cases.

Around April, Homebridge was hired by the city of San Francisco to create a certificate program as a part of Project Roomkey, a national project that utilizes FEMA funds to provide housing for people who are at a high risk of contracting COVID-19 but who do not have appropriate shelter. Usually, this money is used to disperse people from shelters and get folks out of tent encampments and into hotels and motels. Homebridge’s response was developing the CERT program (Caregiver Emergency Response Team) to help people transition from shelters and the street to a private room in a hotel or motel. The city is still moving people into hotels (as of August 2020) so Mark believes the response team will continue growing — as well as their partnership with the state.

Not only has Homebridge staff pivoted to get on top of the crisis, but their services have become more important. “When hospitals shut down,” said Mark, “having our workers in tune with clients makes us more important in our ability to identify health emergencies, which is critical at a time like this because folks don’t have as much access to regular services (like hospital care) as they normally would. We’ve been the only people coming in to check on people and check in with their world, helping with food delivery and health checks,” he said.

“Aside from what we do every day, we have hero moments constantly,” he said. “And frankly, I’m impressed with how quickly and easily we were able to go remote; we went from being 90 people in an office overseeing 300 people in the field to being 90 people at home overseeing 300 people in the field, and there was not one catastrophe.” Not only that, but Homebridge, like many client-based organizations, started working with delivery services, including Meals on Wheels. With good reason, their volunteers over 60 years old, who sometimes helped with food assistance, stopped coming out of safety concerns, but food delivery to clients continues.

As cities continue to scramble to find a suitable plan for citizens as COVID-19 wears on, Mark wonders if they’ve left anything out and “what is going to go wrong that we haven’t thought of yet!” Homebridge has managed to keep clients fed using delivery services, opened up the veins of communication utilizing new technology, and developed a new training program for his homecare workers with state support, and yet, COVID-19 is powerful enough to keep us all on our toes.

“Our single biggest challenge right now is to bring on new workers so that we can continue meeting the needs of the community,” said Mark. “I need to hire more so we can support more people. I’m optimistic that we’ll be able to bring on more folks and continue using remote technology as long as the government is able to hold up through all of this,” he said, pausing.

“Then I think we’re going to be able to continue what we’re doing. We’re in a strong place, it’s just, is the world around us strong enough to see this through?”

Stories by Sahara Marina Borja; Photography by Hasain Rasheed