A man standing outside a tent talking to a homeless resident about their situation.
Peter Matlon, a board member of a D.C. nonprofit that serves homeless veterans, conducting outreach on November 11, 2019. Photo by Victoria Ebner

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Over the past 30 days, as cases of COVID-19 have skyrocketed, D.C. service providers have scrambled to adapt to the public health situation and continue serving the homeless residents who rely on them.

One concern that emerged early on among case management providers involved the billing structure they were subject to under the D.C. Department of Human Services (DHS), which they said did not factor in the added costs and staff shortages they were anticipating in the coming weeks.

Under the standard billing system, providers are paid on a monthly basis for each client they serve. In order to be paid at the full value of their contract, providers must meet a set number of case management interactions, which include face-to-face, phone and attempted contacts.

For Miriam’s Kitchen, which provides case management to 216 of its guests, receiving a temporary waiver from the billing requirements was crucial, according to CEO and President Scott Schenkelberg. 

By March 13, just two days after Mayor Muriel Bowser declared a public health emergency, Miriam’s had cancelled all volunteer shifts and was preparing to move its meal and case management services to an adjoining outdoor courtyard, where people could more easily distance themselves from others. Around that time, a coalition of service providers, including Miriam’s and Pathways to Housing D.C., requested that DHS temporarily waive the requirements and pay providers at their full rates.

The staggering cost of moving Miriam’s entire operation to the courtyard, which entailed setting up tents and renting three portable restroom stalls, along with overtime expenses and increased spending on food, was nearly $200,000 per month, Schenkelberg said. The portable restrooms alone, depending on usage and the frequency of septic servicing, can cost up to $6,000 per month.

By March 20, the request for temporary waivers had been initially approved for all case management providers, and during a phone call with providers on March 23, DHS discussed the new regulations which would allow for full billing, Schenkelberg said. A formal agreement stipulating the new terms of billing was circulated to providers on March 26.

Schenkelberg said the response from DHS was “impressive” and estimated that being able to bill at the full rate could translate to almost $100,000 in billing through the end of the fiscal year.

Pathways D.C. Executive Director Christy Respress said she was “thrilled” that DHS was “really listening in this time of crisis and really flexible to the extent that they can be.”

The organization plans to use the extra funds to purchase cell phones for clients who lack them and are harder to contact, as well as essential supplies like masks, hand sanitizer, gloves and disinfectant wipes.