From Shelters to Hotels: An Enduring Solution to Ending Homelessness for Thousands of Americans

As the COVID-19 pandemic raged in April 2020, public health authorities recognized that “dedensifying” homeless shelters was a major public health priority. In a move that was both financially possible (utilizing Federal Emergency Management Agency [FEMA] funding under the Coronavirus Aid, Relief, and Economic Security Act) and guaranteed to save lives, many local governments authorized shelter providers to move residents into hotels left empty by a dramatic drop in tourism and business travel. The total number of homeless persons moved nationally because of COVID-19 is unknown, but it was substantial—approximately 9,500 in New York City and 4,300 in Los Angeles County alone.

A Bold Approach Is Possible

From the outset, anecdotal reports underscored the positive impacts on shelter residents who suddenly found themselves living in the relative comfort of a climate-controlled room with clean linens, private bathroom, and—last but not least—an address and stable living situation. Although presumed temporary because of an expected end of FEMA funding, this housing solution offered much-needed relief for residents from the dangers of crowded shelters or life on the streets.

Most shelters—especially those housing persons with serious mental illness awaiting supportive housing placements—relocated their support staff to the hotels where they maintained onsite services. Perhaps not surprisingly, a few hotels faced local opposition as these relocated hotel residents were considered unwelcome in some neighborhoods. At this juncture, the aphorism “never let a serious crisis go to waste” seems fitting. Ending homelessness for thousands of individuals and families can be achieved by taking advantage of this once-in-a-lifetime opportunity to convert empty hotels and unused business properties into affordable housing. If the necessary political will and organizational innovation can be summoned and sustained to support this strategy, the expensive—and dehumanizing—circuit that homeless persons often traverse between streets, shelters, jails, and hospitals (1) can be broken.

This bold approach is already under way in California, where the state’s Project RoomKey was expanded to Project HomeKey in June 2020 with the intention of combining federal and state funds to purchase and convert hotels into more permanent housing. However, the scope of this initiative is designed to house <30% of the homeless population (https://thehill.com/opinion/finance/509666-what-the-pandemic-taught-us-about-the-homeless-and-what-we-shouldnt-forget). Other states, including Oregon, Vermont, New Mexico, and Minnesota, are considering similar initiatives (2). With the numbers of homeless persons almost certain to rise in 2021 and beyond, we have reached an historic inflection point. Hotels should be used as long as necessary to replace congregate shelters, and those that can be converted to permanent apartment units should undergo needed alterations as soon as possible.

Life in Hotels: Some Promising Outcomes

The virtual absence of empirical research—impeded in part by COVID-19 restrictions—has left us with limited evidence describing the impact of moving homeless people from streets and shelters into hotels. However, the evidence so far is encouraging. A longitudinal study currently under way in Seattle used interviews and administrative data to track individual outcomes after transitions from homelessness to hotel living. Preliminary findings are uniformly positive: reduced rates of COVID-19 infection, improved mental and physical well-being, reduced interpersonal conflicts (and 911 calls), and more transitions to permanent housing, as well as increased engagement with service providers (3).

One agency in New York City reported a two-thirds decrease in substance use–related incidents (including 911 calls) after shelter residents relocated to hotel rooms (https://www.projectrenewal.org/lucerne). A qualitative interview study of hotel residents in New York revealed the benefits extended to multiple domains, including general medical and mental health, personal hygiene, feelings of safety (from COVID-19 as well as violence), improved sleep, diet and nutrition, easier access to public assistance such as food stamps, and other advantages of having a stable address for applying for jobs or permanent housing and making and keeping appointments with providers. Relationships with hotel staff were positive, and problematic incidents were infrequent and typically handled by support staff from the sponsoring agency (Padgett, Bond, and Wusinich, 2021, submitted manuscript).

Best Practices Are Available to Help

Two evidence-based practices—Housing First (HF) and Critical Time Intervention (CTI)—present opportunities for ensuring successful moves from shelters to hotels and homes. HF is an approach that prioritizes housing without behavioral contingencies, has been adopted widely, and provides guidance on accelerating the path to independent living for persons experiencing homelessness, particularly those with serious mental illness and co-occurring substance disorders (4). CTI is an empirically supported, time-limited care coordination model that could assist hotel residents in connecting with community resources, including formal services, informal supports, and permanent housing (5). Both HF and CTI could also include efforts to help build mutual support among hotel residents, consumer-led advocacy efforts, and other forms of collective action.

Few would argue, especially not the individuals who are experiencing homelessness (https://www.streetroots.org/news/2020/05/22/survey-moving-motels-hotels-top-choice-unhoused-people), that shelters are preferable to hotels. Yet some shelter staff may experience new challenges resulting from this transition. For example, staff have to adjust to providing services to clients who are not under the level of scrutiny typical of congregate settings. The fact that clients “can just close the door on us” may run up against a clinical mandate to detect substance use or other infractions. Thus, key tenets of HF, including consumer choice and harm reduction, may be difficult for some providers to accept. From the client’s perspective, this viewpoint is problematic. One interviewee in Padgett et al.’s study (Padgett, Bond, and Wusinich, 2021, submitted manuscript) reported that during her stay in a city-run hotel, multiple “bed checks” were conducted throughout the night that interrupted her sleep and invaded her sense of privacy. Despite the existence of these sometimes opposing interests of residents and providers, we note that the consumer preference for hotel living, combined with greater protection from COVID-19 and the stresses of crowded shelters, clearly renders the transition to hotels a win on multiple fronts for persons experiencing homelessness.

There is immense diversity among single adults experiencing homelessness—a minority diagnosed as having a serious mental illness, those in the throes of addiction, and the “silent majority” who live with trauma from life on the streets and extreme poverty but do not have serious mental illness or addictions. Many members of all of these groups are able and willing to work if given adequate supports such as job training, additional schooling, and similar opportunities. A stable home makes this far more likely.

Conclusions

We fear that hotels might end up being just temporary waystations to mitigate the immediate impact of COVID-19 on the homeless population if the opportunity to convert them to more stable housing is lost or, in the places where this housing approach is being trialed, becomes derailed by feasibility challenges. There are certainly obstacles to overcome. Changes will be needed in zoning requirements, in shortening wait times for building permits, and in raising capital to pay for support services and other costs not covered by federal or state funds. It is also possible that some hotel conversions will devolve into troubled institutional settings because of programmatic neglect. Ultimately, of course, hotel conversions must be considered within the larger context of increasing multiple forms of affordable housing, hopefully made possible by an anticipated new infusion of federal funds via the American Rescue Plan Act.

There is a growing realization that the status quo is not only expensive but also not working. It took a calamitous pandemic to open the door to potentially real and lasting transformations in homeless policies and practices. Failure to act on this immense opportunity will continue to deny our most vulnerable fellow citizens the fundamental right to safe and secure accommodation.