Interim Considerations for Health Departments for SARS-CoV-2 Testing in Homeless Shelters and Encampments

Note: This document is intended to provide considerations on the appropriate use of testing and does not dictate the determination of payment decisions or insurance coverage of such testing, except as may be otherwise referenced (or prescribed) by another entity or federal or state agency. CDC is a non-regulatory agency; therefore, the information in this document is meant to assist health departments and homeless service providers in making decisions rather than establishing regulatory requirements.

Homeless service provider sites and encampments can present unique challenges for coronavirus disease 2019 (COVID-19) investigations and public health action. In congregate settings such as homeless shelters, the virus may spread easily among clients, staff, and volunteers. Additionally, many people experiencing homelessness are older adults or have underlying medical conditions [1], [2], which are risk factors for severe illness from COVID-19. This document describes testing strategies for homeless shelters and encampments. Testing to diagnose COVID-19 is one strategy and should be used in conjunction with promoting behaviors that reduce spread, maintaining healthy environments, maintaining healthy operations, and preparing for when someone gets sick.

State, Tribal, territorial, and local health departments should review these considerations in the context of local recommendations, resources, acceptability, and feasibility. These considerations are meant to supplement—not replace—any federal, state, local, territorial, or Tribal health and safety laws, rules, and regulations. For details on appropriate procedures and safety measures and personal protective equipment to use during testing, see procedure for testing in congregate settings.

The purpose and process of all testing and other public health activities should be clearly communicated to clients and staff at the homeless service site to promote understanding and acceptability. Testing strategies should be carried out in a way that protects privacy and confidentiality to the extent possible and that is consistent with applicable laws and regulations. In addition to state and local laws, regulations and policies, site administrators should follow guidance from the Equal Employment Opportunity Commissionexternal icon when offering testing to staff. Any time a positive test result is identified, ensure that the individual is rapidly and appropriately notified, separated from others, provided appropriate medical care, and linked to appropriate alternative housing for isolation, as necessary. Additionally, review the guidance for responding to cases at homeless shelters.

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