Policy changes during COVID-19 have mixed impact: Qualitative data collected via Community Solutions’ survey

When The Center for Community Solutions designed our survey to find out how COVID-19 and the Stay-at-Home order were impacting service providers we included a number of open-ended questions. This enabled respondents to share experiences and thoughts without being confined to the answers provided in multiple choice questions. Taken together, these responses can be an account of what people experienced in the early days of the novel coronavirus pandemic. It complements the qualitative analysis we previously released.

The 734 survey respondents shared more than 3,000 thoughts in their responses to open-ended questions in our survey.

The 734 survey respondents shared more than 3,000 thoughts in their responses to open-ended questions in our survey. Community Solutions’ research team typically spends several weeks, or even months, sifting through this volume of qualitative information. But because the situation in Ohio is changing so quickly and we want to ensure that agencies are able to continue much-needed services in communities across Ohio, we knew we had to analyze this information as quickly as possible.

Key takeaways from the qualitative data:

  • Service providers across the state are concerned they won’t be able to reach Ohioans who are most in need. Technology helps some clients remain connected while in-person services are suspended, but providers are worried that segments of population will be left behind.
  • The Stay-at-Home order is the public policy causing the most disruption. However, many respondents indicated they supported the orders and understood its necessity.
  • Obtaining sufficient personal protective equipment (PPE) is an urgent need. Several respondents indicated that even when they could access PPE, the cost was prohibitive.
  • There is mixed experience with government funding during this public health emergency. While some service providers indicated that their funders have been flexible, others identified challenges.

All quotes included below have been very lightly edited for clarity.

Please briefly describe, in your own words, how your service offerings have changed as a result of COVID-19 and/or the Stay-at-Home order.

Most respondents described changes related to switching to remote services. Many expressed concern about disruption of services and the impact on clients. This was due to clients cancelling services because they couldn’t see providers in person, due to a lack of technology, or inability to use it.

Some discussed cancellations, which seemed to generally be in legal, mental health, behavioral health and other medical services. Several people shared that their elderly clients, people with disabilities, or those with severe mental or behavioral health conditions were unable to navigate the technology that’s needed to use remote services. Many respondents have had to stop taking new clients, and others also shared concern about having to stop services often needed by vulnerable populations. Recurring types of services in these responses included: home visits; services for those with developmental disabilities; residential treatment services; services for at-risk youth; respite services; adult day programs; and housing services for the homeless.

Respondents also reported seeing an increase in need for basic needs (i.e. food, toiletries, etc.), and for emotional support. Many organizations have made home deliveries and started doing regular telephonic check-ins to support clients. Some organizations that offered this seemed to do so because it was a presenting need, creating remote service protocols from scratch. Many food pantries have also turned to touchless home delivery, drive thru delivery, and prepackaged boxes instead of the usual “choice” styles of offering food. There has also been an increase in services with many providing food weekly instead of the normal monthly scheduling.

With the reduction of volunteers, layoffs and furloughs, some essential staff have had to cross-train and fulfill additional duties to continue operations.

Other areas of concern were the cancellation and/or decrease in donations and pledges, and the lack of access to PPE masks for social distancing measures.

Policy-related questions

What local, state or federal government responses have been most helpful to your agency and the people you serve?

Our survey asked three questions about government policies and actions that are impacting agencies and their ability to deliver services, the first was what state, local or federal responses have been most helpful to your agency and the people you serve.

By far the most common responses indicated that the Stay-at-Home order and/or social distancing requirements themselves are constraining agencies’ ability to provide services, however many acknowledged the necessity of these orders. Many mentioned specific challenges presented by social distancing, including: loss of volunteers; inability to hold events; inability to reach clients who don’t have reliable internet access/devices; inability to access proper PPE for staff and clients; challenges adjusting to working from home; and social distancing impacting the mental health and well-being of staff and clients. There seemed to be particular concern around how to continue to effectively serve older adults and people with developmental disabilities.

What government policies are constraining your agency’s ability to provide services, or to do your work effectively?

Another common concern had to do with funding; many organizations are unsure about their funding going forward, or are facing restrictions on funding or reporting requirements that inhibit the ability to shift service delivery during this time. Many of these respondents mentioned specific agencies or funders that they are struggling with. Specifically, developmental disability (DD) agencies mentioned issues they foresee with funding if centers can’t be at capacity due to the current funding structure. Communication was a common theme – people are struggling with unclear, untimely or conflicting communications policies during this time. General sentiment was that the federal government response has been inadequate, while the state government response is seen in a more positive light. Many organizations are also facing employment challenges – either they are struggling to retain and pay the staff they currently have, or they need to quickly increase their workforce but stringent licensure/hiring process red tape is making that difficult.

On the other hand, state government was often listed as being the most helpful. This category by far received the largest number of comments, followed by local government. In addition, several people identified regulatory changes in the federal Supplemental Nutrition Assistance Program (SNAP) as particularly helpful. The Ohio Department of Developmental Disabilities was also often listed as the agency that had been most helpful both in providing guidance and funding. The federal CARES Act and helpful communications from public officials, largely in the form of guidance from the state government through the daily briefings of Gov. Mike DeWine, Dr. Amy Acton and Lt. Gov. Jon Husted were listed as among the most helpful is responses. Telehealth and the ability to be reimbursed for remote service delivery were mentioned by a large number of respondents, along with flexibility of funders.

Please list any specific administrative, regulatory, or policy changes that could better equip organizations to provide services during this crisis.

Respondents shared their thoughts about administrative, regulatory and/or policy changes that could better equip organizations to respond to the crisis. Many answers, perhaps unsurprisingly, focused on funding. Some advocated for more federal and state government funding to be allocated to local governments and agencies, while others lamented restrictions on current funding, stating that relaxing those rules could enable them to respond to the needs of the community more quickly. Answers also mentioned the need for clarity on rules that are created and enforced by the state, in particular, Medicaid and telehealth meetings with clients.

Answers also mentioned the lack of personal protective equipment (PPE), to protect both employees and clients. Finally, answers mentioned concerns about topics related to the social determinants of health and the health and human services safety net, including transportation, criminal justice and housing.


Who or where do you turn for information about COVID-19 and how to adjust your services?

More than two-thirds of those who identified a source of information cited the State of Ohio and/or the Ohio Department of Health. Several respondents noted that they watch the daily news conferences of Governor DeWine, Dr. Amy Action and Lt. Governor John Husted. The Centers for Disease Control (CDC) was also listed as a common source of information. Fewer people relied on information from an employer. While news media of various kinds were mentioned, they were not the primary source of information for most people.

This suggests that people are looking for facts that affect their daily lives directly from the source—the governor and health department director—rather than relying on second-hand information via the media or other individuals.

 Please briefly describe the population you serve. Generally speaking, what are the age and racial demographics?

The final open-ended question in the survey attempted to gather some information about the types of people served by the agencies who responded. Most indicated that they serve a diverse clientele. There were slightly more agencies that indicated they serve adults rather than older adults or children. Several reported targeting services to special populations, including homeless families and individuals, people with disabilities including developmental disabilities, and individuals with mental illness. There were several dozen respondents who said they serve primarily people of color, and others with responses that indicated their clients tend to be low-income or living in poverty.

More about the survey

Over two weeks in late April, Community Solutions surveyed groups across Ohio to collect real-time feedback on the impact of the COVID-19 crisis. We gathered a total of 734 responses from a wide range of local government agencies, philanthropic funders, faith-based groups and nonprofits including direct service providers, associations and policy organizations.

This survey was targeted to those associated with organizations and agencies that provide services to Ohioans. Two-thirds of respondents represented direct service providers, most in social services or health. Philanthropic or charitable funders, nonprofit intermediaries, government agencies and educational institutions also participated in the survey. Responses came from across Ohio, from agencies that serve residents every county, as well as several statewide organizations. While the entire state is represented, the pool of respondents leans heavily toward Northeast Ohio, especially Cuyahoga County.

Respondents were most likely to be working at nonprofit agencies. The agencies they represent are varied. Responses came from groups with fewer than 10 employees, more than 500, and everything in between. Likewise, the populations they serve run the gamut.

In just two days, a group of volunteers from our staff, including many who do not normally conduct research, read, categorized and reviewed all of the comments to all of the open-ended responses. Thank you to Taneisha Fair, Roslyn Kaleal, Sheila Lettsome, Emily Muttillo, Will Tarter, and Kate Warren. They turned anecdote into data.