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Are there housing lessons to be learned from the pandemic?

In late March, Dr. Thomas Huggett spent much of his time scouring homeless shelters. A physician who works for Lawndale Christian Health Center, he was recruiting residents to live in Hotel One Sixty-Six Magnificent Mile, which offers a rooftop lounge and tech-savvy amenities. Why? Chicago’s shelters were packed and tests for COVID were unavailable; the city government was afraid of tragic consequences as people cycled in and out of high-contact homeless shelters and into their communities.

He visited 23 shelters and interviewed people who were at high risk: anyone over 60, with high blood pressure, severe obesity, respiration problems, or diabetes. He found 172. By mid-July, Huggett’s team had cared for 258 residents in the hotel; 39 had been transferred, with full-blown COVID, to Northwestern Medical Center, and six of those were intubated. No one died. One patient was 92 years old.

Chicago’s approach to decongesting congregate shelters has proved fairly common. New York City has housed people experiencing homelessness in 139 hotels, or 20 percent of the city’s hospitality stock. Tucson contracted for 315 rooms for this purpose. California leased upward of 15,000 rooms, and the governor is proposing that hotels could be a permanent solution.

So is this the answer?

The picture is appealing. News stories feature people successfully completing drug recovery and coping with long-running problems, aided by the stable housing. In Hotel One Sixty-Six, Huggett’s patients watched the empty streets below and were grateful for their shelter, and the results are encouraging. “We probably saved some lives,” he says with characteristic modesty. But he doesn’t believe this is the answer. “It’s much more intensive and expensive.” Start with the nine doctors who staffed Hotel One Sixty-Six. Add the three meals a day—delivered—and the cost of renting the rooms. Instead, Huggett looks toward models like one in Denver, where the Colorado Coalition for the Homeless recently purchased a Quality Inn & Suites, retrofitting it for specific needs. He also hopes for more stabilization units in Chicago (not SROs, or single-room occupant facilities). “Studio apartments,” he says, “with services on-site.”

But mostly he hopes lessons learned in the pandemic will stick. The lessons are:

  1. Health disparities in this country are accentuated during the pandemic. With heightened demand for health services, the inaccessibility of care for a large swath of Americans is laid bare. It’s also a threat to all of us.
  2. Housing is healthcare. Huggett has said this before, but the Hotel One Sixty-Six project has proved the point. Stable housing supports management of diabetes, heart disease, and even mental illness. “It is really difficult to achieve good health without steady housing,” he says.
  3. There are serious bottlenecks in the system. As Huggett’s team tried to find housing for discharged patients, problems arose. In one case, a man with a $1,100 housing voucher found an apartment for $880 in nearby Berwyn, but the landlord rejected his application. Reason: The man’s credit score wasn’t high enough. The reason for the compromised score: $6,000 in traffic camera tickets, which had also contributed to his homelessness. And the result: The man is still in the hotel. “Even though his rent was guaranteed,” Huggett laments.

With these learnings in hand, he has something close to mixed feelings about the hotel project. “We’ve seen the health value of this,” he says. It works. But he’d rather not be managing more than one hundred patients in a luxury hotel made for vacationers, honeymooners, and executives with credit cards. “I’m not in the hotel business,” he sighs. “I’m a doctor.”