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How One Center for Vulnerable LGBTQ+ Youth Is Helping Its Clients During the Pandemic

The coronavirus pandemic has caused strain and hardship in so many ways and for so many people—but one demonstrable effect is that it has made the vulnerable more vulnerable. If it was already difficult to be an LGBTQ youth whose parents or caretakers don’t understand or accept their sexuality/gender identity, that stress is magnified during a time when we, as a society, have been advised to stay indoors. The situation can effectively trap these people between the forces of a global pandemic outside and virulent bigotry inside.

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The New York-based Ali Forney Center (AFC) continues to serve homeless LGBTQ youth, even during a global pandemic, providing housing, mental health support, meals, and a transitional living program that teaches youth to live independently. Though the AFC has been impacted by covid-19 in several ways, it is largely meeting the increased demands, according to executive director Alex Roque, who talked to Jezebel last week about the AFC’s operation in the midst of a crisis. The organization’s drop-in center, which serves new clients with no place to go, remains open (though it has moved to the organization’s Bea Arthur Residence in Manhattan’s East Village). There’s been an increased demand—in part because many of their former clients who were in college have been sent home, which means needing to return to one of the 18 AFC facilities around the city. Despite this, AFC has managed to increase its meal budget and spending for its recently out-of-work clients. (An info sheet sent out by AFC’s communications department says that 90 percent of the organization’s housed clients have lost their jobs as a result of the pandemic.) Further, salaries of AFC’s essential workers have increased by almost 50 percent. “We really felt strongly that we needed to recognize how critical and how valued our essential workers are,” Roque told me.

In our conversation, Roque explained how AFC has managed to do it, and how it is managing in general. Our interview has been edited and condensed.

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JEZEBEL: Overall, how is the Ali Forney Center been managing during this pandemic?

ALEX ROQUE: AFC is in a unique position because we are an essential services provider that’s caring for a largely disenfranchised, uncared-for population of young people who are rejected by their families because of their LGBTQ identity. Around the country and across the world, people have been asked to stay home and to shelter in place and find safety in their homes, and comfort in their families. Our young people don’t have any of that, so it’s kind of a punctuation to what their realities are that even in these dark days and awful circumstances, they have nowhere to go.

Things are pausing. Pollution is down. Wild animals are running free. Critical care hospitalization—like, heart attacks and strokes—has also declined significantly, according to the New York Times. I thought that maybe homophobia and transphobia would also just take a little pause. That hasn’t been the case. We’re seeing an increase in young people in our care and a demand for our work. A lot of it has to do with young people who were in our care before who went off to college and then were sent back because of shut-downs and we were their home before college. Some of it has been with young people who left their homes at younger ages because of homophobia and transphobia and were employed and have lost their jobs and now have no family to rely on. And another part of it is that a number of youth services providers have shut down in the city. A number of the shelters have shut down as a result of staffing issues, a number of community spaces and things like that have closed their doors. That’s increased the demand for our work. But there’s this understanding that covid-19 is disproportionately affecting communities of color, disproportionately affecting communities struggling with poverty and lacking access to care. It’s true for our young people. Among the most marginalized communities, our young people are still marginalized. Among LGBT youth, our young people are homeless LGBT youth.

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Are you able to provide the same services that you were providing pre-coronavirus?

The drop-in center was moved to the Bea Arthur Residence at the recommendation of our medical provider. We have an onsite medical clinic and when covid started, we retained our medical provider to advise us on how to operate following CDC protocol. The CDC protocol was that there should be no more than 10 people congregating in a space. That’s difficult for us to do at the drop-in center, especially because we had on average anywhere between 60 and 80 young people coming there a day. We moved to a smaller facility where we can structure it more: housing referrals, offering meals, and offering crisis intervention for young people at Bea Arthur, and then more importantly, making sure we’re getting them into a stable bed as we work through this. Initially, it was a big increase and then when the new protocols came into place on March 23 about stay at home and 10 people or less, we moved it to Bea Arthur. A bulk of our services that were drop-in related were moved online. About 70 percent of our counseling, mental health, psychotherapy, medical, and educational services moved online. We’re offering those online to young people and we’re still doing a structured drop-in program.

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So, if someone is sheltering in place with a homophobic or transphobic parent, they still can leave and come to you?

Correct. They can come and access a meal, they can come and access support, and they can come and access solutions to housing options. We have 18 sites throughout New York City, and so we have beds at all those sites, except for the drop-in center. So if a young person is unstably housed, they can come to us, have the crisis de-escalation, have the intervention they can offer, and then have a housing referral to our program, which is preferred, or to another program that we work with.

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In a follow-up email, Roque provided further clarification and information about new intakes:Intakes have continued though our main intake site, Harlem Drop In Center services were relocated to Bea Arthur Residence. An intake does not mean a young person is assigned a bed. Unfortunately, there are waiting lists for beds across our housing sites and in many other city agencies due to the limited number of beds. On average we have 100-150 young people on a waiting list for a bed. If a young person is under 21 they are connected to a bed rather quickly because there are more beds/openings of beds in that age range. A young person who is 21 and over on average can wait up to 90 days for a bed. An intake means that we connected with the person for the first time, conducted an assessment, offered housing referral, medical and or other clinical assessments.” 

What is the process in place for someone who comes in and has been potentially exposed to covid, and could expose other people? Is there any sort of quarantine?

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Young people across all of our sites are assessed twice a day for their symptoms: temperature and a health check-in. Similarly, for clients that we’re intaking, we’re following a protocol. Outside of covid, when a young person would come into our care, they would have a medical evaluation and a check-in. Part of that evaluation now also includes covid, but also assessing them on their experiences and other health issues. We do have an isolation option at each of our housing sites. We have an isolation protocol at all of our sites so we’re not rejecting anyone from housing regardless of their exposure. We’re working with the city’s Department of Youth and Community Development on running a hotel to service isolation. If a young person is needing isolation, instead of isolating at our site, they will be picked up by a transportation service that will bring them to the hotel. At the hotel, they will be given a room. There will be 24-hour staff on site, like there is in our housing sites, and there will also be medical staff on site—a nurse and a medical doctor providing care.

You have increased demand—are you able to meet it? Is it stretching your resources?

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The increased demand has been largely from clients who were accessing care in other places, like meals and group activities and access to employment or employment help. Right now, we’re facing a lot of applications for unemployment. There are young people that we work with that are facing immigration issues, legal services. Young people are very resilient and resourceful, so typically we’d piece together different resources throughout the city they could go to. And now because all of those have closed, we’ve had to increase our access to meals, consultation, mental health services and therapy, medical care, and also just access to a person. We’re one of the few providers that are providing access to in-person care. So it’s an increase in volume, but not to the extent that we have to bring in a new staff team for that. We have the staff in place.

You’ve been able to manage this extra demand?

We have.

Was it a challenge to get the youth on board with sheltering in place?

Yeah. It’s been a challenge for most people around the world and our young people are no different. We definitely have struggled and had to rethink our work. We started having conversations with young people that went: “What can we do to keep you here?” We heard some really awesome things. When we really had to start to enforce the stay at home order, which came about a week after we started the covid response, they had some great ideas. They wanted more groups online, they wanted to be able to see their friends and they needed technology for that. They wanted to have pizza parties and ice cream socials and taco nights. They all wanted their own Hulu accounts. We had experiences with young people who lost employment and young people who didn’t have conventional employment and needed help getting money because they still want to buy their own things.

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We came up with a way of offering incentives. If you are covid compliant, you get a weekly stipend for staying at home and following those protocols. The reality is this is what families are dealing with across the country. I have a five-year-old and I’m having these conversations about staying at home and why we’re here and why he can’t see his friends. I think any supportive or loving environment is going to creatively brainstorm around that. So now we do Zoom dates with our friends and are playing more video games and he has all the junk food he wants, which he never has before. We’re embracing it. We’re all in this together and we’re going to do everything we can to keep you happy and support that. What’s different for us than a traditional family is that we are dealing largely with young people who are traumatized by their family rejection, who are dealing with some really, really awful backgrounds related to living on the streets and what they’ve had to do to survive. This is retraumatizing, so we’re also infusing this approach to being creative during covid with a host of mental health services, a host of direct care and support groups and activities that are clinically based to help cope.

You’ve increased spending—where did that money come from?

Fortunately, a number of agencies have come together to help. The city is offering help for their programs. We have city, state, and federal programs. Our meal program is largely unfunded. We serve over 220,000 meals a year and that’s a largely unfunded program so we’ve had to shoulder that ourselves. We’ve been able to petition to get more funding in those areas. We’ve also reached out to our community, that’s helping. We reached out to restaurants that sent food. We reached out to other partners who are meal providers. A lot of that has been helpful in getting food to our clients. The reason the number went up so much is because in our transitional living program, which is a graduating part of our work, the people in that program learn to buy their own groceries, the learn to cook for themselves, they’re required to have a job or being in school. And with them losing their jobs, we’ve had to increase our food expense, which is already difficult to meet. We’ve been reaching out and securing meals. We’re OK this week. It’s kind of like Groundhog Day in many ways: “Okay, here we go again. How are we finding meals this week?” But we’re getting through it.

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It sounds like you’re doing well, all things considered.

We’re very fortunate. We’re a very young and scrappy organization that’s also very mighty and driven by an incredible staff team. Many have the lived experiences of many of our clients, many come from communities that represent our clients, and many understand this calling, that we are these young people’s family. We are their comfort. We are their safety. There’s a lot of unity and compassion in the work and it’s something that we’re very proud of. We’re stable. We have over 200 employees, and at any given time the average has been 30 staff members out because of covid, either because they’re at higher risk or because they’ve had covid. The number of staff members who’ve had covid is much, much lower, but it’s been rotating. Staff will be out for a two-week period and then they’ll come back around and someone else is out. What struck me is the commitment of our team to being there. Our call-outs having to fill slots hasn’t been out of the ordinary. It’s been what we typically see, and we thought we were going to see a big decline in staff being able to show up for work. We’ve been very fortunate and as a result, we’ve been reaching out to providers and offering help because so many of them are not as fortunate as we are.

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With staff members out and new clients coming in, are you secure in your ability to keep everyone safe from infection?

We’ve had no shortage of young people who have been symptomatic and who have been put in isolation. We haven’t had outbreaks. We’re following the protocols closely, we’re following the isolation closely, we’re following the cleaning. We’re making sure the young person is cared for in a way that they’re not exposing [anyone else]—that there’s ventilation, there’s a number of protocols in place. We’re a month in, knock on wood, and we haven’t had an outbreak. What’s also to our benefit is that we’re in small, home-like environments and we have the same staff working our sites mostly, so it’s kind of like a family.

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Can you give me a sense of what increasing staff salaries has looked like, in terms of a percentage?

There’s been a 44 percent or almost 50 percent increase in our [payroll] for this period. We really felt strongly that we needed to recognize how critical and how valued our essential workers are, and that 90 percent of our staff team is essential workers, frontline workers. So we’ve increased that in appreciation and support and recognizing that they are doing the extraordinary. At any given time, we have over 70 to 85 people on site, on staff, working around the clock. They’re showing up for our young people and we really needed to recognize that. There’s so much gratitude across the board, and there is that moment of unity and this abundance of love that we’re feeling and a call to humanity right now. It definitely feels that way.

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In a follow-up email, Roque provided further clarification and information about the pay increases: “Ninety percent of AFC’s workforce is comprised of frontline workers all of whom received either hourly increases of time and half pay (50 percent pay increase) or if they are not hourly employees were given bonuses for covering shifts. To be clear this is for staff showing up to work a shift not those working remotely. Bonuses and additional pay was also offered to facilities teams working on sanitation of sites, isolation rooms, etc., and to other staff who have stepped in to help with running or program needs as well.”

Do you have a sense of the morale among the youth?

It’s gone up and down. Initially, there was a shock in seeing other programs close, in watching this starting to happen. There was a big moment of fear. There’s some restlessness right now. For some young people, there’s been an increase in depression. This is isolating. The homeless population is largely isolated from the world and we work really hard so that people don’t have that isolation. We mitigate and disrupt these feelings of isolation and now we’re re-isolated. We’re doing meditation and yoga.

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Has there been any change in your trans youths’ access to hormones?

During week two, after the stay at home order and we started to move our services to teleservices, we introduced a protocol to address hormone replacement therapy. We have a transgender housing site that has 18 young TG and T individuals. Our medical provider offers a guided live session with a staff person and a young person, so there’s two people helping a young person with the administration of HRT.

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What can people do who want to help?

Visit our website. It doesn’t have to be money. Money is obviously needed, it’s helping us make the decisions for the purchases we need, but obviously that’s not available to everyone and some people want to help in a different way. We have set up an [Amazon] wishlist, which allows you to understand the unique needs of an individual young person and also we have a way to sign up to engage in other ways. You can interact with a young person in a safe and secure way, or if you want to write a card, if you want to host a yoga session or talk about meditation or your job. We’re open to connecting. At the core of our work is demonstrating to young people that there’s nothing wrong with them, that there are people in our world who care about them, who value them, and who wish nothing but the best for them in spite of what their parents contend. Connecting with people is so important.

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Update (May 13, 2:45 p.m.): Quotes in this interview have been amended with additional clarifying information, which has been noted in the body of the post.

Some Pig. Terrific. Radiant. Humble.

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