Resolution No. 220273
May 27, 2022

Executive Summary
Resolution No. 220273 directs the City Manager to conduct a feasibility study aimed at establishing hygiene facilities for people experiencing homelessness. Health Department staff collaborated with members of the Health Commission, the Houseless Task Force, and the Houseless Prevention Coordinator in conducting the study.

Other jurisdictions have seen mixed results in providing hygiene facilities for the homeless. While some have been able to connect the homeless to medical and shelter, others have reported fights breaking out while people are waiting in line for the facilities, as well as a constant shortage of funds, leading to shutdowns of the facilities. In addition, weak regulation of the facilities was identified as a concern.

We have examined several options for providing hygiene facilities. If City Council wishes to proceed with providing the hygiene facilities, we recommend any new facilities be portable to match the transient nature of the population. Eleven locations have been identified for portable toilet facilities at an estimated cost of $165,165 per year. Existing showering facilities at Community Centers as well as the Hope Faith facility downtown can be used, along with a portable showering facility through a contract with a local non-profit organization.

Background
On April 14, 2022, City Council passed Resolution No. 220273, which directs the City Manager to “study the feasibility of establishing hygiene facilities for individuals and families experiencing homelessness.”   The study was to be completed in 60 days. This report provides the results of that study.

Kansas City Health Department staff collaborated with members of the Health Commission, the Houseless Task Force, and the Houseless Prevention Coordinator to conduct the study. This group concentrated their efforts on the following tasks:
• Experiences of other jurisdictions in provide hygiene facilities
• Determining possible locations for hygiene facilities
• Determining how to collaborate with homeless service providers
• Determining non-profit organizations and advocacy groups who could operate and staff a facility
• Determining the cost of acquiring and running hygiene facilities
• Determining how existing resources could be used to establish hygiene facilities for individuals and families experiencing homelessness
• Determining the viability of providing City funding or City-owned property for the establishment of hygiene facilities

Hygiene Facilities in Other Jurisdictions
Staff contacted other jurisdictions to determine their investment and experiences with providing hygiene facilities. Attachment 1 contains a summary of that research.

Non-profit organizations have usually taken the lead on these types of projects and the City is responsible the initial costs, while the non-profits oversee any reoccurring costs thereafter. Research indicates that many organizations have tried to recruit volunteers, but due to the nature of the job and the training required to address any incidents that might come up, these must be paid employees. Training includes but is not limited to:
• Registering new individuals to the site, and ensuring a waiver disclosure form is signed;
• Cleaning of the individual bathrooms and shower sites, as well as restocking them with fresh supplies after every use;
• Preparedness on how to respond when an individual self-harms or overdoses inside a bathroom or shower;
• Breaking up fights or aggressive encounters that may arise while individuals wait to go into these facilities.

While the cost to hold these facilities is usually provided upfront by local jurisdictions, research found that they are not responsible for regulating or enforcing these sites when implemented due to the inconsistent nature of these facilities. In fact, the City of Duluth, Minnesota reports that since the commencement of this project, locations where their mobile facilities have been placed, have seen significant increases in “overnight traffic” and their only method of protection, security cameras, have not deterred any individuals from vandalizing the property and stealing equipment such as drainage pumps. Like Duluth, many cities have experienced similar issues, causing them to continuously exhaust funds and forcing them to shut down until they can apply for more grants.

Estimated re-occurring costs to maintain these facilities range from $100,000-$250,000 depending on population size and location. As of January 2022, Kansas City is estimated to have about 2,000 homeless individuals within its city limits. This estimated cost would not include staffing or any other incurred costs outside of the facility needs.

Kansas City acknowledges the barriers to stable housing experienced by homeless individuals and families. Lack of stable, permanent housing has significant impacts on the health of these individuals. However, in an effort for protect all its citizens, the impacts left on the communities as repercussions of these facilities in other cities, must be acknowledged. Since the introduction of these projects, cities report the following impacts in their communities:
• “Overnight traffic” has picked up, causing a shut down after the most recent break-in where over $10,000 worth of equipment were taken (Duluth, Minnesota).
• Navigation teams are reported to have contacted 2,768 people, helping them connect to medical care and shelter (Seattle, Washington).
• There is a limited number or showers and bathrooms with extremely limited funds, the help never is enough (Manhattan, New York).
• The homeless population has decreased by 10% (506) since 2017 (Oahu, Hawaii).
• Reports of large crowds congregating, fights constantly breaking out in the lines, and a lack of funds, causing them to permanently shut down (St. Louis, Missouri).

When examining the findings from other cities, our assessment team identified weak regulation of hygiene facilities as a main area of concern. This lack of enforcement was compromising the safety of citizens, as well as staff without increasing access where it was most needed. Additionally, finding adequate funds to keep these sites running appears to be a common issue all non-profit organizations continuously run into. 

Possible Locations for Hygiene Facilities
It may seem obvious, but the best locations for these facilities is where houseless encampments are located, and no such services exist. Based on staff and partners’ knowledge of houseless density, Attachment 2 contains the suggested locations for the hygiene facilities. It is important to recognize that this population tends to be transient, so the facilities should be able to follow the population.

Collaborating with Homeless Service Providers
For hygiene facilities, we believe collaborations with Hope Faith and Team Jesus would be appropriate. These facilities can provide showering facilities and Team Jesus can move the showering facility from site to site.

Non-profit Organizations and Advocacy Groups Who Could Operate and Staff a Facility
Some non-profit organizations were identified to operate and staff a facility, but they do not currently have resources to do so. It would take funding from some source to allow them to do so. One such source could be through contracts with the City.

Cost of Acquiring and Running Hygiene Facilities
Based on experience in providing hygiene facilities, we recommend portable toilets be used in the locations identified on Attachment 2. This will allow for an existing City contractor to provide the facilities and service/replace them when necessary. This is more economical then building facilities which then need to be maintained. In addition, the use of portable toilets solves issues in needing the facilities to be mobile, cleaning/exchanging the toilets, and provides a sanitary option.

Based on providing three portable toilets at the 11 facilities in Attachment 2, 33 toilets would be needed. We recommend two units and one ADA-accessible unit be located at each location and that the units be serviced twice per week. Based on the current City contract, this would result in an annual cost of $165,165.

(Weekly cost of unit serviced twice per week is $88.75, weekly cost of ADA-compliant unit serviced twice per week is $111.25. 22 units x $88.75 = $1,952.50; 11 ADA units x $111.25 = $1,223.75, resulting in a total weekly cost of $3,176.25 ($1,952.50 + $1,223.75). This results in an annual cost of $165,165 ($3,176.25 x 52 weeks).

Shower facilities can be provided though the City’s Community Centers, mapped on Attachment 2. Also, Hope Faith currently provides three showers (two male, one female), to service those in the downtown area. They were expecting Community Development Block Grant (CDBG) funds to expand the shower facilities but have yet to receive those funds. The CDBG funds will allow them to expand to six men’s showers, two women’s shower and one non-binary shower when/if (CDBG) funds are awarded to them. In addition to these resources, we recommend a portable shower facility be transferred among the areas where other shower facilities are not already located. Team Jesus has a portable shower facility (they also provide towels, soap, underwear, and clothes), and are willing to contract with the City for two days per week. Team Jesus has never set a price for this service. They usually provide it as a free service. At this point in time, they do not have a cost estimate, but are willing to pursue developing the estimate should the City Council decide to move forward. These same facilities can be purchased for approximately $75,000 plus the cost of towels, soap, water, operation (minimum of two staff per unit) and maintenance. Based on this comparison, we recommend contracting with Team Jesus or a similar provider.

How Existing Resources Could Be Used to Establish Hygiene Facilities for Individuals and Families Experiencing Homelessness
As mentioned previously in this report, we recommend existing Community Centers be used for showering facilities. In addition, showers located at Hope Faith can be accessed for those downtown. 
In lieu of using existing facilities for toilets, portable toilets eliminate the need for regular City-provided janitorial services and other maintenance.

Viability of Providing City Funding or City-owned Property for the Establishment of Hygiene Facilities
As mentioned above, we believe the best use of City-owned property is the use of showers in Community Centers. City funding could be used to provide portable toilets and portable showering facilities.

Community Input
Input from citizens living around the proposed hygiene sites has not yet been obtained. Once we have direction from City Council on which recommendations or other directions they want to explore further, community input will be obtained from virtual sessions with the communities. Also, an email address will be developed as another option for community members to submit comments.

Recommendations:
Should City Council wish to proceed with providing hygiene facilities, we make the following recommendations:
• Toilet facilities should be placed at locations where houseless people are located to allow for easiest access. Since this population is transient, we recommend the facilities be portable. An existing City contract can be used to provide these services.
• Showering facilities located at Hope Faith and in Community Centers should be used, as well as portable showering services to be provided through a contractor.

Print the Feasibility Study pdf.