Operation Safer Ground (OSG) was established in California to support people experiencing homelessness (PEH) during the COVID-19 pandemic. In March 2020, an executive order allowed local governments to access emergency funding to address the pandemic’s impact on PEH. Alameda County Health utilized this funding to create OSG, focusing on COVID-19 risks and broader health and housing challenges faced by PEH.

A study examined the implementation of OSG using the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Researchers conducted interviews with 34 public health officials involved in OSG’s development. The study found that cross-sector collaboration was essential throughout the implementation process. Previous partnerships between agencies helped expedite preparations, while engaged leadership facilitated a smooth program launch. Empowering staff and partners fostered a sense of inclusion and recognition.

Despite these successes, securing permanent housing for OSG participants remained difficult due to a shortage of affordable housing in the county. The study underscores that effective collaboration, strong leadership, and flexible funding can lead to significant improvements in providing housing and integrated services for PEH with complex needs.