Federal aid for pandemic response includes billions of dollars for programs that can help states address homelessness. These funds, in combination with the urgency of stopping the spread of COVID-19, have led to a heightened level of action and commitment to aiding unhoused citizens.
Groups dedicated to ending homelessness hope to build on this unanticipated support for their mission, and to build greater awareness of proven strategies for getting unsheltered Americans into housing.
In July, the National Alliance to End Homelessness convened a virtual Town Hall.
Housing Is Health Care
Homeless or sheltered, all Americans are in the current public health crisis together. “If anybody’s got the virus, there’s the chance of spread,” says Roman. “We have to attend to each other.”You can’t practice self-isolation if you don’t have a place to live, she points out. The maxim “housing is health care,” first used decades ago during the AIDS crisis, has never been more relevant.
More than a third of all homeless people are unsheltered. The “sheltered” homeless may find refuge in transitional housing or a shelter, but as HUD starkly puts it, an unsheltered person resides “in a place not meant for human habitation” – a park, an abandoned building, the street.
These men and women are 25 times more likely than sheltered people to be tri-morbid, with co-occuring disorders, such as physical and mental problems as well as substance abuse, according to Roman. Considering their extreme vulnerability to illness of any kind, much less COVID-19, not enough is being done to reach out to them even now.
“That’s not right in a country such as ours, to let people sleep on the street,” she says.
To guide government leaders in their efforts to protect the homeless, and their communities, NAEH has developed a Framework for an Equitable Homelessness Response that includes detailed suggestions about the best ways to use funding sources. The focus should be on getting as many people as possible into housing while these resources are available, says Roman.
“Moving ahead, we don’t know what to expect,” she says. “It doesn’t look pretty when eviction moratoria end, when supplemental employment insurance ends, when we enter a recession and local governments have fewer resources because of lost tax revenue.”
NAEH, along with some of the most successful government efforts around the country, advocates a “housing first” approach to current efforts. This model, developed in the 1990s in New York, emphasizes getting the unhoused into housing right away, without preconditions.
The real-world results from such programs reflect the common-sense observation that life on the street is a weak base from which to overcome life-altering physical, mental or economic setbacks.
A One-Stop Facility
Julia Orlando worked in New York City for 20 years, helping the mentally ill within the nation’s largest homeless population. Eleven years ago, she came home to New Jersey to serve as director of the Bergen County Housing, Health and Human Services Center in Hackensack.A George W. Bush-era mandate for states to develop a 10-year plan to end homelessness if they wanted HUD funding set New Jersey on the path to a uniquely effective approach, says Orlando.
The state hired a consultant and interviewed 200 stakeholders for feedback on existing programs and what could be done differently. It looked at best practices across the country.
One outcome of this work was that Bergen County adopted the housing first model for its programs. At the time, the county had four shelters. “We decided that we wanted to have one shelter, open 24 hours a day, 365 days a year,” says Orlando. “We were also going to make it a one-stop facility, where people can go to get a meal, a shower, get benefits, apply for housing, get clothing, get connected to medical care, anything they need.”
Rather than staffing the facility with its own employees, the county put out an RFP to find groups in the community that were best able to provide the services it needed. The housing component was awarded to a faith-based group already running a shelter in the county and knew the homeless population by name. Case management went to a nonprofit providing primary care, drug rehabilitation and counseling services.
“They contracted with the housing authority to manage the facility,” says Orlando. “You’re attaching the housing resources directly to the shelter – that’s a brilliant model, in my opinion.”
Since her arrival, Orlando has worked with the police, hospitals, child protective services and other agencies in the county to develop protocols for referral rather than just dropping people at the shelter, to smooth intake and assessment. “We’ve made everyone accountable for homelessness,” she says.
These efficiencies helped the collaborative end veteran homelessness in Bergen County and become the first in the nation to end chronic homelessness.
“Our shelter is not housing, it’s a place where we get people into housing,” says Orlando.
The pandemic brought new challenges. In mid-April, Orlando shut the shelter and placed clients in motels. She has already moved 36 from hotels into housing; to date, none have contracted COVID.
“Right now, landlords who were not very interested in my folks pre-pandemic are very interested in renters with subsidies, and guaranteed rent,” Orlando says. “It’s my opportunity to show them how good it is to work with us.”
A Bridge to Permanent Housing
Since 2012, the Coalition for the Homeless of Houston/Harris County has cut the homeless population in its service area by 54 percent, from 8,000 down to about 3,900, says Ana Rausch, its vice president of program operations.“We’ve been able to do this primarily though permanent supportive housing interventions, and our continuum of care,” says Rausch. “We’re very close to ending chronic homelessness.”
The coalition has used a mix of strategies that align with the housing first approach. Those who are most vulnerable, have been homeless for extended periods and have disabling conditions that prevent them from being able to live on their own are priorities for placement in permanent supportive housing.
“These individuals won’t be able to address another issue, like income or health, until they are housed,” Rausch says. “They get a housing subsidy as well as supportive services.”
Those at less risk, who may be able to stay housed through rental assistance and support from a case manager, receive a short-term intervention known as rapid rehousing, which can be used temporarily to shelter the chronically homeless if permanent supportive housing is not immediately available.
Whichever path the client is on, their case manager helps them develop a housing plan that outlines what they need in terms of medical care, child care, employment or other resources to achieve self-sufficiency.
Funding from the CARES Act will enable the coalition to expand its rapid rehousing effort to serve those who have become homeless because of job loss or illness. “They will receive 12 months of rental assistance and light touch case management to connect to child care, income, or whatever they may need in order to get back on their feet,” says Rausch.
Diversion strategies will be incorporated in the continuum of care, to assist those at risk of becoming homeless. This could mean resolving a family conflict through mediation. “Diversion can also be used creatively,” Rausch says. “It can be used to pay for car repairs so an individual can get back to work, or to buy a bus ticket back to their hometown and their support system.”
These new efforts will be fueled by $65 million from federal funds, city support and private philanthropy.
“This can help us meet the needs of approximately 5,000 individuals over the next two years, and end chronic homelessness by providing a bridge to permanent housing,” says Rausch.
Call 211
Connecticut has established a statewide network with the kind of service consolidation and collaboration that serves Bergen County so well.“We used to have 16 different local continuums of care,” says Richard Cho, chief executive officer of the Connecticut Coalition to End Homelessness. “Now we have two, one for the whole state and one for Fairfield County, adjacent to New York City. The two coordinate closely.”
Instead of 60 or 70 individual shelter programs, each with their own philosophy, business model and intake and application processes, Connecticut now has one statewide system with seven service regions. “Instead of every program having their own wait list, and the person having to apply to 20 or 30 programs, there’s one list for the state,” says Cho. “The providers work with the regional system to match people to housing.”
The network can be accessed through a 211 information line that operates on a statewide basis, serving as a lifeline for anyone experiencing, or on the verge of, homelessness. A call responder triages the case and determines the nature of the housing crisis, then makes a referral to the appropriate service location, where intake staff will be ready to receive the caller.
Once a person is in the system, the emphasis is on getting them housed. “We’ve made housing first the DNA of our whole system,” says Cho. “We use a variety of levels of financial and rental assistance, as well as connection to services, to help people resolve homelessness quickly.”
The coalition also practices shelter diversion, providing one-time financial assistance for rent or security deposits. Of the 13,000 households that contacted service regions last year, 5,000 were diverted from shelters, says Cho.
The pandemic has had catalytic effects on how the state thinks about homeless service, he says. The infusion of federal dollars, used well, could house many who are currently homeless and make it possible to invest even more in shelter diversion.
“This could enable us to keep our rates of homelessness very, very low,” says Cho.
Mixed Messsages and Unheard-of Numbers
In addition to what's coming from the CARES Act, other federal proposals are on the table that could support local government efforts to help the homeless and keep their numbers from growing. These are largely being driven by Democrats in the House and Senate.The version of the HEROES Act passed by the House includes $11.5 billion for Emergency Solutions Grants (ESGs), $4 billion for public housing rental support and $100 billion for emergency rental assistance to help low-income renters avoid eviction.
“The packages that have been passed or considered by the House, and most of the conversations about them are talking about award amounts in numbers that are unheard of,” says Samantha Batko, a senior research associate at the Urban Institute.
Batko, who worked with NAEH for more than a decade before coming to the Urban Institute, notes that the $4 billion in ESG funds provided by the CARES Act is the largest single ESG allocation ever. “The only thing that would compare to it would be the $1.5 billion spent on homeless prevention and rapid rehousing in response to the Great Recession,” she says.
During the pandemic, more renters are falling behind than ever before and their eviction would overwhelm systems of care. Packing them into shelters or sending them onto the streets is fraught with risk, as is asking landlords to survive rent moratoria lasting as long as a year. Even so, the administration has not yet made it a high priority to push for large-scale rental assistance, says Batko.
Rental assistance and diversion are important pieces of the puzzle. They are not the same as helping those already unsheltered, and the table is not set for an easy partnership between Congress and the administration.
The recently-appointed “homeless czar” opposes a housing first orientation, and believes that food and shelter should come only as rewards for good behavior. In recent years, the administration has suggested that police enforcement with regard to the homeless should be stepped up.
Despite mixed messages, ambitious long-term proposals are also in the mix. The Housing is Infrastructure Act, introduced in the House in 2019, calls for an investment of $100 billion in the nation’s housing infrastructure. This would include $70 billion to make up for past failures to appropriate funds for public housing maintenance and repairs, $5 billion to support the creation of hundreds of thousands of affordable housing units and $1 billion to address substandard housing on tribal lands.
While this may be the first time that the numbers being talked about in Washington are in line what homeless advocates believe is really needed, it’s too early to predict what might ultimately become available to states.
In the meantime, CARES funds are flowing to local government. “Based on my information, what they have currently may not be enough,” says Bakto. “I would expect to see more money, I just don’t know how much.”
What Political Will Looks Like
Even if COVID recedes soon, stimulus funds are spent wisely and the economy lurches into life, the current national shortage of affordable housing will mean that too many Americans will still be unsheltered. The consequences of a prolonged period of high case rates and economic stagnation could range from troubling to terrible.The first step toward progress is for governments to make it a priority to do something about homelessness, according to NAEH's Nan Roman. This is the common denominator of successful programs.
As obvious as that may be, the needs of half a million unsheltered Americans can get lost during the nationwide public health emergency, economic turmoil and worldwide protests demanding the dismantling of police departments and systemic racism.
Assisting the homeless does have something to do with untangling this chaos, however. The populations that are disproportionally contracting COVID, losing jobs and suffering violence at the hands of law enforcement are also disproportionally homeless. Though Blacks account for 13 percent of the U.S. population, they are 40 percent of the homeless population.
Homelessness is a solvable problem, says Orlando. In addition to her work in her home state, she shares what she’s doing in Bergen County with colleagues around the country.
“People always say to me, ‘How did you convince the government there to do this?’,” she says. “I'm always reminding them that this is the government – this is what political will looks like.”
