Homeless shelters that help Bay Staters get off the street and into supportive housing or treatment services struggled for years under costs that exceeded the funding state government made available.
And then COVID-19 hit.
The pandemic exacerbated long-standing challenges to attract and retain a workforce to staff the constellation of homeless shelters across Massachusetts, whose leaders now find themselves jockeying with larger companies to entice potential hires with the care of some of the state's most vulnerable residents on the line.
"We have really struggled historically, but especially in these past two years to recruit and retain a workforce. We're competing with McDonald's, with Amazon, for wages," St. Francis House President and CEO Karen LaFranzia said during a legislative briefing on Wednesday. "We're trying to recruit mental health workers, clinicians, frontline shelter staff to work with some of the most vulnerable people. If we're going to continue to do the excellent work that we've been doing and continue to move and see the successes, we're going to have to recruit and retain a talented workforce."
On any given day in Massachusetts, about 6,000 people experiencing homelessness are living on the street or staying in a shelter, according to Pine Street Inn Executive Director Lyndia Downie.
The close quarters in most shelters proved to be an enormous challenge when the highly infectious coronavirus began sweeping through the state. In the first COVID-19 surge, Downie said, about 36% of Pine Street Inn's guests tested positive.
At one point, about 15% of the shelter's staff were out sick or quarantined because of the virus, she added.
"When I tell you that COVID was for all of us a really challenging and incredibly stressful event, it's an understatement," Downie said. "People were living in shelters with beds that were a couple of feet apart with no barriers. We had, at the time, no PPE. People were literally eating, sleeping together in very close contact. It was probably the worst environment possible for this kind of escalation."
An injection of federal emergency aid helped shelters across the state open additional sites using hotels and dormitories, where they could steer additional clients to reduce crowding and in-person exposure risks, and to rehouse people.
While Downie praised the success of those efforts, she said the short-term response also underscored the need for permanent change.
"We cannot go back to shelters the way they were," she said. "We cannot go back to the kind of overcrowding we've tolerated across the state. We're really looking to change the numbers in shelter and looking to do as much as we can to rapidly move people out of shelter."
While the COVID-19 pandemic posed additional obstacles, advocates and industry leaders said the state has underfunded their work for years.
More money will be needed to catch up and ensure Bay Staters are getting the best care possible, they said, echoing arguments made about the state's K-12 public school funding formula overhauled in the 2019 Student Opportunity Act.
During Wednesday's briefing, the Coalition for Homeless Individuals said money that flows to its roughly three dozen member agencies via the annual state budget typically only covers about 65% of the costs incurred to help people experiencing homelessness.
"The shelter and provider system that supports homeless individuals has been stretched for years — but we are not at a breaking point," said Susan Gentile, CEO of the South Middlesex Opportunity Council. "The COVID pandemic permanently altered how we serve our guests but without additional funding we will not be able to adequately serve all those who need our help."
Funding expended in a trio of line items the groups flagged has increased in recent years, from about $59 million in FY20 to a projected $79 million in FY22.
The coalition said it will press lawmakers to bump that figure up to $110 million for the upcoming budget year, roughly $17 million more than the amount Gov. Charlie Baker proposed in his $48.5 billion spending bill.
LaFranzia said a larger budget allocation each year is key because homeless shelters are not eligible for so-called Chapter 257 social services rate adjustments that other providers can receive from the Executive Office of Health and Human Services.
The push for additional state funding to support shelters and supportive housing comes after a reignition last year of the intertwined homelessness and addiction crises in the area of Massachusetts Avenue and Melnea Cass Boulevard in Boston.
A city survey found more than 140 people living in the area in December, before Mayor Michelle Wu's Jan. 12 deadline for getting residents into housing and removing encampments.
As of this week, six expanded housing and shelter sites designed to help "Mass. and Cass" residents — including Pine Street Inn's shelter at the Shattuck in Jamaica Plain — were serving 175 people, an increase over the 143 initially served on Jan. 12, according to Wu's office.