When temperatures dip below 25 degrees this winter, as they could this weekend, area churches and one overflow site will open as warming centers for people who are unhoused.

The Office of Housing Stability is assembling a long-term strategic plan to address homelessness.

The Knoxville-Knox County Office of Housing Stability coordinates the warming center program, which was credited with saving lives during last January’s snowstorm and long-lasting freeze.

While the warming centers provide a short-term respite in times of extreme cold, the office is working on a long-term strategic plan to address homelessness in a more comprehensive manner.

Among the goals of both the short-term warming center effort and the long-term strategic planning process is preventing deaths among the homeless population. According to the office, approximately 140 people known to be homeless have died in Knox County this year.

Warming Centers

This is the second year for the warming center program, which utilizes churches and volunteers to provide emergency accommodations for people who do not stay in homeless shelters.

Four churches — Cokesbury, Vestal United Methodist, Magnolia Avenue United Methodist and Fountain City United Methodist (which is just now being activated) — and the overflow site have a combined 147 beds. During the six nights they’ve been open in 2024 so far, the warming centers have provided beds for 766 people. 

According to KnoxHMIS, which tracks homelessness in Knox County, there are 406 beds in homeless shelters. That means a total of 553 beds are available on the coldest nights of winter.

Erin Read, executive director of the Office of Housing Stability, said in an interview that this year’s experience at the warming centers so far has been closer to what officials envisioned when developing the program for last winter.

“The first time that warming centers really opened was January, during that week of dangerous cold temperatures, snow and ice, where the entire community shut down,” she said. “We had to pivot very quickly from only being open overnight to being open 24/7 because buses weren't running and people couldn't get anywhere, and it was dangerously cold.”

With the 25-degree threshold for opening, the Office of Housing Stability expects the warming centers to operate a total of up to 21 nights during the winter. 

New this year is the overflow warming center, which is housed in the former Salvation Army Thrift Store on Broadway (most recently it was the Foyer, a low-barrier shelter that closed at the end of March). 

Located in what many refer to as the Mission District, the overflow warming center serves people in the downtown area who are unhoused but do not or cannot stay in shelters. The overflow warming center has been at or above capacity at times already this year, Read said, so the Office of Housing Stability is working to secure space for another overflow center nearby.

Read said operations have gone smoothly so far, though the Office of Housing Stability is searching for partners to help provide laundry services for the warming centers during the coming weeks.

Strategic Plan

The Office of Housing Stability is taking on the role of the lead agency for the “continuum of care,” replacing Knoxville city government. The continuum of care is the coordinated delivery of services across different stages of homelessness involving multiple agencies over time. The U.S. Department of Housing and Urban Development requires a lead agency for continuum of care in any community that receives federal homeless funding.

As part of its new role, the Office of Housing Stability is responsible for strategic planning. The new plan, which is still in development, will offer a comprehensive approach to providing services to the homeless population, Read said. The process is intended to build on previous efforts, use evidence-based approaches and incorporate public input.

“We'll definitely be addressing emergency homeless services as well as temporary services for people who are at risk of homelessness or who have just become homeless, and also longer-term and supportive services for chronically homeless individuals,” Read said.

The Office of Housing Stability has held five listening sessions in recent weeks to gather public opinion and will hold more in January that will include people experiencing homelessness. More than 100 community members have attended the sessions.

“Overwhelmingly, what we are hearing in public listening sessions is that people want a compassionate, practical response that both recognizes individuals experiencing homelessness as human beings and offers up a path to self-sufficiency for them,” Read said.

At a meeting of the Office of Housing Stability Board of Directors on Monday, Read said she has met with city and county government department heads whose offices interact with the homeless population, including parks, libraries and law enforcement. 

The planning process will continue in January with strategy sessions with service providers and first responders. The plan should be finalized in the spring. 

As part of its role as lead agency for the community, the Office of Housing Stability, in collaboration with a consultant, will be overhauling the organizational structure for the continuum of care. A new Continuum of Care Board of Directors, made up of service provider representatives and other stakeholders, will be formed.

“The Continuum of Care board will be the brains, (while) the Office of Housing Stability will be the hands and feet,” Read said during Monday’s meeting

Previously, the Knoxville-Knox County Homeless Coalition had served as the continuum of care board, but Reid said the nonprofit organization would now lean into its roles in advocacy, education, and “bringing voices of lived experience into decision making.”

Healthcare Needs

One focus of the Office of Housing Stability’s approach will be healthcare. Cherokee Health Systems runs a clinic near the shelters in the Broadway-Fifth Avenue area, but Read said more needs to be done. 

The Office of Housing Stability, the Knox County Health Department and service providers are looking at using a common electronic medical records system. The system would be accessible to agencies, street outreach programs, first responders and others providing medical care for the unhoused.

According to Read, informal surveys of people in the homeless community 

found that wound care is an unmet need. She also said the population has high incidences of chronic disease such as high blood pressure, and that medication management, especially for psychiatric disorders, should be a priority. 

Another area of medical care that is lacking for people experiencing homelessness is hospice care. “There are people on the street who are dying,” she said.

At Monday’s meeting, Andrew Church, vice president of programming for Knox Area Rescue Ministries and an Office of Housing Stability board member, said two people with chronic illnesses have died at KARM in recent days. He said that Denver, Colo., has a shelter with an attached clinic offering hospice care. Read said Knoxville would benefit from a similar space.

“We do have a small number of chronically homeless individuals on the street who have terminal illnesses — cancer, COPD — and there is a need in the community for them to have hospice care,” she said. “They need a place that they can go to have peace in their final days.”

In Memoriam

A grim reality for the unhoused is that people die — in the streets, in shelters, in tents, in emergency rooms, in any number of forgotten corners of the community. According to the Knoxville-Knox County Homeless Coalition, the average life expectancy of someone experiencing homelessness in Knox County is 48, compared to a life expectancy of 73.6 for the county’s general population.

“The issue of homelessness presents profound risks that extend beyond mere lack of a roof over one’s head, significantly impacting health and overall well-being,” Bruce Spangler, chair of the homeless coalition, said in a statement. “Without access to safe and permanent shelter, many of our vulnerable neighbors are exposed to increased threats of various illnesses and injuries. Tragically, this precarious situation can lead to fatal outcomes.”

The homeless coalition is holding the annual Homeless Persons’ Memorial Day service from 6-7:30 p.m. Thursday for those who were known to be homeless who died in the past year. 

At 6 p.m., a candlelight walk will begin at Volunteer Ministry Center, 511 N. Broadway, and cross the street to St. John’s Lutheran Church for an indoor service. 

The service, which has been held every year since 2009, both honors those who have died while homeless and raises awareness about the challenges and need for community involvement.

Read said about 140 people (a minimum number) have died while experiencing homelessness this year, down from around 170 last year. 

“One reason for that could be our overdose death rate overall as a community has gone down significantly over the past year,” she said, noting the increased availability of Fentanyl test strips and naloxone. “Unhoused people who are using drugs are especially vulnerable to overdose death, and so we do see a lot of it.”

Read emphasized that people who are experiencing homelessness can die of a number of causes, but all deserve to be mourned.

“The Homeless Persons’ Memorial is an opportunity for us to come together and remember the homeless neighbors that we've lost, and to grieve those deaths together. It's also an opportunity to talk about the conditions that contributed to those deaths … There are things that we can do to bring this number down.”