Impact of Local COVID-19 Policies on the Homeless Population: Case Study in Two Montana Counties

COVID-19 has had a significant impact on people experiencing homelessness in Montana. In each Montana County, local policies in addition to individual shelter policies determine the requirements for homeless shelters in relation to capacity, distancing, and other public health measures designed to prevent the spread of COVID-19. The policies often differ from county to county, which often lead to different outcomes across the state. This case study analyzed data from multiple sources on the number of COVID-19 cases and deaths among the homeless populations in Missoula and Lewis and Clark Counties in Montana and linked them to the effectiveness of local COVID-19 policies in these two counties. To supplement the data and policy analysis, local health department directors were interviewed to gain a deeper understanding of the background and decision-making process involved in local policy-making. Findings from data and interviews indicate that local policy was very informal, but effective at keeping COVID-19 cases low in the homeless shelter settings from March 2020 to March 2021