Housing is Health Care: Responding to COVID-19 in a Comprehensive and Systemic Way

Coalition for the Homeless Recommendations for Immediate Policy Responses

A sample of the Coalition’s recent policy correspondence is available here. Our recent statements are available here. Our report “COVID-19 and Homelessness in New York City: Pandemic Pandemonium for New Yorkers Without Homes” is available here.

Homeless New Yorkers Experience Compounding Risks for Exposure to COVID-19 as well as Increased Risks of Serious Symptoms and/or Complications

• Homeless New Yorkers in shelters:
  • Cannot isolate at home and cannot practice social distancing due to congregate design of shelters.
  • Are not adequately screened upon entry to shelters.
  • May not be able to wash their hands as frequently as needed due to lack of soap, shared bathrooms, and inoperable fixtures.
  • Live in environments where the necessary levels of cleaning and sanitation may not be effectively implemented, especially in light of the large number of individuals using the facilities and lack of adequate maintenance staffing.
  • May face serious shortages of core shelter staff to provide food and cleaning services.
  • Have a higher age-adjusted mortality rate than New York City as a whole. Click here for up-to-date calculations and charts.
• Homeless New Yorkers on the streets or in the transit system:
  • Face a critical lack of access to food and bathrooms, as soup kitchens, restaurants, gyms, and other businesses close or suspend operations.
  • Do not have access to basic supplies including hand sanitizer, wipes, socks, toiletries, and blankets.
  • Face increased shortages of basic resources, including clothing, as well as increasingly limited access to day centers, libraries, and other public safety net programs.
  • Face increased exposure to COVID-19 because they live in public spaces.
  • Experience highly intensified levels of stress and isolation on the streets that exacerbate symptoms of serious mental illnesses as well as chronic and acute physical health conditions.
• A significant percentage of homeless New Yorkers are considered at high-risk, including seniors as well as adults and children with underlying health conditions such as respiratory conditions, diabetes, heart ailments, compromised immunity, etc.

Urgent Action is Required

In order to address the disparate impact of the coronavirus pandemic on homeless people, including Black and Latinx New Yorkers, the City and State must take immediate and comprehensive action, grounded in the principles of public health and human rights. They must immediately:

• Provide thousands of single-occupancy hotel rooms for all homeless individuals living in congregate shelters and those living on the streets or sleeping in the subway system in order to facilitate appropriate social distancing, with access to private bathrooms and showers, as well as the safety of an indoor place in which to isolate and recover.
• Continue free, widespread, voluntary testing for all homeless New Yorkers and those serving them, and increase the frequency of system-wide testing to at least every two weeks.
• End the criminalization of homeless people sleeping in the subways and on the streets, and cease all street sweeps.
• Ensure that individuals who are unsheltered have access to basic hygiene supplies and facilities, including masks and face coverings, hand sanitizer, clean clothes and socks, blankets, wipes, handwashing stations, restrooms, showers, and laundry facilities.
• Publish detailed COVID-19 statistics on infection, hospitalization, and mortality among homeless New Yorkers, including family composition, age, shelter status and type of shelter, race, and other relevant demographics, including risk factors.
• Engage community health centers, including Health Care for the Homeless and street medicine providers, in the contact tracing corps to ensure that the communities most isolated from mainstream health services are reached in that effort.
• Ensure that shelter residents, unsheltered New Yorkers, and staff who serve people who are homeless are offered immediate access to available vaccines, including informed consent and clear, consistent, culturally competent, and accessible information.

While taking immediate action to keep homeless New Yorkers safe during the pandemic, the City and State must also act for the medium- and long-term to:

• Quickly and equitably distribute emergency rental assistance to those at risk of losing their homes, and continue to advocate for additional Federal funds to fully meet the need.
• Support a broader Federal housing relief package including robust investments in affordable housing (which would also create jobs) and universal access to housing vouchers for those who are homeless or at risk of losing their homes.
• Support and enact statewide rental assistance legislation, including Home Stability Support and Housing Access Vouchers.
• Establish medical respite and supportive housing with on-site medical services in lieu of nursing homes for homeless people in need of nursing and personal care services who do not require inpatient care but cannot live safely in a shelter.
• Prioritize the production of permanent supportive housing in the State and City budgets.
• Initiate the redesign of emergency shelter facilities, with the expectation that the risk of exposure in future pandemics will require the provision of private rooms including bathrooms for each individual or household, and with attention to the principles of safety, public health, and individual autonomy.

Updated Tuesday, May 18, 2021