Picture shows the exterior of the Holiday Inn on Rhode Island Ave. NW
Holiday Inn on Rhode Island Ave. NW is one of three DHS PEP-V sites. Image courtesy of Wikimedia Commons

Update: FEMA announced the night of Aug. 3 that federal reimbursements for non-congregate shelters related to the pandemic response will continue through Nov. 30. The D.C. Department of Human Services has not yet announced the fate of PEP-V based on this new information.

On Aug. 10, DHS told Street Sense Media it “will operate PEP-V beyond September 30. However, as people who are currently staying in PEP-V exit to housing, the District may consolidate some of the locations … The recent influx of emergency housing vouchers, combined with local resources allocated to end homelessness in D.C., will provide permanent housing solutions for over 70% of current PEP-V residents.”

D.C.’s program to offer hotel rooms to unhoused people who are exceptionally vulnerable to COVID-19, in place of congregate shelters, is scheduled to end Sept. 30 when its federal funding runs out. Several councilmembers, however, have joined advocates in calls for the Pandemic Emergency Protection for Medically Vulnerable Individuals Program (PEP-V) to become permanent.

Introduced on March 17, 2020, PEP-V offers housing for immuno-compromised individuals who are at a higher risk for severe illness from COVID-19. Those accepted to the program are eligible for permanent supportive housing and were originally allowed to shelter in PEP-V hotels indefinitely until transferred into that housing. As of Aug. 4, a total of 339 clients had transitioned from PEP-V into a home of their own through a permanent or temporary District housing program, according to DHS — just over 40% of the program’s capacity at its height. 

According to the D.C. Department of Human Services (DHS), 564 residents remained dispersed across the four hotels as of July 27. Now that the program has an end date, individuals experiencing homelessness without housing plans will have to return to congregate shelters or live outdoors.

Homeless advocates, however, are challenging the program’s end, arguing that the city should use available funding to continue housing for medically vulnerable individuals both while COVID-19 remains a danger and as a permanent resource within the city’s homeless services system. 

PEP-V kept people alive during COVID-19

 

Amber Harding, a staff attorney for the Washington Legal Clinic for the Homeless, is one advocate calling for the PEP-V program to remain a resource for immuno-compromised individuals past September. She told Street Sense Media that PEP-V has been essential for keeping people alive who are experiencing homelessness while COVID-19 spread through congregate living shelters. Since the District’s PEP-V Program opened in March 2020, there have been only 16 client-related positive cases of COVID-19, according to DHS.

“We are advocating a lot harder to extend the program past September to at least allow people to try and stay longer and not go to congregate shelters,” Harding said. “It’s been critical for keeping people alive.”

DHS agrees with PEP-V’s effectiveness. The program, however, was always intentioned as emergency relief rather than a permanent program. “Our main objective is to ensure that residents in PEP-V sites and those referred to this program are connected to the vaccine and the services they are eligible for in the homeless services continuum,” a DHS spokesperson wrote.

In February, PEP-V was able to house 652 residents with another 555 eligible people on the waiting list that week, according to D.C. the Department of Human Services (DHS)

Two months later, the program expanded to four hotels due to demand for housing, increasing the number of residents served to over 800. When the expansion was announced, the city also said the waitlist, which had grown to 650 people seeking medical housing, would be capped. The capped waitlist was supposed to help the program end gradually, but hundreds of residents still need to be moved by the fall.

Chart of people staying in medically vulnerable hotel rooms through PEP-V from April 2020 to July 2021.

The number of people staying in PEP-V non-congregate shelter rooms from April 2020 through July 2021. Data and chart courtesy of the D.C. Department of Human Services ArcGIS Storymap

While advocates had pressed for more PEP-V hotels since the fall of 2020, DHS initially resisted, citing cost and logistical hurdles. “It is not off the table, but at the same time, I do not want to set the expectation that this is something we are poised and able to do right now,” DHS Director Laura Zeilinger said in February. Through a public records request, Street Sense Media determined that all but 3.75% of expenses for the program — qualified for federal reimbursement through FEMA. At that time, DHS was moving an average of 15 people per month out of PEP-V and into permanent supportive housing, a rate that would not lead to housing for all current PEP-V residents, much less those added to the program when it was expanded in April.

“DHS stopped accepting new referrals to the PEP-V waitlist and asked all referring partners to instead collaborate with DHS and Unity Health Care to support people experiencing homelessness, especially those with underlying health conditions, to access a COVID-19 vaccine,” a DHS spokesperson said.

As of June 2021, every person on the capped waitlist has been contacted and offered a place in PEP-V housing, according to DHS. Every person on the waitlist that wanted housing was moved into a PEP-V site.

[Read More: DHS expands PEP-V hotels but caps waitlist for medically vulnerable people]

Risks of congregate living

 

At the start of the pandemic, COVID-19 cases rapidly spread through congregate shelters. D.C. residents experiencing homelessness were three times more likely to die from COVID-19 and shelter residents were three times more likely to contract the virus compared to the District’s housed population.

Marcus McCall, a Street Sense Media artist and vendor, applied for PEP-V housing in August of 2020 after returning from prison and was granted housing. McCall’s has uncertain relocation plans for housing after PEP-V ends. While he’s currently searching for permanent housing accomodations, if he’s unable to get any before the Sept. 30 deadline, he said he’d probably end up back on the street or in a tent. 

D.C. Will End Hotel Shelter For Medically Vulnerable Residents In September (dcist.com)

 “If I had the opportunity to stay there, yeah I would,” he said. “It would be a great resource.”

The delta variant looms

 

The need for PEP-V isn’t going to evaporate. With recent CDC reports of the highly contagious delta variant becoming the dominant coronavirus strain in the U.S., safe housing accommodations —especially for medically vulnerable people, especially during the winter season — will continue to be a concern. 

We don’t think that the pandemic is going to be gone automatically on Oct. 1,” Harding said. 

But while the pandemic prompted the implementation of PEP-V, Harding said private housing resources for those experiencing homelessness should have existed even before COVID-19. “For decades really, we have been talking about how congregate housing is unsafe and unhealthy for residents,” she said. 

Harding pointed to a trend where people experiencing homelessness have been opting to live on the streets instead of in a shelter over health concerns. “If you have a compromised immune system and one person gets a cold in a room with hundreds of beds, you’re going to get that cold. You have no way of protecting yourself,” she said. 

Pie chart from March 19, 2021 showing the residences of people on the PEP-V waiting list, with "unsheltered" being the biggest category (38%).

Data as of March 19 showing the residences of the 656 people on the PEP-V waiting list. Data and chart courtesy of the D.C. Department of Human Services.

By continuing the program, Harding argues PEP-V could fill an essential need for general medical housing. “My hope is we go out of this better than we went into it. We can do better and the way to do better is through private housing,” Harding said.

At the same time, McCall said the relatively new PEP-V program has had its own batch of operational issues. “It’s been great, but there needs to be better communication between the residents and staff,” he said, referring to the time he traveled to the 7th Street Convention Center for his vaccine when, apparently, DHS had gotten George Washington University students to come to his PEP-V site to administer vaccinations. McCall also expressed frustration with how the government informed them about COVID-19 testing availability and times.

Fred Jewell, who is also a Street Sense Media vendor, is another current PEP-V resident. Jewell described residents being offered a lack of autonomy, such as limited doctor’s appointment times and restrictions for the length of time residents can leave. Jewell said that regular wellbeing check-ins, while important for medically vulnerable residents, often lead to violations of personal space. 

“They [the residents] are homeless. They are not prisoners and they’re not in an institution,” he said. 

[Read more: Vaccine rollout efforts in DC shelters and PEP-V centers began in February]

Additionally, McCall said his PEP-V living situation was unsafe. His roommate frequently overdosed or was in need of medical attention. McCall would leave the room for at least 48 hours, PEP-V requires residents to return within 72 hours, to avoid his roommate, feeling threatened.

While PEP-V is not perfect, McCall said that if the program had been available prior to the pandemic, he would have sought housing there instead of a congregate living shelter. Before living outdoors, McCall previously resided in a shelter. “It was very unhealthy there. It was bed bug-ridden and completely moldy,” he said. 

Challenges to finding permanent housing

 

In April, PEP-V residents were informed that PSH vouchers had run out. Two current residents of PEP-V, who requested to not be named in case it interferes with their applications for housing vouchers, said that they came to PEP-V under the impression it would be transitional accommodation while they wait for permanent housing. 

Now, the two roommates are waiting for permanent supportive housing vouchers despite being told no vouchers are currently available.  

“They keep saying that they don’t have vouchers, but I keep hearing that they’re giving them out. I know someone who just got a voucher,” one resident said. The same resident has applied for a voucher with their case manager, but does not know if they will be granted housing by the Sept. 30 end date.

When asked if current residents know about the approaching end date, Jewell replied, “Supposedly. It’s kind of up in the air.” McCall said that community meetings were supposed to inform people about the program’s closure, but that many are uncertain about when exactly they need to exit the hotels. 

Jewell also pointed out that while all residents are working with case managers, that does not mean securing housing will be a quick process. “Most case managers are not case managers, they give information and referrals,” he said. “I would call them resource coordinators.”

PEP-V clients are being offered emergency housing vouchers as part of Biden’s March $1.9 trillion American Rescue Plan. The plan directs $5 billion dollars to all states and Washington, D.C. to obtain stable housing for people experiencing homelessness — including by providing emergency housing vouchers (EHV) and purchasing new buildings, such as hotels, to convert into permanent housing. 

When the American Rescue Plan funding has first announced, Ward 1 Councilmember Brianne Nadeau,  called for the purchase of the PEP-V hotels to be converted into permanent supportive housing units. 

According to a spokesperson for Nadeau, who chairs the D.C. Council Committee on Human Services, $50 million was added to the fiscal year 2022 capital budget for the purchase of hotels and other properties into general permanent housing. “The Committee strongly encourages DHS and DHCD to identify locations that are accessible to public transportation, amenities, and overall, are responsive to the needs of the residents,” Nadeau’s spokesperson said in an email to Street Sense Media.

DHS does not have plans to purchase any hotels with city or American Rescue Plan funding at this time. “Instead, DHS will fully leverage the influx of new resources available from the federal government and local budget allocations to help people exit PEP-V to housing,” a DHS spokesperson wrote.

The emergency housing voucher program alone, however, would not cover even half of all the remaining PEP-V resident’s transfer to permanent housing resources. Approximately 232 individuals, both from the 564 remaining PEP-V residents as well as those in the broader community who would qualify them for  PEP-V, will be offered emergency housing vouchers through DHS’s Coordinated Assessment and Housing Placement program. 

Table of number of people in 5 D.C. hotels through July 1-July 7.

A daily census for the last published two-week reporting period of individuals in PEP-V and Isolation and Quarantine (ISAQ) rooms: July 1-7. Courtesy of the D.C. Department of Human Services

The proposal to buy the PEP-V hotels and continue the program is supported by current PEP-V residents, like McCall and Jewell. “We need to get them to buy the hotels,” Jewell said. “The people that actually live in the hotels have no place to go.”


Update (08.05.2021)

This article has been updated to include information received after publication: The number of positive COVID-19 cases detected in PEP-V, the number of people who transferred from the program into housing, and FEMA’s announcement of extended funding for programs like PEP-V.

Update (08.10.2021)

This article has been updated to include DHS’s determination that the PEP-V program will continue past the Sept. 30 deadline we previously reported.