COVID-19 has illuminated some of the unique public health and legal challenges facing currently homeless individuals. Particularly as COVID-19 worsened during the winter months, cities and homeless individuals were with faced tough choices that cannot be easily resolved.
Individuals experiencing homelessness have been “largely invisible victims” of the pandemic, especially because the U.S. Department of Housing and Urban Development, the federal agency primarily responsible for overseeing programs for the homeless, did not require its national network of service providers to gather information on infections or deaths among the homeless population.
However, for homeless individuals, COVID-19 has been a crisis within a crisis. Many homeless people are in poorer health than the population at large. Now, they have often lost access to services that previously provided food, water, and shelter. Many homeless individuals are also facing increased barriers to legal services; prior to the pandemic, many legal service organizations operated clinics directly at shelters to provide assistance with a wide variety of civil legal issues, such as obtaining benefits or accessing affordable housing. When the pandemic forced legal aid organizations to operate remotely, the in-house provision of legal services also ceased. Simultaneously, the COVID-19 pandemic has led to an unprecedented increase in federal government aid to homeless individuals and a corresponding change in how federal funds are distributed. Amidst the challenges, there has been a slim silver lining: increased awareness of the issues facing the homeless community and policy innovation.
As the CDC noted, “many of the recommendations to prevent COVID-19 may be difficult for a person experiencing homelessness to do.” At the most foundational level, staying home is difficult without a stable living situation. While many shelters have changed their policies to allow longer-term residence, shelters themselves are congregate settings that can make social distancing difficult. There is a high risk of transmission in shared accommodation. Many state and local governments have set up isolation units for homeless individuals with COVID-19. However, this can only partially combat spread since many individuals may be asymptomatic carriers or may spread the virus prior to developing symptoms. Finally, since many people who are homeless are older adults or have underlying medical conditions, they are at increased risk for severe illness from COVID-19 than the general population. Over the last months, this has meant that homeless individuals who become sick with coronavirus are more likely to be hospitalized and have higher fatality rates, adding to the strain on community health centers.
Despite initially lower than expected infection rates, many homeless shelters have seen a surge in coronavirus cases. This wave is predicted to be particularly acute in colder states, as homeless individuals are forced to choose between the risks of local shelters and remaining unsheltered. As further discussed below, shelters are also facing difficult tradeoffs.
Challenges to vaccination:
Although the vaccine roll-out has begun, vaccinating the homeless population may be uniquely challenging. Homeless shelter staff are generally considered essential workers, and thus are generally able to access the vaccine prior to the general public. However, with each state setting its own vaccine priorities, it is unclear where homeless individuals fall in the vaccination prioritization scheme. Some states, such as Kentucky, have loosened the vaccine prioritization scheme, such that members of the general public may be vaccinated before higher priority groups. Others, such as Massachusetts, have prioritized individuals living in congregate settings as part of Phase I of vaccination. Thus, the timing of when the vaccine is available to homeless individuals, sheltered or not, is likely to vary greatly.
Even once the prioritization scheme is established, a number of challenges remain. First, unlike other congregate settings, the population of homeless shelters is more fluid. Second, the structure of the COVID-19 vaccine – two doses, administered at least three weeks apart, of the same type of vaccine – will be logistically challenging. Finally, within the homeless community, mistrust of the medical system is more common, often based on past negative experiences with medical providers, a history of trauma, and generally higher rates of mental illness.
Funding for homeless individuals’ needs during COVID-19
The first CARES Act included $4 billion for aid to the homeless, through Emergency Solutions Grants (ESG). The money was intended to “support homelessness services including emergency shelters, street outreach, homelessness prevention, rapid re-housing, and Homeless Management Information System (HMIS) services to persons experiencing homelessness (sleeping in a shelter, outside, or other place not meant for habitation) or at-risk of homelessness.” This cash infusion was comparatively massive: nearly 14 times greater than the funding provided last year.
Critically, the CARES Act required the Department of Housing and Urban Development (HUD) to develop a different way of allocating funds for homeless individuals. For decades, homelessness advocates have pointed out that the standard ESG funding allocation metric had “no real nexus to homeless needs.” As reported by Capitol Hill and HUD staffers, “the formula’s flaws were well-known to anyone who worked on homeless policy, but the problem persisted because there was not enough political will to push through reform.” However, with the massive increase in homelessness funding, there was accompanying political will to push for a new funding formula.
Ultimately, “[t]o fix the formula, HUD adopted four basic metrics to assess need during the pandemic: total homeless count, as determined by HUD’s biennial Point-in-Time homeless census; total count of unsheltered homeless people; the rate of renter households whose family income is less than half the area’s median family income; and the rate of the very low-income renter households, who are living in overcrowded conditions or without a full kitchen or plumbing.” The new formula resulted in a dramatically different distribution of funding. States with higher homeless populations received far more money than they otherwise would have.
Despite early initial optimism among homelessness advocates, change has been halting. First, the change in funding formula is only temporary; without action by Congress, the funding formula will revert to the traditional ESG model. Second, as of August 2020, only 30% of the promised ESG funds had been released. Even once the money was released, communities have been wary to spend it; HUD was slow to announce how the money may be used, meaning organizations have held off on spending it for fear of later being required to pay it back. Accordingly, much of the promised money has yet to be spent. Perhaps as a result, when the “Consolidated Appropriations Act of 2021, which included further COVID-19 relief, was passed, there was no additional funding for homelessness. The most recent COVID-19 relief bill, “The American Rescue Plan,” again changed course. The final bill includes $5 billion to directly mitigate the impact and combat the spread of COVID-19 in homeless populations.
Hard tradeoffs and secondary challenges
Beyond the first order challenges, COVID-19 has created a number of secondary issues and tricky tradeoffs for service providers.
Tradeoff 1: Decreasing capacity to prevent the spread of COVID-19
One of the primary challenges facing shelters has been balancing how to best serve their clients. To cope with coronavirus and comply with safety best practices, many homeless shelters have had to decrease capacity. Yet, particularly in the winter, offering shelter is critical to prevent cold weather-related injuries or death. Traditionally, many shelters have added beds in the winter months by turning common spaces into makeshift housing. This year, that will not be possible.
Instead, many city and state governments are pursuing new strategies to add temporary capacity. The most common solution has been using CARES funding to rent hotel rooms for homeless individuals. Yet, many cities are now winding this program down amidst concerns about long term expenses and viability. The next step remains uncertain.
Tradeoff 2: Use of funds to keep people currently in homes sheltered rather than releasing funds to help those who are already homeless
A second hard tradeoff has been how to use the funds released through the ESG program; there is a constant pull between providing services to individuals experiencing homelessness and to individuals at risk of homelessness. ESG funds can be used for either. Some policy experts fear that “local governments will direct the majority of the money to homeless prevention” as it is often “politically and operationally easier to focus on eviction prevention for people who are in housing, and who are, unfairly, often seen as more worthy of assistance than people who are experiencing homelessness.” This quandary may be exacerbated as state and national eviction moratoria expire. While eviction moratoria have kept individuals housed throughout the pandemic, the moratoria have not reduced or forgiven rent. As they expire, nothing will prevent those who have been unable to pay from being evicted. This tension may lead to more money being directed to rental assistance or emergency relief funding to prevent homelessness, rather than to helping individuals already experiencing homelessness.
Secondary challenge 1: Loss of public spaces
An additional ongoing challenge for homeless individuals has been the loss of public spaces. The closure of local businesses and indoor public spaces restricts the space that community members, including homeless individuals, can find refuge in during the day. Libraries in particular are often vital community resources for individuals experiencing homelessness, providing warmth, services, and a place to relax. The loss of such community resources exacerbates the challenge of limited capacity at shelters and the danger of remaining unsheltered in the winter.
Secondary challenge 2: Difficulty in the provision of legal services
Finally, as most legal services have shifted online, homeless individuals have struggled to access them. Lower income individuals have generally faced a number of challenges with the shift to virtual legal services. Prior to the coronavirus pandemic, many legal services and legal-adjacent services, like benefits application clinics, were co-located with homeless shelters. However, this practice has largely come to a halt during the pandemic. Now, for homeless individuals, the curtailment of access to legal services has been particularly severe. Although many homeless individuals do have smartphones or access to smartphones, which remain a vital tool, access to computers remains more difficult. As previously mentioned, public spaces with internet access have been shuttered by COVID-19.
Looking ahead, many challenges remain for homeless individuals and service providers. Just as the extremes of winter weather threaten homeless individuals, so does summer heat. While the COVID-19 pandemic has meaningfully increased funding for homelessness services, the funding has yet to be fully deployed and tensions remain on how it best can be deployed. Yet the COVD-19 crisis has also spurred innovation, ranging from ideas like “recuperation units” to create safe spaces for homeless individuals to convalesce to ideas such as the development of new wraparound services based out of temporary hotel shelters to transition homeless individuals into permanent housing. Hopefully, in the months to come, the unique challenges the pandemic poses can be met with equally unique and innovative solutions.
 Further, statistics on infection rates among the homeless population are quite difficult to calculate. Advocates have pointed out that federal statistics likely underreported the rate of infection. See this investigation for further reporting.