TO: Mayor Bill de Blasio

FROM: Daliah Barg, Meng Lin, and Isabella Romano

SUBJECT: Addressing the rise of homelessness in NYC due to the COVID-19 pandemic
DATE: February 28, 2021

The purpose of this memo is to provide a two-part plan to address the rise of homelessness
amidst the COVID-19 pandemic, including both short and long-term solutions. The first
element is to provide emergency housing choice vouchers available to individuals at risk of
eviction. This will create immediate economic stimulus by providing payments to landlords, and
also minimize the potential for an increase in homelessness once eviction holds are lifted. The
second element is to implement the Housing First (HF) program which, as a starting point, will
secure over 5,000 long term housing options and create avenues of support for issues such as
mental health and addiction that are key factors in the cycle of homelessness. The HF approach
will create cost-effective, evidence-based housing solutions for NYC’s lowest income
populations, and will result in long term economic recovery.

Homelessness in New York City has skyrocketed 1 in recent years and that trend has only
been exacerbated by the pandemic. Additionally, once eviction restrictions are lifted there
will be a “tsunami 2” of eviction filings. During 2020, almost 130,000 unique individuals spent
at least one night in an NYC shelter, an increase of 143 percent from 2009.3 The homeless
population is especially impacted by COVID-19. One study estimates that “up to 10 percent of
[the homeless] community will be hospitalized due to COVID-19 – nearly 56,800 people.
Homeless individuals infected by COVID-19 will be twice as likely to be hospitalized, two to
four times as likely to require critical care, and two to three times more likely to die than the
general population.”4 Also, homeless individuals experience a COVID-19 mortality rate that is
78% greater than the citywide average. 5 Permanent housing solutions which will lower the social
and economic cost of homelessness. The two-step plan is beneficial in the context of the
pandemic because neither initiative will have income requirements, such as those in Your Home
NYC (2020) which exclude many low income houses, specifically those of Black and Latino
individuals. 6 Significant economic impacts of homlessness include emergency medical services,
ambulance rides, and shelter stays. Also, there is the exorbitant cost of COVID-19 medical care.

1
“Homelessness is a Shared Experience in the New York metro area”. The Bowery Mission.
https://www.bowery.org/homelessness/#:~:text=Today%2C%20more%20New%20Yorkers%20are,or%20in%20other%20public
%20spaces.
2
Brenner, Ryan. “Data Update: Eviction Filings in NYC Since COVID-19”. https://furmancenter.org/thestoop/entry/data-
update-eviction-filings-in-nyc-since-covid-19.
3
Routhier, Giselle. “Governor and Mayor to Blame as New York Enters Fifth Decade of Homelessness”.
https://www.coalitionforthehomeless.org/state-of-the-homeless-2020/.
4
Routhier, Giselle and Nortz, Shelly. “COVID-19 and Homelessness in New York
City.”https://www.coalitionforthehomeless.org/wp-content/uploads/2020/06/COVID19HomelessnessReportJune2020.pdf
5
Johnes, Zoe Christen. “COVID-19 is driving New York City’s record homelessness figures, advocates say”.
https://www.cbsnews.com/news/covid-19-homelessness-new-york-city/
6
Zevallos, Pablo. “Opinion: De Blasio’s Housing Plan is Neither Affordable Nor Fair”. citylimits.org/2019/04/18/opinion-de-
blasios-housing-plan-is-neither-affordable-nor-fair/.
To combat NYC’s growing homelessness problem, mitigate the risk of COVID-19 to NYC’s
homeless population, and provide short and long-term economic benefits, this memo
recommends a two-pronged permanent supportive housing approach. The first
recommendation is intended to both reduce homelessness and allow landlords to recover some of
their lost rent wages as the pandemic nears an annual marker. Roughly a third of landlords
make less than $50,000 a year 7, which means that the landlords are likely to their income in
ways that will stimulate the economy, including healthcare costs, daily necessities, and their own
rent/mortgage payments. Since an emergency housing choice voucher system already exists,8
expanding this program to include those facing eviction risks related to the pandemic would
build on existing government agency funds and operations. This initiative should include
retroactive rent compensation as well as erasing pandemic-related rent debts from credit scores.
Such debt is crippling to credit scores 9 and an individual’s ability to achieve future financial
stability. One possible hurdle is the Housing and Urban Development (HUD) inspection
requirement for voucher approval, which should be delayed or waived entirely for the duration of
the pandemic. However, inspections could be incentivized by offering 80% of rent to be paid
upfront, and the remaining 20% once repairs are completed. This would both update
infrastructure and create further immediate economic stimulus through building repair spending.
The second recommendation is to implement, test, and potentially scale a Housing First
approach to directly place individuals and families experiencing long-term/repeated
homelessness and chronic conditions into homes. This approach provides long-term near-total or
total rental assistance, move-in assistance, and optional supportive services (case management
and mental health/substance abuse treatment). The rental assistance will be reevaluated on a bi-
annual basis and continued indefinitely until the individual or family can pay the full rent amount
on their own. This memo recommends initially identifying 5,000 units and families/individuals
for participation in the Housing First initiative, and then scaling the program based on its success
(see Appendices 1 and 2 for costs).

Permanent housing programs result in overall cost savings. Housed persons are less likely to
require emergency services, including hospitals, jails, and shelters. Appendix 3 includes a
compilation of studies analyzing costs for fifteen Housing First programs across the US which
provided permanent supportive housing for a total of 2,664 persons. In all fifteen studies, the net
impact of overall costs was negative, meaning the cost spent on the program was less than cost
decreases in other areas. Areas where costs were reduced include incarceration, inpatient and
outpatient medical and mental health treatment, ambulance rides, police and arrest spending,

7
Iacurci, Greg. “Millions can’t pay rent. Landlords making less than $50,000 a year are caught in the middle”.
https://www.cnbc.com/2020/09/21/landlords-making-less-than-50000-a-year-hit-hardest-by-rent-loss.html
8
“Emergency Section 8 Housing: Eligibility, Priority Waiting List, How to Apply”. https://www.hirefelons.org/emergency-
section-8-housing/.
9
DiGangi, Christine, “How Renting Can Impact your Credit”. https://www.credit.com/credit-reports/how-renting-can-impact-
your-credit/.
incarceration, shelters, alcohol and drug detox treatment, case management, and hospital visits.
These cost savings are especially relevant in a time when COVID-19 related healthcare costs, as
well as costs for emergency services including shelters, food pantries, and ambulance rides are
on the rise.

Based on the proven success of permanent housing approaches in saving costs, reducing
homelessness, and improving quality of life, this memo encourages Mayor de Blasio to
propose the two-step plan outlined above to the City Council’s Committee on Public
Housing. The implementation of the emergency housing voucher program has the potential to
save the state millions of dollars. “The cost of allowing a family to lose their home and end up in
the shelter system is approximately three times the cost of ensuring they keep their home.” 10
After expanding housing vouchers, the City Council should approve a plan to test the HF
program with 5,000 participants. The New York City Housing Authority (NYCHA) will oversee
identifying vacant, affordable housing units; identifying participants, and gathering data over a
two-year test period. Based on the data gathered after the first two years, NYCHA will report
outcomes and suggest possible expansion to the City Council.

10
Hallum, Mark. “Eviction ban in New York to be extended for the rest of 2020, but rent crisis still unresolved”.
https://www.amny.com/news/eviction-moratorium-in-new-york-extended-for-rest-of-2020-but-rent-crisis-still-unresolved/
Appendix 1: Cost Analysis of NY/NY III Supportive Housing Program (2007-2009)
This cost analysis compares a total of 1,695 persons in permanent supportive housing in New
York City through the NY/NY III Program. These persons were of the following populations:
homeless & with serious mental illness (SMI) or mental illness (MI) & a substance abuse
disorder (SUD); previous residents in state-operated psychiatric facilities & at risk of
homelessness; homeless & have an SUD; homeless & have been treated for an SUD; heads of
family with an SMI or MI & an SUD; heads of family with an SUD, disabling medical condition,
or HIV/AIDs; young adults leaving foster care & at risk of homelessness. The cost analysis
compares this combined population to a combined population of 3,700 unplaced persons.
Per-Person Cost Analysis
Adjust costs for Adjusted costs for Cost Differences
Cost Category placed applicants unplaced applicants
Jail $410 $1,708 -$1,298
Single adult shelter $164 $5,591 -$5,427
Family shelter $10 $1,502 -$1,492
State psychiatric $750 $19,418 -$18,668
Medicaid $18,134 $19,069 -$935
Food stamps $1,793 $1,357 +$436
Cash assistance $2,094 $2,375 -$281
Institutional/Benefit total -$27,665
costs $23,355 $51,020
NY/NY III cost $17,566 $0 +$17,566
Total $40,921 $51,021 -$10,100
Program Cost Analysis
Adjust costs for Adjusted costs for Cost Differences
Cost Category placed applicants unplaced applicants
Jail $694,950 $2,895,060 -$2,200,110
Single adult shelter $277,980 $9,476,745 -$9,198,765
Family shelter $16,950 $2,545,890 -$2,528,940
State psychiatric $1,271,250 $32,913,510 -$31,642,260
Medicaid $30,737,130 $32,321,955 -$1,584,825
Food stamps $3,039,135 $2,300,115 $739,020
Cash assistance $3,549,330 $4,025,625 -$476,295
Institutional/Benefit total
costs $39,586,725 $86,478,900 -$46,892,175
NY/NY III cost $29,774,370 $0 $29,774,370
Total $69,361,095 $86,480,595 -$17,119,500

The data in table A2:1 was compiled from the following source; the data in table A2:2 was
generated by the author of this memo based on the same source:

Levanon Seligson A, Lim S, Singh T, Laganis E, Stazesky E, Donahue S, et al. New York/New
York III Supportive Housing Evaluation: Interim Utilization and Cost Analysis. New
 York City Department of Health and Mental Hygiene in collaboration with the New York
City Human Resources Administration and the New York State Office of Mental Health;
2013.
Appendix 2: Scaling NY/NY III Supportive Housing Program
The following are projections of scaling the NY/NY III Supportive Housing Program for 5,000;
10,000; and 15,000 individuals.
Cost Projection for Housing First Program for 5,000 individuals
Adjust costs for Adjusted costs for
Cost Category placed unplaced Cost Differences
applicants applicants
Institutional/Benefit
$116,775,000 $255,100,000 -$138,325,000
total costs

NY/NY III cost $87,830,000 $0 +$87,830,000

Total $204,605,000 $255,105,000 -$50,500,000
Cost Projection for Housing First Program for 10,000 individuals
Adjust costs for Adjusted costs for
Cost Category placed unplaced Cost Differences
applicants applicants
Institutional/Benef
$233,550,000 $510,200,000 -$276,650,000
it total costs

NY/NY III cost $175,660,000 $0 +$175,660,000

Total $409,210,000 $510,210,000 -$101,000,000
Cost Projection for Housing First Program for 15,000 individuals
Adjust costs for Adjusted costs for
Cost Category placed unplaced Cost Differences
applicants applicants
Institutional/Benef
$350,325,000 $765,300,000 -$414,975,000
it total costs

NY/NY III cost $263,490,000 $0 +$263,490,000

Total $613,815,000 $765,315,000 -$151,500,000
The projections above were generated by the author of this memo based on original data from the
following source:
Levanon Seligson A, Lim S, Singh T, Laganis E, Stazesky E, Donahue S, et al. New York/New
York III Supportive Housing Evaluation: Interim Utilization and Cost Analysis. New
York City Department of Health and Mental Hygiene in collaboration with the New York
City Human Resources Administration and the New York State Office of Mental Health;
2013.
 Appendix 3: Cost Analysis of 15 Housing First (Permanent Supportive Housing) Programs
All fifteen programs provided permanent housing for participants and resulted in a negative net
impact on overall costs, meaning the amount of decreased costs in areas such as medical,
criminal justice, and emergency services was greater than the amount spent on the program. The
data is compiled from sixteen sources, listed following the table.
Location Target Number Observa Perspect Measured Main Net Areas
of tion ive Costs Results impa where
Particip Period ct on costs
ants overa decrease
ll d
costs
Skid Homeles 50 5 years Govern Alcohol Over Negat Medical
Row, LA s, Top 50 ment and drug two-year ive treatment
highest incarcerati study , mental
hospital on, period: health
service medical, Total cost treatment
users mental offsets of ,
health 3.284 Incarcera
M$. tion,
Surplus substanc
of $4774 e abuse
per treatment
occupied
unit
New Chronica 431 1 year Govern Total Costs Negat healthcar
York City lly ment- Medicaid, lower by ive e, state
homeless subsidize state $878 per psychiatr
single d psychiatric person ic
adults centers, for all centers,
with SMI shelters, measure jails
or with food ments
dual stamps, except
diagnosis cash cash
of mental assistance, assistance
illness jail and food
and stamps.
substanc Costs
e use lower for
disorder shelters
by $9,916
Greater Urban 99 1, 2 Not Healthcare, 2007 Negat physical
Portland, homeless years Stated mental study: ive healthcar
ME (24% after healthcare, cost e, mental
 chronic ED jail, decrease healthcar
homeless ambulance, of e,
) police $14,036, ambulan
surplus of ce,
$944 per incarcera
person. tion,
2009 police,
study:
cost
decrease
of
$13,492,
surplus of
$133 per
person
Rhode Chronic 48 1 year Govern Hospital, Cost Negat Hospital,
Island, homeless ment mental decrease ive inpatient
NY health of $7946 physical,
overnight, per incarcera
alcohol/dru person tion,
g police,
overnight,
ED,
jail/prison,
shelter
Los Chronic 4 2 years Govern Inpatient Cost Negat Physical
Angeles, homeless ment treatment/d decrease ive healthcar
CA etox of e, mental
admission; $80,256 healthcar
alcohol per e, justice
and drug person system,
outpatient substanc
treatment/d e abuse
etox; ED,
hospitaliza
tion,
mental
health
clinic,
arrests,
jail, prison
Asheville Chronic 25 4 years Govern Substance Cost Negat ED and
, NC homeless ment abuse decrease ive inpatient,
service, of inpatient
shelter, $60,441 psychiatr
jail, ED, ic,
 outpatient, incarcera
HIV tion,
services, outpatien
psychiatric t
hospital, physical,
inpatient HIV
mental services
health,
outpatient
mental
health
Illinois Homeles 177 2 years Govern Medicaid, Cost Not Inpatient
s or at ment state decrease States psychiatr
risk of prison, for all ic,
homeless county variables Inpatient
ness with jails, physical,
mental mental ED,
illness health outpatien
and/or hospitals, t
who are uncompens physical,
formerly ated outpatien
incarcera hospital t mental
ted services health,
paid by
hospital,
substance
abuse
treatment
services
New Chronic 15 2 years Health Hospital Savings Negat Inpatient
Jersey homeless insurer overnight, per tenant ive psychiatr
mental per year: ic,
health $9429 inpatient
overnight, physical,
ER, ED
alcohol/dru
g
overnight,
jail/prison
overnight,
shelter
overnight
Albuquer Homeles 33 Over 1 Govern ED, Cost Negat Ambulan
que, New s with year ment inpatient decrease ive ce,
Mexico behavior medical, of inpatient
inpatient $27,146 physical,
 al health behavioral incarcera
disorder health, tion,
outpatient outpatien
medical, t
outpatient physical,
behavioral shelter,
health, substanc
detoxificati e abuse,
on detox
services,
ambulance
services,
fire
department
response
services,
ACT, jail
bookings,
case
manageme
nt, shelter,
arrests
San Homeles 25 2 years Govern Psychiatric Cost Negat Ambulan
Diego, s heavy ment hospital, decrease ive ce,
CA service arrests, of inpatient,
users of jail, $220,467 ED,
health detox/sobe police
and ring arrest,
justice centers, incarcera
services crisis tion,
house,
PERT
visits,
shelter
North Chronic 42 2 years Govern Jail, Cost Negat ED,
Dakota Homeles ment shelter, decrease ive incarcera
s detox, of tion,
clinic, ED, $204,140 police
hospitaliza arrests,
tion, outpatien
arrests, t clinic,
administrat shelter,
ion detox
Calgary, Homeles 176 1 year Govern Hospitaliza Cost Negat Inpatient,
MA s with ment- tion, decrease ive ED,
ambulance, police,
 complex subsidize ER, jails, of incarcera
needs d police, $34,132 tion,
courts, shelter
shelter
Massachu Chronic 766 2 years Health Medicaid Cost Negat Medicaid
setts homeless insurer billing decrease ive ,
with claims (in- of incarcera
disabling patient, $24,586. tion,
condition outpatient, Surplus shelter
transportati of $9118
on to per
medical person
visits,
ambulance,
pharmacy,
dental
care),
shelter,
incarcerati
on
Boston, Homeles 700 2 years Health In-patient Cost Negat Mental
MA; s insurer and out- decrease ive healthcar
Chicago, veterans patient of $7431 e,
IL; costs medical
Dallas, (mental healthcar
TX; health, e,
Bronx, substance inpatient
NY; abuse, psychiatr
Detroit, medical). ic,
MI; Los substanc
Angeles; e abuse
Philadelp
hia, PA;
New
Orleans,
LA; San
Francisco
, CA;
Washingt
on, DC;
Portland,
OR;
Syracuse,
NY; Bay
Pines,
FL;
Denver,
CO
Moore Chronic 73 2 years Health Hospital Cost Negat ED and
County, homeless system billing decrease ive inpatient
N.C. with (hospitaliz of
disabling ation and $29,070
condition ED)

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