We, a concerned group of healthcare workers and public health professionals, oppose the city's plan to move individuals currently sheltered in hotels back into congregate shelter for the following reasons:

- The mortality rate for New Yorkers living in congregate shelter has been estimated at 49% higher than the mortality rate for the general New York population by the Coalition for the Homeless
- Hotelling, a program that has been fully reimbursed by FEMA, was instituted to allow social distancing
- Delta variant is on the rise and there is a lack of clear data around vaccination rates among people experiencing homelessness
- Hotelling is also associated with a reduction in overdose deaths among New Yorkers experiencing homelessness and improved mental health and reduced 911 calls among individuals elsewhere

We oppose a move from hotels to congregate shelter and advocate for the rapid enaction of legislation such as Intro 146, the “Housing Our Neighbors with Dignity” (HONDA) Act, and expansion of the Family Homelessness & Eviction Prevention Supplement to increase access to affordable, permanent housing.

Please read the full statement below, and if you would like to sign on in support, please fill out the form below.

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Dear Department of Social Services Commissioner Steve Banks, Department of Homeless Services Deputy Commissioners Molly Park & Erin Drinkwater, and Deputy Mayor for Health and Human Services Melanie Hartzog:

As health care and public health professionals we urge the city to halt its moves of individuals from hotels back into congregate shelters. Moving half of the adult shelter system into individual hotel rooms during the pandemic saved lives. Despite this, by June 2020 COVID-19 was the second leading cause of death for those experiencing homelessness. In the year not yet accounted for in the city’s data, we witnessed the virus sicken and kill more from this community, including through the brutal winter surge. Therefore, we are alarmed by the decision to move almost 8,000 individuals from hotels to shelters, a decision that does not seem to have been made with health considerations in mind.

People experiencing homelessness are at increased risk for severe COVID-19, as they are older and have high rates of chronic disease. Throughout the pandemic, individuals experiencing homelessness who were living in congregate shelters faced high risk for COVID-19 infection and mortality. One analysis by the Coalition for the Homeless found that through February 2021 the mortality rate for New Yorkers living in congregate shelter was 49% higher than the mortality rate for the general New York population. This increase was largely attributed to the spread of COVID-19 in shelters, settings where congregate living made social distancing impossible.
In response, the city opened hotels to those who had been living in shelters. This was an urgent public health intervention that allowed thousands to self-isolate, thus protecting themselves and others from the virus. The federal government supported these efforts, with FEMA providing reimbursement for COVID-19-related shelter interventions, funding that could persist until September 2021.

Cases of COVID-19 are once again on the rise in New York City fueled by the Delta variant which is now responsible for the majority of infections. The high infectivity of this variant makes it particularly dangerous for those not yet protected by vaccines. Unfortunately, vaccination rates among individuals experiencing homelessness are unclear. The Department of Homeless Services (DHS) has reported that 6,851 clients have been fully vaccinated through its own vaccination program as of July 2. Even if this number is an undercount it is still a far cry from 70% of the total adult shelter population. Relocating individuals into congregate shelter, with no means to properly socially distance within shelters, is a dangerous decision. Recently there has been an outbreak of dozens of COVID-19 infections within a shelter in Santa Rosa, CA which had a vaccination rate of around 40%. Increased transmission within shelters could lead to an explosion of cases across the city.

We withhold our confidence in the City’s ability to monitor rates of infection and vaccination in shelters given that the data released so far has been so sparse. We call on the DHS to immediately make public all data on testing results from shelters including the number of tests conducted, number positive, percent positivity and continue to release data for tests conducted each week in a timely manner. In the absence of this data, we cannot begin to surmise what criteria the City is using to determine that returning to shelters can be considered safe.  Furthermore, this relocation plan flies in the face of the state’s own reopening guidelines. In accordance with CDC recommendations, the state’s plan clearly states: “Unvaccinated individuals and individuals who have an unknown vaccination status must be spaced six feet apart in assigned sections.” Adhering to such guidelines is impossible in a congregate shelter.

The moves into hotels did more than just protect from COVID-19. A study of the population moved into hotels from shelters during the pandemic in King County, Washington showed improved mental health and reduced 911 calls. In NYC, recent data show that overdose deaths among people experiencing homelessness decreased when hotelling began. Other municipalities have seen increases in overdose deaths among their populations relocated to hotels, possibly related to people using alone. Ensuring that hotels are adequately staffed with providers trained in overdose reversal can help prevent such issues from arising here. We are in the midst of an overdose death crisis in NYC, with the highest number of opioid overdose deaths in the history of the city. Overdose continues to be the leading cause of death of individuals experiencing homelessness. Forced relocation to congregate settings could thus compound both the risk of COVID-19 infection and deaths from overdose.

Repopulating shelters now directly threatens the health of thousands of homeless New Yorkers and, indirectly, that of the entire city. The hastiness of this decision was recognized in a recent federal ruling, which stated that the city must investigate reasonable accommodations for individuals with disabilities prior to relocation. This requirement is a bare minimum. If we are to continue to protect the health of the most vulnerable among us and prevent another resurgence of the virus, we must not move forward with the plan to relocate the remaining individuals into congregate shelter. We must reverse the relocations that have already happened, and we must again de-densify the shelter system by moving people into permanent supportive housing. Hotels and other forms of individual shelter options must be maintained, created, and funded, but should be stepping stones towards permanent, stable housing. Finally, we must rapidly enact legislation such as Intro 146 at the municipal level and the “Housing Our Neighbors with Dignity” (HONDA) Act and FHEPS expansion at the state level to make real commitments to providing affordable, secure housing for our most vulnerable.

Congregate shelter is not an adequate substitute for secure, stable housing; it is high time that we recognize that health is a human right, and that housing is vital for health and must thus also be recognized as a human right.