Welcome, everyone. We might have a few stragglers coming in who registered but aren't here yet, but
we're going to go ahead and get started.
I'm excited to see you all. We have not had an in-person event for a while, so thank you for coming.
This is really good to see a lot of familiar faces, but also some new folks as well. I'm Mary Morgan
with Heading Home of South Central Indiana. We periodically hold these kinds of trainings on issues
that affect or are useful for different agencies and organizations throughout the community.
We are going to be focusing on our 2025-26 winter contingency plan, which many of you were involved
in putting together. So thank you for that.
But before we get to that piece of our program, we are excited to have Ashton Jacobs here today. He
is a nurse practitioner with Health Net's Homeless Initiative Program, and he is going to go over some
information about how to take care of people in severe winter weather. So let's welcome Ashton.
I've done in like 10 years so you know give me some grace here. So like I said my name is Ashton. I
am a nurse practitioner with the homeless initiative program here in town. Myself and my colleagues
we do street medicine so our clinic is whatever we carry around with us. We go to homeless shelters
a lot of times we're at Wheeler Mission. I do some work at permanent supportive housing at Crawford
Apartments.
but then we also try our best to get out to wherever people are. We're pretty familiar with the encampments
by the beeline and Switchyard Park, so on and so forth. So I was asked to put together this presentation,
and I wasn't exactly sure about the nature and the composition of my audience, but it is basically a
primer on the basics and the underpinnings of what to do when it's cold as far as protecting the human
body and human life goes.
So without further ado, cold weather injuries, a serious topic here. And we're going to start with a
reference to my favorite film, or one of my favorite films of my childhood, The Matrix. If you recall,
in The Matrix, humans were turned into batteries to power robots.
which is a pretty outlandish idea. It's also horribly wrong because that's like the most inefficient
way that you could generate power. That being said, there is some, there's a modicum of truth in this.
We do generate a fair amount of thermal output and that's gonna be really important as we move forward.
Either way, it's a super cool film. If you haven't seen it, what are you doing? Some nerdy stuff here.
This is basically some of this,
I want to kind of explain this because my opinion, if you understand some of the fundamental concepts
associated with thermoregulation and thermodynamics,
it better helps you understand hedge cases. You might not remember all the rules, but if you remember
the concepts, you can apply them to help your clients, your patients out. So that formula you see in
the top of the screen, that is the actual formula for determining homeostatic thermoregulation in the
human body. I don't think any of us will be applying that, myself especially.
But it just goes to show how complicated it is, the movement of all the different energies that move
around your body. But the big rule of thumb here is that heat will always move from a hot system to
a cold system. And it does this from a physics perspective in three different ways. Conduction, which
is your hand.
touches something solid, and the heat from your hand transfers to whatever object is there. Or if the
object is hot, it transfers to your hand. You touch a hot pot in a stove, notice how fast that heat
transfers. It is almost immediate, right? So conduction is one of the fastest ways that you can transfer
heat from a hot to a cold area.
Convection is the other one. Convection is really conduction with extra steps in my mind. Convection
is when you have a heat, you have like a wind moving air through a system or you have water moving around
a system and that is constantly pulling away heat from an area. Depending on if it's a liquid convection
or if it is a air convection, that can be like moderate to slow heat loss in that way.
And then radiation is the one that we really can't do a whole lot about. We are always radiating heat.
When you think radiant heat, think about a coal in a fire. It's barely putting off any light. But you
put your hand over it, and you can still feel the warmth coming off of it. That is an example of radiation.
And then for human body, there is evaporation, which is not technically, from a physics perspective,
a way that heat is transferred. But it is vitally important when you understand human thermoregulation.
Another kind of important underpinning is the square cube law. The idea with that is that the more volume
someone has, proportionally the less surface area they have. So surface area is the area that interacts
with the environment around you. Things like fingers, nose, ears, these are areas with low volume but
high surface area. You're gonna change, exchange heat very quickly in that, whereas areas with
high volume low surface area, your core, your upper legs, these are areas that can generate heat and
preserve it much better. So that's kind of an important underpinning to consider as well. Like if you're
cold, what do you do? You tuck into a ball. You are effectively decreasing your surface area and increasing
your volume by doing that.
The final one is basal metabolic rate. A lot of things that people forget in the cold is that your nutrition,
in terms of just raw calories, is one of the most important things. When you shiver, you can increase
your basal metabolic rate by up to fivefold. Now that's probably not sustainable long term, but it just
goes to show that you can increase greatly your thermal output. If you can't sustain that with calories,
there's no way you're going to sustain that kind of thermal output either. So nutrition is vitally important.
So these are some of the important factors. I've discussed a lot of these already. Calories, keeping
them well fed is super important. And honestly, this is where things like fat, which have a lot of caloric
value for low weight, is really important. Keeping dry, we talked about conduction, convection.
Once you have water involved, the heat transfers can increase up to 25-fold. So you will lose heat a
lot faster when wet. Layers, that's really important. And we'll get to that more in a little bit. Hydration,
we often forget that hydration is involved with just about every metabolic process in your body. And
so people are often deluded into not drinking as much, oh, because the water is cold. Yes, but if you
don't stay well hydrated, you're in for a bad time. Alcohol.
Also nicotine, these are both substances a lot of our clients use. Nicotine is going to be a tough one
because it actually causes your veins and arteries to constrict on the periphery. So if you're already
having reduced blood flow to your hand and you're smoking a cigarette, you're making it worse. By the
same token, alcohol is a vasodilator. It will cause your blood vessels to expand. And so while you might
feel great and warm for a little bit,
If anyone knows the story of the baker who got drunk on the Titanic and survived in the water because
he was drunk as a skunk, it's a bit of a gambit, right? You will lose your core temperature incredibly
fast, but you'll feel pretty good for a while. So those are both substances a lot of our clients use
that can be difficult. And then ground insulation is a huge important factor. Remember, conduction is
the fastest way to lose heat many times. And then wind, trying to avoid the wind.
I spent like 30 minutes trying to make up an acronym for all of these together. The best I could come
up was Caiklin. But that's really stretching for it. So if anyone has an idea for a better acronym,
please reach out to me. I may have to do one of these presentations later. And if so, I feel like Caiklin's
kind of lame. But it's a nice little acronym. Might help you remember it. Calories, air, aqua, keep dry.
which is a fancy way of saying alcohol, layers, yard insulation, ground insulation, a bit of a stretch,
and nicotine. So things that modify the air temperature. You will always hear, oh, it's going to be
25 degrees today, sunny, with a chance of, you know, whatever.
Whether things that can modify weather so the effective temperature that your body is interfacing with
is actually lower than the bulb temperature as it stands. Wet is probably the most concerning one. I
tell my boys who are six and three, it is one thing to be cold. It is another to be cold and wet.
Like I said, 25 increased thermal loss when you are soaking wet. The risk of hypothermia goes all the
way up to 60 degrees ambient temperature when you're wet, which is not that cold.
But if you're dry, you can kind of hold out up to 40 degrees. Wind is another one. It's kind of got
a weird curve. If it's a very low wind speed, it really doesn't do that whole lot, like 30 degrees because
it's 27 degrees Fahrenheit with five mile an hour winds. But if you go up just a little bit to 10, it
goes down to 16 degrees effective temperature. And it peaks out at about 40. Once you're past 40 miles
an hour, it really doesn't make a lick of difference.
I really hope we got bigger problems if we have 40 mile per hour winds sustained here in town. So. There
are a lot of medical terms regarding cold weather injuries but I'm going to kind of brush over the big
ones. But really you can divide them into two categories freezing and non freezing injuries. Hypothermia
is basically when the body loses all of its energy all of its thermal regulation.
globally, across the entire body. Frostbite, which we'll talk about in a bit, that's when it's more
isolated to a specific area. Hypothermia basically starts officially when the core body temperature
is dropping below 97
97 degrees Fahrenheit. However, there are three stages to it, and I forget exactly the cutoffs for each
one, but it's kind of a spectrum of illness. In mild hypothermia, it's very vague, nonspecific. They'll
be hungry, a little bit irritable, maybe not quite as sharp as they normally are. They could be shivering,
right? You expect to be shivering. And the two I would like to point out is shivering and fast breathing.
In mild hypothermia, the person still has good thermoregulation.
is fighting back. So they're breathing faster because they're increasing their metabolism and they're
shivering because they're trying to increase how much heat they're outputting. So what do you do? Well,
this is a great comic that I think accurately demonstrates it. Bill Watterson, please don't sue me.
This is from Calvin and Homs, if ever you remember, one of the greatest comic books ever made. And the
idea here, it's grandma treatment, right? Keep them warm.
Get them next to an area of warmth. Keep them dry. Give them something with a lot of calories, like
the peanut butter crackers and the hot chocolate that Calvin is getting here in this comic strip. These
are all things that kind of help someone get warm in a mild hypothermic state. And that's pretty quickly
reversible. But it does take a lot of energy if you can even get more nerdy and talk about specific
heat of water. To raise a small amount of water's temperature takes a ton of energy. And we are mostly water.
If it is anything lower than mild hypothermia we are now in the area where you should not be intervening
at all. This is now getting into like pretty serious medical conditions. If you get to moderate hypothermia
or even severe hypothermia it has a 40 percent plus mortality rate. And so this is beyond something
you can treat on the street and frankly
I mean, at this point, they're going to be lethargic. They're not going to be thinking well.
And if they say, no, I don't want to go to the hospital, I would still call 911. It's arguable that
they do not have capacity to make that determination at this point. The big thing with higher degrees
of hypothermia is that they are slowing down. In mild hypothermia, the body is still putting up a fight.
But once that starts to fail, they start to fail. And this eventually results in cardiopulmonary arrest.
the electricity in their heart basically gets all wonky and their heart will stop. So yes, if you think
that someone is beyond mild hypothermia, then you need to be getting a medical evaluation ASAP. And
you can start warming them immediately to try to mitigate it. Frostbite, like I said, this is where
the injury is more specific to an area. Hypothermia is global heat loss. Frostbite is when heat is lost
to a specific area and it freezes. And I talked about this earlier, we are about two thirds, 70% water.
Water expands when it freezes. It's one of the few substances that does that. But if it expands, it
causes traumatic damage everywhere that it freezes to. Areas with the highest surface area to volume
ratios tend to be the most affected. Like I said earlier, square cube law, your toes, fingers, hands,
nose, ears, all these places are more susceptible to frostbite.
At first, frostbite's a tricky medical diagnosis to make because there's no real imaging or cutoff for
it. It's a clinical diagnosis, which means that you just kind of have to decide it based off of your
physical examination. And it doesn't look too bad. And it won't feel too bad either. The person loses
sensation to whatever part is getting frostbitten. But the key is that something that's frostbitten
feels hard. It feels hard because it's frozen. And so it won't look too bad. Sometimes you can
get some blistering, like as the water freezes, it can shear blood vessels and cause like some bruising.
But they generally don't look too bad, just kind of this pale, slightly swollen, hard section of the
body. However, over time, the damage will become readily apparent. The most important thing I would
say with frostbite, if you ever encounter a situation where you think you're onto it, is do not rewarm
that area until you are positive that it can stay warm.
You, by going into a freeze-thaw cycle over and over again, you are actually causing more harm to the
person just by waiting it out and then warming it up once.
So if you have a shot at warming it up obviously do so but make sure you can maintain that or you have
a high degree of suspicion that you will be able to maintain that before you start doing it. If you
do decide to warm like if you're trying to warm up someone from frostbite because they won't go to the
ER or you're waiting for 911, the best way to do it if you can is kind of have tepid to warm water and
immerse the part of the body that's frostbitten into it. It will hurt like crazy because what happens
is is after the part of the body warms up it gets slammed with
all these inflammatory cascades and that's when you start seeing the destruction from frostbite. NSAIDs
work particularly well. That's things like ibuprofen if they have some on hand. But all frostbite needs
to be evaluated because within the next three to five hours as those inflammatory markers start swarming
into the area, it will start swelling, blistering, and then eventually
you will start figuring out what tissue has died and what tissue has not. You will never really know
until everything's warmed up. And you'd be surprised. Sometimes a person reclaims a lot of tissue. Other
times, they don't reclaim a whole lot at all. And then the final part is your body basically demarcates
one area. This is where it's alive. This is where it's dead. And then that's when you see the more typical
signs of frostbite. Let me use my laser pointer here.
So let's look at this one here. You can see how it's almost dry and shriveled up. That is 100% dead
tissue. That's probably not going to come back. Maybe the bone is still alive. But this is obviously
something that is mostly dead. Up here, it's a little more interesting. This is blistered. And you can
see that kind of bluish discoloration. There's some tissue necrosis going on there. But it's hard to
say how much of that finger is salvageable. I don't know how many of you have seen
I mean, I know over this last winter when I started the job in January, I've seen a lot of partial finger
amputations from frostbite. And that is why, you know, it's hard to tell. All of this needs to eventually
be evaluated by a hand surgeon. But the ER is a good place to start. What I would say, too, as far as
keeping your hands warm, a little tip is that
Gloves are better than mittens. We talked about surface area versus volume. Mittens basically create
one encapsule for the entire four fingers, whereas gloves allow surface area interface with the environment
for each digit, which is why you'll actually lose heat faster with those.
Chills Blaine, which I just call frostbite light, is a non-freezing injury. So this is where you're
kind of exposed to the cold over time. And it causes that inflammation I talked about associated with
frostbite, but it's a little bit more diffuse. It's a little bit less suspicious. But if you do think
someone may have Chills Blaine, the biggest advice I give is the same as you would with anything else.
Keep it warm, keep it dry, keep it clean, but also some reassurance that the pain goes on for a while.
Now, if you're not a medical personnel, you're not supposed to like die
but this is just good information to kind of have on hand. Many of our clients will refuse to go to
ER urgent care, or they won't, but it's just some good general intel. There is a thought that Chills
Blaine can be related to underlying inflammatory issues like lupus or autoimmune disease. I might not
mention that to most people, but there is some evidence that people with Chills Blaine tend to have
a proclivity towards this. And then the final one I want to talk about is trench foot.
Well, what was formerly known as trench foot, the technical name is immersion foot now. Everyone would
know what you're talking about with trench foot. Trench foot is, it's not specifically a cold weather
injury, but something you often see in the cold. People don't want to take off their shoes because it's
too cold to do so. The basic idea behind trench foot is that, you know how your fingers get pruned up
when you're in the bathtub too long? This is basically that on steroids. You have this kind of breakdown
of the skin, you get this big,
Basal inflammation going all over the place. It's pretty uncomfortable. The key is just to keep it clean,
keep it dry. Most of the time, that's enough to reverse it, but trench foot or immersion foot often
leaves people susceptible to more serious injuries or more illnesses, and that's why it has to be monitored
closely. That is something you will likely see in the cold, but it can happen during hot weather as well.
Keeping warm when someone's roughing it. So this is we're now switching into What's some strategies
that individuals can do who are unhoused that might help them stay warm during the winter? Tents a lot
of people push for tents They think oh it's gonna insulate me and it kind of does but more from the
wind than anything else tents actually don't do a whole lot to save you from
from heat loss. However, they protect you from wetness, and they protect you from wind. And that is
where their most important factor comes into. Another thing that people often forget is that a fair
amount of heat you lose when you're sleeping is from the ground. The harder and the more metallic the
ground, the more likely it is to sap the heat out of you.
And thankfully, there is a pretty easy remedy for that, cardboard. Cardboard has an insulation factor
that's about as close to some high-end camping mattresses. If you have an inch of corrugated cardboard,
that's the equivalent, as long as it's dry. The second cardboard becomes wet. It is no longer effective.
Excuse me while I turn this off. Another thing to mention is a lot of people
Put fires out when it's cold, makes sense. It gives off a lot of radiant heat. That is generally a no-go,
especially if it's inside a tent. That is extremely dangerous. But if you do it outside a tent,
that's fine, as long as it's a well-ventilated area and it's not going to cause some sort of fire risk.
But that's something that a lot of people do. We all kind of remember people using hand sanitizer to
burn last year. That comes with a lot of risk, especially in an enclosed space. And the final thing,
I told you I'd talk about this later, layers is probably the single most important thing. A lot of times,
people want
simple clothing, they just want one big layer that holds everything in, but there's this careful balance
that you have to do when it's cold and you're doing any kind of activity. You do activity to get warm,
but if your body overheats in the slightest, it will start putting out sweat.
And sweat, when it evaporates, takes too much of your heat away. So the idea is that if you're doing
any kind of exertion, you want to be able to shed your layers to get to the point where you're right
at that nice equilibrium. Not too hot, not too cold. And then you can re-layer on as your activity goes
down. Because if you do it in just one layer and then you get really sweaty, the second you stop moving,
it's going to be a bad time. So that's some good advice.
Lots of smaller layers is better than one giant layer. And then also, we talked about the square cupola.
If someone is doing exercise to keep themselves warm, it is much better to do a squat than push-ups
or bicep curls. And that's because the idea is the heat is being generated in your core and your upper
legs. That is where it's going to be dispersed less. Your body will use blood to reroute your heat across
your body to try to keep areas perfused. But if people are moving their hands and stuff like that, a
lot of that heat is just going to be lost immediately.
Uh, rubbing? Yeah, like that, no? I mean, not a bad idea. It's friction generates some heat. And I suppose
if it's held like purposely against their body, you've basically gotten rid of all the surface area
on the front of your palm, not to the back. I mean, it's not a bad idea. But like I would say, if someone's
trying to exercise, I'd recommend squats, right? You're just going down, up, down, and up. You're involving
almost all your major muscles
And that's not gonna be lost as quickly as anywhere else But yeah, I mean do whatever you can people
will do what they do to stay warm But as a general thumb the more you can exercise your legs, especially
like the more that heat is gonna be kept in the core So what if someone is like you go out you're doing
some outreach and someone's like yeah, I got a fire inside my tent Well, don't do it keep like
encourage them not to light a fire in their tent. It's got carbon monoxide. However, there are some
little tricks and tips that you can use to help someone use a fire to warm the inside of their tent.
Probably one of my favorite ones is taking a stone, preferably a non-porous stone, because the porous
ones can have water trapped inside and explode when you heat them up. But if they're non-porous, you
can warm them up, shove it inside a sock, and then leave that inside your tent. That should disperse
heat for about two hours or so.
And that provides a fair bit of thermal regulation inside a tent. The other option is if you can get
water boiling and put inside like a metal water bottle, that also confers a lot of heat to the inside.
But if they do use a plastic bottle, they should not drink it afterwards. That's the only other thing
to think of. And then any time they heat up an object, there will be a temptation to put it directly
against their skin. That is a potential recipe for skin burns, so something to be careful about.
Okay, well, what if they say, screw that, I'm just gonna burn something inside a tent anyways, no matter
what you do. Okay, well, if they're gonna do what they do, and that's a reality for a lot of our clients,
at the very least, I thought I'd include some information about how to make it as safe as humanly possible.
I am in no way endorsing this. It is basically turning their tent into a potential death trap. That
being said, there are some ways it could be done to make
it at least somewhat safe. You'll see a picture here of a setup that I really liked as I was looking
through it. This is really cool. Basically that jar at the bottom is filled with rubbing alcohol and
it wicks up into this copper pipe near the top and the heat from the flame evaporates it
And so the air circulates underneath the loop, and then it burns out through the top. That terracotta
pot that sits over it is to collect the heat and then radiate it out slowly over time. It was a pretty
cool setup. So I mean, if they have to do it, if you come across someone doing something like this,
I'd say you are in no way obliged to enter that tent, because that is putting you at danger for carbon
monoxide poisoning, that sort of thing.
But if someone absolutely has to do it and they are hell bent on it, then I would say a setup like this
with a stable base or with a small flame that is unlikely to cause a major fire risk is the best way
to possibly do it. And also keeping good air ventilation. You want a source of air coming in from the
base of the tent and exiting out the top to create continuous airflow. I'd also remind you a lot of
our patients clients are using substances that
greatly impairs their judgment or their judgment is impaired anyways. It will be a case by case basis
on how you navigate this, but the reality is if you ever find someone burning something inside their
tent, you know, do what you can to mitigate the damage that they could potentially cause to themselves.
And that is everything I've got. Does anyone have any questions for me?
So mittens the idea that you're all your non thumb fingers are encapsulated in a single pocket is superior
because it decreases the surface area of each individual finger. I mean something's better than nothing.
And the best setups I've seen are taking gloves like wool gloves. Wool does very well even when wet
as an insulator. So wool gloves inside a mitten is probably your best bet.
Because the wool gloves can be exchanged out if they get wet. And then you can keep the actual mitten
dry. And like I said, that's important. Any other questions? All right, sweet. Well, here's my sources.
And there's my presentation. Thank you very much. Thank you. Thank you so much, Dash. And that was really helpful.
Talk amongst yourselves while I change to a new slide deck. Don't notice the man behind, the woman behind
the curtain. Tell a good dad joke.
That was a very quick talk amongst yourself. Sorry about that. We're just going to move right into our
2025-26 winter contingency plan discussion. Are you with me? OK, great. We want to give props to all
of you who have been doing this for so many years.
And then especially to the Wheeler Mission crew, who at the end of last season had some meetings that
were foundational for looking at how we can improve our work related to severe weather planning. We
at Heading Home picked up that work, used that baseline, and had additional conversations with many
of you in this room and other community members.
talking about how we're doing things previously and then how we can make them better. One of the things
I wanted to do with this group to start off with is take a look back at the last season or previous
seasons and kind of reflect on what do you think worked really, really well that we should definitely
keep doing? And maybe what are some of the things that we can improve on? So these are just some questions.
Who or what do you think was
instrumental in meeting some of the winter needs last year. Just shout it out. The Church Warming Center,
the BSWERS Warming Center. I know a lot of people use that and had some interactions with that. I don't
think there is anybody here right now from BSWERS. I don't think they could make it. But we'll talk
a little bit about some changes there later in this presentation.
So Beastverse, yep. Anything else that we should just absolutely give props to? Wheeler Mission. Wheeler
Mission. I'm going to come over here, Bill, and I'm going to have you tell me why Wheeler Mission did
such a great job. Oh, it's really easy. They are the big shelter in town, and they've bent over backwards
to help folks get in and lower barriers as much as possible.
Yay, Wheeler. Yay, the Wheeler crew over here. All right. What are some of the positive outcomes that
you saw last season? Are there any examples of things that you saw as part of that winter contingency
effort last year that you'd want to give some shout outs to? Celebrate. Any individual or something?
OK, Charles.
I have to because because our friends here at Katz need to need to hear you through the microphone again.
Jamie from the county sends out emails in regards to weather changes and advisories and that has been
incredibly helpful.
Yay, Jamie. Jamie was invited, and she and her crew had some training in another community. So we did
not have her here, but we're going to get into a little bit later her new role and that department's
new role at the Monroe County Emergency Management. And then what lessons did you think you learned
during the last season that we should apply this time? Are there things that you
change during the year that you feel like we need to make sure that we continue? Anything like that?
Yeah, Melissa? I think that our end, like, we had a couple days or a week or so of just severe weather
and the fact that everybody just pitched in. I think that was the biggest lesson as to how well we were
made to and how we can really kind of hit on that as well, just to make sure that nobody freezes to
death, nobody dies. Yeah.
Katz viewers. Melissa was just saying there was a period where there were a couple of weeks of really
severe weather. People really pitched in, coordinated, really worked together as a community very, very
well to make sure that nobody died. And that's our goal, right? That nobody dies or suffers from severe
injuries. All right. So let's give a round of applause for last year. Yay. Okay.
On your tables, there's a QR code. There's a QR code here to the 2025-26. Severe weather sheltering,
we used that instead of winter contingency just so that people might understand a little bit better
what that is. This is a heading home led effort with many of you involved to really put together something
that the community can see.
and that can demonstrate how coordinated we are and a few new elements that we're adding to see if we
can make it even better than last year. And of course, our objectives to prevent injury or death,
number one. So there are a lot of people that don't necessarily go into shelter. We want to make sure
that everybody has a place where they're comfortable and safe during winter weather that's very severe.
So just a general description.
This takes effect November 1st through March 31st. Obviously there are other days before and after that
period that we might need to activate but that's the general time when we put this winter contingency
plan into effect. There are some changes in the community and how we do things to make that happen.
One of the big changes this year is that Jamie Nibel and the Monroe County Emergency Management Department
is going to take the lead
in activating white flag nights. So in the past, and I think this was particularly true for BSWERS,
the faith-based shelter, everybody was kind of making their own call and using different temperature
or other criteria. And so we're giving that responsibility to Jamie. We've had some conversations with
her. We're excited about this new role that she's going to play.
So she will have access to the forecast. And as Charles mentioned you know they do that already. So
what additional step they'll do is based on these temperature and wind chill criteria. She will send
out emails to distribution lists that we will provide for her which will include all the partners that
are involved in winter contingency as well as heading home so that everybody knows that OK from this
date to this date
We expect that there will be white flag nights and we'll need to start our winter to contingency protocols.
So that is a great thing I think for our community and what we are excited about is the possibility
of talking with other counties in our region to see if their emergency management departments would
take on that same role. So we have a centralized point where everybody can look to to get that information.
And then we're going to do a partner round up. So the.
Details of all these groups are in the full winter contingency plan, which is on your table or through
the QR code online. But we really wanted to just go over. And if there are those of you that have not
met some of the people that are involved in these shelters, that you have a chance to do so now. So
I guess I'd really like to just have folks who are from some of these different agencies just raise
your hand so everybody can know who you are. I don't see anybody from New Hope here. Am I wrong?
Anybody from New Hope? No. How about Monroe County Youth Services Bureau. They are dealing with the
youngins. I don't see anybody here. I do see people from Wheeler Mission. So yay. All right. We have
folks from Beacon. I don't think they're here. Middle Way House also. I don't see them. So we miss them.
They're here in spirit.
These are the places that are operational and that will be adapting in some ways when there are white
flag nights. And then this is the BSWARE's program that we mentioned earlier, the Bloomington Severe
Weather Emergency Shelter. One of the big changes that is happening this year is that there is a new
church that's going to be involved. So last year, there were two churches, First Christian Church and
First United Methodist downtown.
And earlier this year, the congregation at First Presbyterian Church downtown also voted to join this
effort. So yeah, let's give it up for BSWARS. They need to activate, oh yeah, go ahead.
Yes. So there the fire was on the roof it was contained. And as far as I know unless things have changed
since I last talked to Caleb they're still good to go. Yeah.
They do need a little more time to activate because it's a volunteer-based group. So that's one of the
things we're going to communicate to Jamie, that we need as much time in advance. And that's a little
tricky, right, because weather changes. So we'll see how that goes. And they primarily prioritize women
and people with medical conditions, but they also take other folks as well. And then crisis intervention
and winter outreach
Shout out to our friends at Stride. Jennifer's in the back. Stride Center does offer some of emergency
overnight capability but I think that that is I'm going to ask Jennifer to speak to that a little bit
and also to the role that you play in the mobile response. Can you come up here. I told you I was going
to put you on the spot.
Hi, everybody. I didn't know I was getting the microphone. Awesome. So firstly, let's just say we did
an amazing job last winter. So let's keep it going. I'm all inspired again. But the Stride Center is
definitely here, as you all know, for 24-7, 365 walk-ins. So we greet a lot of individuals at the door.
And in the winter, come on in. I'm not gonna misrepresent that we don't reach out to our lovely folks
at Wheeler and our awesome partners at Friends Police Shelter as well. And then also the Emergency Winter
Shelter to see if there are shelter capacity for the individuals at Stride.
because we do want to reserve the space that is available at the Stride Center for individuals who cannot
access a safe space to sleep, right? So I think that's kind of where we come into play is mobile crisis
was out on the streets last year. We were definitely showing up in the nighttime hours at the emergency
winter shelter.
because our experience from what we viewed, there were still individuals that were lined up outside
of the church and there just wasn't enough room. So our team volunteered to go put them in the car and
figure out how to keep them safe with these goals in mind. We ended up sometimes having two teams of two
Going out so two cars out on the road Because we definitely wanted to keep in mind that when it's a
very cold outside We got to go fast, right? We had a great representation as well. Shout out to our
sheriff's department officers in our BPD officers because they're very familiar with first of all how
to encourage someone to get in their car as well and come to the strike center and our officers are
phenomenal and
They bring them to our front door as needed throughout the winter. So do we have beds? No, Stride doesn't
have beds, right? Because we're not licensed as a shelter. Are we going to welcome an individual who
is experiencing homelessness into the Stride Center?
Yes, we are. We're sorry we don't have a comfy bed, but we do have a warm, safe space for you. And we
also have peers in recovery and crisis specialists that will try to support you in any way that we can.
So some mornings at Stride, we did have 10 to 16 people hanging out with us. And that's OK. Stride wants
to continue to partner as a resource here in our community.
We definitely want to be available. If you all ever want to bring anybody over, go ahead and do it.
And encourage folks to seek the Stride Center or call the Stride Center and ask for Mobile to come and
pick them up anytime in the winter. We will be transparent if our teams are busy. But Mobile also swooped
into several tents outside
who just miraculously survived super cold nights for people who still chose to sleep outside at night.
And we were able to bring them to other resources or the Stride Center to warm up as well. I love our
community. We are amazing. I'm proud of all of you. And we're here for you. Thank you Jennifer. You
have a question. So I was asking about the 23 hour safe stay.
So if they were to pick someone up one night and then they're back on the streets the next night. What
is the protocol for that I guess. Did you hear that Jennifer. What is the protocol if somebody stays
the 23 hours and then comes wants to come back the next day. Welcome them back.
the next night as well. We are going to continue to encourage use of safe shelter and verify safe shelter,
so I don't wanna falsely advertise that. And we're also gonna offer a safe ride to that shelter if it's
available. I think Nicole and Patrick got used to seeing us pull up there a lot last year. All right,
great. Also wanted to give a shout out to HealthNut, the Homeless Initiative Program.
during their, the winter, I mean, they're out on the street all the time, right? But during winter weather,
they also mobilize for unsheltered individuals. And the Bloomington Fire Department Mobile Integrated
Health Unit. Woohoo. All right. This is an important piece of our communication and the services that
are provided here. Jennifer spoke a little bit about transportation. That is an ongoing challenge, right?
One of the things that happens as she mentioned is that there is somebody might show up at one place
there's not a bed available. And so how do we transport that to a place where there is a bed available
or another warm shelter. We have talked with Bloomington Transit and they have offered to do a pilot
program with us to be available if there is enough advance notice for them. So we're going to check
it out if there is a 12 hour notice they can have one of their bus
has come to the B-Swares location if we think that's where the need is going to be to transport people
to Wheeler or to Wheeler if we think that there's going to be need to transport to B-Swares. One of
the key things that we are missing is that piece of how do we find out where the available beds are.
One of the things that is exciting to me, we have an organization in town called Binary Heart.
that is exploring the development of an app that would allow us to in real time identify the number
of beds that are available. And we have Henley here is from Binary Heart. Henley do you want to say
a few words about that effort. Hi I'm Henley Wolin I'm a national board member for Binary Heart. Our
focus is on empowering people through the use of
surplus technology, but we also have an app development arm. And after talking to Mary, I thought, and
you'd share an article about some, there's a program in San Diego where somebody's developed an app
where people can look at available shelter beds and then be able to reserve a space.
in a shelter. I don't know if we're going to go that far, but I think it'd be nice if there was a central
inventory of shelter beds so all the shelter providers can look and see. So like say Wheeler is filter
capacity, but there are two beds over at Friends Place that you, instead of like having to make tons
of phone calls, you can just look and see, oh, you can go over to Friends Place and there's a space for you.
That's the idea. Thank you. Thanks, Henley. So as I said, this is in very early stages of development.
And one of the things that Henley would like to do at some point is to talk with the shelter providers
to see how that might work. But I think that that's a thing that is a really creative approach to problem
solving that I hope we can capitalize on.
We also rely on day centers and warming centers. We do not have the current list yet but we will be
updating the winter contingency plan with that information as soon as we get it. They are in fire stations.
Of course the library serves that role in some capacity and as well as day centers the Shalom Center
and the Wheeler mission.
day center. Now that is going to even in your reconstruction and renovations that's still going to be
open. OK. Awesome. And then animal care is an important piece of the puzzle. Some people don't go into
shelter because they don't want to leave their
Dear furry friends so we have several we have a couple of organizations primarily the Monroe County
Humane Association that will step in and Andrew Krebs had attended some of the meetings when we were
developing this plan so they're on board with that. The animal shelter for the city of Bloomington does
have a temporary shelter but it is shorter than the Humane Association.
And then there are some after hours assistance numbers to call. And so that brings us to general Q&A.
What I would hope to do is for you all to tell us what's missing. What do we need to pay attention to?
What are some things that you feel have been either overlooked or not highlighted?
So that we can add to this living document because we are definitely not saying this is a Document written
in stone. We need to keep learning and improving And so one of the things we hope to do here was to
get some more feedback from you all So is there anything that you have seen noticed? Yeah Hang on
Last year, we had came across an individual that went to one of the day warming centers, and that warming
center did not know they were a warming center. So yes, I feel like that might need to be addressed
at some point. Yes, indeed. OK. Do you happen to know the category of warming? Like, was it a? I don't
want to say it's too close to Shelby, but it was a firehouse. OK. OK.
Well, I think that that's really important feedback. Because one of the things that we need to do for
all of the resources that we have is make sure that they are up to date and not misleading, right? Because
the last thing you want is somebody to slog through a snowstorm to a place where they're not available
for help. Yeah, yeah. OK. That's great feedback. We will definitely keep an eye on that. I think you
and I already talked about that. I think they're updated now. They are updated? OK. I think you and
I already talked about that. Yes, we did.
And so I will update the plan. Do you know where they live? Can you send me a link? Online? Sure. OK,
that's great. And then I'll just update the plan. Fantastic. Anything else? Bill, looks like you're
thinking. No? I'm just thinking of the list of things I need to do. That's it. OK. Yeah, Bobby. Every
year we have a conference of township
Every year this man presents that look that is up in the Indy area, Noblesville and in that area. And
he has a mobile unit. It's a bus. Have we had him come down maybe to talk because he goes where the
people are. They can sleep in the bus. They have coffee. They have he keeps
like vending machines that have toothpaste and toothbrushes. So it's a mobile unit that goes where people
are staying on the streets. And we haven't had him come yet, have we? Do you have it? I have it at work
because he's also expanding. It is the most wonderful program, the way this guy has it set up. And he's
expanding.
I think offering to increase the area he covers, he wouldn't be every night, but he would rotate through
a community if they're interested in him being there. But I'll get that to you, because I think we should
have him come and talk to us, because this was his idea, because he had been homeless. This was the
solution he came up with, and he's created this just incredibly humanistic way of getting to the people
that are most needing help.
So I'll find out for you. Does this sound familiar to anybody? Anybody heard of this particular program
out of Indy? No. And for those of you who don't know, this is Bobbi Summers. She's awesome. She's with
the Richland Township Trustee's Office in the Ellitsville area. So if you could send that to me, yeah,
we can get in touch. I thought you could come and do a presentation at one of your meetings so we can
start. And then problem solve how we might
I'm all about picking brains. Thanks Bobby. Any other feedback things we should change make sure that
we are paying special attention to as we head into the winter which guys it's coming. I looked at the
calendar the other day November 1st is how many weeks away. Not too many two weeks. Oh my gosh.
Any other feedback on this plan. All right. Well what I hope you can do is after you cogitate and reflect
that if there are other changes to make that you can get in touch with us here at Heading Home. We're
housing the plan and updating it and making sure that we actually follow through on some of the things
that this plan outlines.
And so my email and phone number is here. This is a happy picture that we need to update, because we
have some new staff coming to Heading Home. And it's a good opportunity for me to introduce
Erin Reynolds-Nylund, who is new to Heading Home. She's our new Housing Solutions Director, and will
be overseeing the case managers for street outreach and diversion prevention that we're bringing on
board. So let's give it up for Erin. Yeah, right.
And of course, Tatiana Wheeler, who is my partner at Heading Home for all these many years. Did you
have another question? How do we find out when it's a white flag day? Well, if you recall, so Jamie
Nibel is going to be the one for the Monroe County Emergency Management Department who will make that
call. And we're going to give her a list of everybody who is part of that
response team. If you want to be on the list, let me know. Because really what we're focused on at this
point are all of the agencies that are partnered here. SCAP is not, but maybe it should be. And maybe
that's a, yeah, we'll talk later about.
Yeah, it's gonna be blasted out on social media as well. So that would be, but I think that that's a
good point, that people who maybe are not part of the response, but that are working with clients that
would need that information, that's a good point. So we'll be putting that distribution list together
and then sending it out to folks to get feedback on who else needs to be involved in it. All right,
good feedback, yep. Sorry I'm coming in late with this, but just one more point that I thought
might be interesting to bring up to the group at large and I could task myself with this as much as
anyone but I think this plan is great working with the resources that we have. One thing that if we
if we really wanted to get folks indoors going forward is just to explore any kind of options we can with
pets and animals. I think that's the biggest barrier right now and has been traditionally and I am that
the human the Humane Association program is such an incredible resource. But but just the the the limited
capacity is you know I mean there's only so much they can do. And I think if we could come up with a
with a long term sort of a widespread solution to that quandary we might we might see some real difference
in getting folks indoors because that's that's that I think that's the biggest barrier.
that I've observed over the years. Let me ask you this. So even with a resource of a place for their
pet to stay, their companion to stay, they might not want to be separated for it at all. So really what
our lack is is places that will accept both the humans and the animals. Yeah. Yeah. So I know Friends
Place does that. I don't think.
I don't think Wheeler does. Service animals only. Service animals only, OK. And I'm not sure about beeswars.
I think they do, but I. Yeah, OK, good. Thank you. Thank you for remembering what was on the slide better
than I did. So beeswars also does. But I think you're right, Bill. We are hearing more and more that
there are more people who are having companions. Those pets, so. Yeah.
a quandary without a solution. It just is, I think, identifying that. Identifying the quandary is the
first step, right? So thank you. All right. Any other feedback as we move into our winter weather? Yeah?
I was just going to say, making sure that the plan is shared with all community resources, and maybe
with the boundaries, Red Cross. Because I think people go to a lot of those places that they don't touch.
And so as long as they're aware of that,
That is a really good point. So making sure that the plan and the distribution list includes food pantries
and folks like SCAP and the Red Cross, Salvation Army, some of those other places, the faith-based
communities, right? I think that's a great idea. Yep. Oh, I like that too. Making a one-page flyer with
a QR code linking to the plan. Yeah.
Great idea. OK, cool. That's what this is for. Yay. Glad we're getting such great feedback.
Anything else? Yes. Oh, I'm sorry, Bobby. Yeah, I just wanted to ask, do we not just have QR codes?
Because a lot of people I work with don't have the resources for it, don't know how to use it.
They're first. Heard. Me included. OK, fair enough.
Understood. So have flyers, QR codes, the URL for a web address, but also hard copies, right? So at
your office and all these other places, just hard copies of the plan or connecting with them and suggesting
the agencies print out copies for their folks. Good suggestion. Anything else before we break for the day?
I'm sorry, I feel like I've had my back to you most of this time. All right, well, thank you again.
Please give yourselves a round of applause for the work you're doing in our community. Thank you, and
have a good day.