Adi Talwar

The 53rd Street Men’s Shelter between 2nd and 3rd avenue in Manhattan.

Alvin Peterson, a 63-year-old resident of Samaritan Village’s homeless shelter on East 53rd Street, was having trouble breathing last December. His breathing had been getting worse for years, owing to very severe emphysema and Chronic Obstructive Pulmonary Disease, or COPD. After a hospital visit, he was given an oxygen machine with a tank attached.

But the oxygen tank was considered flammable and violated a rule at New York City’s homeless shelters. As he waited for a smaller, portable oxygen concentrator to be sent to him by his insurance company, he was not permitted to take the tank inside Samaritan Village’s shelter.

Since he needed the tank to breathe, this meant he was essentially barred from shelter. He lived on the streets for nearly a week, bracing frigid temperatures and sleeping in subway cars for warmth.

He was allowed back only after a Legal Aid Society lawyer intervened. The lawyer, Kathryn Kliff, called the shelter and brokered an arrangement: DHS staff would keep Peterson’s oxygen tank in the lobby and when he needed to use it, which was often, he would have to come ask for it.

It wasn’t ideal– walking the distance from his dorm-style room to the shelter’s lobby was tiring and cost him breath – but it kept him inside, during a winter in which temperatures dropped to single digits.

The problems of access and accommodation for homeless people who are disabled or ill have been felt more deeply as the homeless population has grown as well as aged. There were 57,935 people in the shelters as of June 2. While that census is a drop from 60,570 on New Year’s Day, the number of people in shelter is 75 percent higher than 10 years ago, according to the Coalition for the Homeless.**

The number of single adults in shelter who are 65 and older has doubled since January 2014, the first month Mayor De Blasio was in office, to 1,438 last December. The shelter count for those between the ages of 45 and 64 has also grown, and was nearly 10,000 last winter.

A UPenn study estimated the 65 and older population in NYC’s shelters could balloon to nearly 7,000 by 2030 without intervention. Homelessness already disproportionately affects late baby boomers who came of age during recessions in the 70’s and 80’s. That population is now prematurely aging, with medical ages much higher than their biological ages, the report says. The city’s shelter system has been ill-equipped to handle a web of illnesses and disabilities that come with age, and the impact is felt by homeless elders, some of whom have been weathered by years of homelessness.

Episodes like Petersen’s in which disabilities preclude people from receiving shelter were so common in New York City that they led to a class action lawsuit against the city. Butler vs. The City of New York ended in a settlement in 2017, requiring the city to provide reasonable accommodations for disabled people in its shelters. The city agreed to retrain of all Department of Homeless Services staff and make physical upgrades to some shelters to make the system more accessible, as well as to change discriminatory policies with a timeline enforced by court-appointed monitors at the Legal Aid Society. That timeline keeps slipping, the monitors say.

Growing old, getting homeless

The people who spoke to City Limits for this article are mostly elders in the shelter system, who bear the brunt of age-related disabilities, illness, infirmity and mobility issues. But elders are by no means the only population plagued by these deficiencies: While 12 percent of New York City residents are disabled, HUD estimated that a staggering 44 percent of NYC’s shelter population has a disability, as of 2014.

There are a variety of paths for an older person to become homeless. Some were in relationships that dissolved and found they couldn’t pay the rent on their own. Some are the long-term homeless who found themselves outside the formal economy early in life and never found a way back.

Peterson has cycled through jail, prison and homeless shelters since the 1980’s. His first stint was a year in Rikers in 1984 for sale, possession and attempted distribution of narcotics. It was only going to be six month sentence with 54 months’ probation, but he was sent to prison on a parole violation for three more years.

These technical parole violations and more arrests with what he says were exaggerated charges accumulated, and any hope of a stable income or living arrangement evaporated. The first time he entered a city homeless shelter was 1993, after being released from prison, and he’d find himself at shelters many more times. He’s been at the Samaritan Village shelter since 2014.

Elders who are entering the system at intakes who spoke to City Limits often had some kind of disability, pain or illness that hindered their ability to work and could not meet rent.

At the single men’s intake on 30th Street, one sees a snapshot of the disorienting admission process. Throughout the day, men saunter in and out of the building and periodically congregate on a street corner for a cigarette, comparing their experiences.

Bart Silverman, a 58-year-old out-of-work truck driver, described Bellevue as poorly run and intake coordinators as slow. He’s been at the shelter for a year, after being evicted from his apartment. He confirms that the site’s main elevator does not work, saying that an alternate elevator functions, but requires walking up a flight of stairs to the first floor.

“The place is not run well,” he says. But he struggles, too, with his own agitation and frustration. Fidgeting back and forth and ruminating while smoking a cigarette, Silverman says what’s asked of him in his independent living plan is unrealistic: He’s expected to look for work all the time, but jobs in his line of work have been slim. He manages to look for work about two days a week, he says.

Even those with seemingly reliable government jobs have found themselves in the city’s shelters. Tom, a 64-year-old retired postal worker who did not want to give his last name, was evicted from his apartment in Queens Village only a few weeks before speaking to City Limits. He had to retire a few years early due to chronic illness, but spent 20 years at the Post Office. The $700 a month pension he receives was not enough to pay for his $800 a month basement apartment in Queens Village. He’s now trying to get his social security payments early. But at the beginning of May, he got a $100 ticket for theft of services after skipping a subway fare.

When he spoke to City Limits he had only been in the shelter system for one day, after riding the subway and living on the streets for two weeks. It was his first full night’s sleep since becoming homeless, he said, and he felt as though he were still in a daze.

“This is not how I pictured retirement,” he said. “I pictured myself traveling around. Maybe I still will.”

Lawsuits’ legacies

NYC’s social services must comply with several legal decisions in its treatment of disabled persons: A 2005 settlement in the case Lovely H. v Eggleston held that the city’s Human Resource Administration had to provide reasonable accommodations to disabled clients when they apply to HRA benefits, and keep track of client disabilities that could interfere with benefit requirements. Another settlement requires HRA to provide accessible forms to people with vision impairments and, a consent decree requires the city to accommodate those who are hard of hearing.

Butler v. The City of New York was brought against the Department of Homeless Services specifically and alleged the entire system was discriminatory and in violation of the Americans with Disabilities Act (ADA). The city did not admit wrongdoing in an agreement negotiated with the Legal Aid Society in 2017. In a statement to City Limits, a DHS spokesperson said, “We are transforming a shelter system that built up in a haphazard way over decades by making unprecedented investments in our not-for-profit partners to renovate facilities, repair conditions that went unaddressed for decades, and expand accessibility.”

The class action is named for plaintiff Sandra Butler; she and her partner Ricky Gibson are both disabled and were entering the shelter system in 2014. Butler, who suffers from sickle cell anemia, chronic asthma, hypertension and high blood pressure, had an oxygen tank and concentrator which she was required to recharge, and Gibson had multiple back ailments.

The couple was denied shelter after a flawed intake process at the Adult Families Intake Center. DHS staff did not assess Gibson or Butler’s disabilities, the suit alleges, and incorrectly determined that they could stay with Butler’s mother in Far Rockaway, despite the fact that the mother’s home was overcrowded and not accessible. Gibson and Butler spent the winter of 2014-2015 in a parked car outside the family home, using an outlet outside the home to charge their medical devices. When the couple did finally get shelter, DHS failed to fix a broken air conditioner, further agitating Butler’s asthma.

The city requested extensions for multiple deadlines in the settlement. DHS is still surveying facilities, finalizing training and policy changes and making a plan to make more shelters physically accessible, according to Legal Aid Society lawyers, who are the court-appointed monitors for the settlement.

Part of the reason for the city’s lag is how enormous the task is, according to Kliff. In addition to outdated policies for disabilities, Department of Buildings complaints show shelters with chronic elevator breakdowns, and several shelters visited by City Limits had no ramp accessibility or handrails.

Problems like Peterson’s at the Samaritan Village shelter are one sign that some DHS staff are not trained on how to provide reasonable accommodation and that important policy updates for security screenings and housing placements have yet to happen.

Asked about Peterson’s situation by City Limits, a DHS spokesperson sent a statement reading, “No one who needs oxygen should be denied shelter. In general, oxygen compressors are always permitted in shelter, as they are safer in dorm-style settings. In certain rare situations, small oxygen tanks can present safety risks within certain facilities.”

In these instances, the statement goes on to say, DHS will encourage shelter residents to get portable oxygen concentrators without oxygen tanks. But the agency did not appear to have a solution ready for people still awaiting the alternate equipment. The spokesperson told City Limits, “We are working on an overall resolution that guarantees safety as well as accommodating the needs of those small number of New Yorkers who may require the specific equipment and be unable to utilize a compressor.”

Inspecting the infrastructure

The city has enlisted a private firm called Steven Winter Associates to evaluate its shelters and help determine which ones to remediate.

In an e-mail to City Limits, a DHS spokesperson said that the company has surveyed 28 shelters thus far and hasn’t yet created a remediation plan or estimated the cost of upgrades. The remediation plan was due in April*, but the city requested an extension from Legal Aid, which will be spot-checking the city’s work and surveying some of the same shelters, according to Kliff.

“They’re measuring every toilet, every grab bar,” Kliff says. She indicates Legal Aid Society is being patient with the city because the accessibility upgrades are an enormous undertaking. “We don’t want to rush them to meet a deadline, especially with the remediation plan, because that’s a big deal,” she says. “They’re working, just not as quickly as they had hoped.”

Samaritan Village’s men’s shelter on 53rd Street where Peterson resides, is one such shelter with capital needs. The only entrance is behind four steps without any ramps. For Peterson, who walks without assistance but gets winded easily, even those few steps can be a chore.

Few shelters are designed specifically for seniors. One such shelter is George Daly House on the Lower East Side, which has ramp accessibility and handrails leading to its front entrance. Mobility-impaired residents saunter in and out of the facility. A request from City Limits to tour the inside of George Daly house was denied by its owners, New York Foundation for Senior Citizens. But residents exiting the shelter spoke to City Limits about conditions inside.

Louis Kid, 65, is a George Daly resident who is aided with a walker. Kid had only been homeless for a month when he spoke to City Limits, his first time.in the shelter system. He had a stroke that hindered his ability to work and was evicted from his apartment in Harlem. “Life happens,” he says. He thinks the George Daly house is fine, but has only spent time in two shelters; the other, the Bellevue men’s shelter on 30th Street, where many men are housed temporarily after intake, was far worse. The difference is notable. “You want to know the worst shelter?,” Kid says. “Bellevue. Night and day.”

Bellevue Shelter and the HRA Men’s intake on 30th street sit by the FDR Drive and across the street from NYU Presbyterian Hospital and a block over from Bellevue Hospital. Most men are housed temporarily at Bellevue’s shelter after going through intake in the same building.

A dedicated HRA police force with a van monitors the sidewalk in front of the shelter, eyeing everyone who comes and goes. Shelter residents complain that about the heightened security; they pass through metal detectors and submit to a wand search by the shelter’s security staff.

The building has a long list of repair needs. Department of Buildings records show numerous complaints and violations for broken elevators and water leaks. A recent complaint said there are “several problems with the only 2 elevators,” with one not working and the other with rattling, vibrating and overcrowding. Shelter residents outside of Bellevue who spoke to City Limits confirmed that one of the elevators has been broken for months and that an alternate elevator functions but can only be accessed by walking up one floor.

A violation from April 26th reads “failure to maintain building in code-complaint manner, constant flow of water in the cellar.”

Giselle Routhier, Policy Director at the Coalition for The Homeless, says serious repairs to aging shelters make up the bulk of the city’s remediation needs. Broken and nonexistent elevators are among the most common problems.

Problems at each point in the process

The failures of the shelter system to accommodate age and disability begin essentially when someone arrives at one of the city’s homeless intake centers.

The Butler class action sounded the alarm that there was no easy process for requesting disability accommodation during intake, creating a cascade of problems. When the lawsuit was brought, DHS had a request form online for those who need accommodation, but print copies were not available at intake.

But lawyers for the plaintiffs went further in claiming the entire intake process was discriminatory because it is slow, inconvenient and “grueling.” PATH and AFIC, the two intake centers that take in families, have limited hours, and working parents may have to leave work and take children out of school to make appointments.

Applicants can spend hours filling out pages of forms requesting highly detailed housing histories, including every time the applicant slept on the street or subway car or stayed at a friends’ place. Despite the fact that even a person with pristine memory would find this challenging, DHS doesn’t take into account an applicant’s inability to fill out paperwork because of learning disabilities, traumatic brain injury or other cognitive impairments according to the complaint.

Intake for adult families –which can include couples or any adults who depend on one another for care—can be more laborious than the single adult intake or family with children intake, and can take between 6 and 12 hours, according to the lawsuit. It often continues overnight while clients wait in plastic chairs; Butler and Gibson had multiple overnight stays at the intake office despite their health issues.

“There are many people who can’t sit there for hours and hours,” Kliff says, “especially if you’re looking at elderly clients.”

Individual living plans crafted by case workers typically require people to visit a certain number of affordable rentals a week. But a lack of affordable rentals in the city create long waitlists, and shelter residents can be pressured to take the first vacant apartment available, even if their age or disability makes it more inaccessible than shelter.

Creating a shelter system in which disabilities are accommodated requires policy changes, which the city has not yet finalized, and training, which it has begun. The city is required to re-train existing staff and help them understand issues around disability. DHS has made steps toward some of these goals.

A DHS spokesperson told City Limits that the Department of Social Services, the agency under which DHS and HRA are housed, now provides mandatory training on disabilities to new staff members. DHS shared a training PDF with City Limits, which includes information on appropriate language around disability, background on the Lovely and Butler class actions, the Americans With Disabilities Act, and a detailed description of shelter staffers’ legal responsibility in these instances.

But the type of specific policy updates that would prevent someone like Peterson from being barred from shelter have yet to be finalized.

Peterson says he’s repeatedly been shown apartments by a housing specialist at Samaritan Village’s 53rd Street Shelter that violate all the restrictions his disability places on him. Some of these conditions are products of the city’s other inaccessible infrastructure: He needs to live along a bus route because he can’t travel up and down the subway stairs without losing oxygen. He can’t live on a hilly street for similar reasons, or in a building without an elevator. He prefers to live in Manhattan because his network of doctors and therapists are in lower Manhattan. But he’s repeatedly been shown apartments by one specialist that are in The Bronx and are inaccessible.

“I couldn’t walk up the steps and then get on the train, and then walk up the steps to get out of the train. I just couldn’t do it,” he says of one of the apartments he had to pass on. Another apartment in the Bronx was on a hill, and he had to pass as well. He knows people may think he’s being picky. “You know, without this condition, one wouldn’t be like ‘oh man these hills’,” he says. “But with this condition?”

A recent apartment interview left him hopeful. During a hospital stay in March, he was notified by his case worker that DHS and Metro Plus had been repeatedly calling him, trying to see when he’d be free to view some apartments becoming available. On March 25, he visited and interviewed for the place. It had everything he needed. It was in Manhattan and accessible to a bus route and close to his doctor. It had a stove and a mini-fridge so he’d be able to cook. There’s assisted living, including a social worker and a nurse on the premises.

“It’s perfect for me,” he says of this space in early April, at which time he was still waiting to hear if he’d get it. The housing specialist told him he was a very good candidate, especially because of his medical condition, which is taken into consideration. If he misses out, he’s been told, he just needs to wait—something else will be available.

Worries about the long term

One serious issue outlined in the Butler lawsuit is the lack of beds for those in the single adult system who need help with activities of daily living, which include washing, using the toilet or being transported. The communal beds of the single system can’t safely accommodate these needs, which obviously are more likely as a homeless person ages. State regulations bar these single adults from being housed in family shelters, where private beds are available.

This problem has grown direr since the lawsuit was brought. At the time, there were only 32 long-term care beds within the single adult system, at a shelter owned by Barrier Free Living, a national nonprofit for domestic violence survivors and people with disabilities. That shelter has since closed and there are no beds in the system for single adults who need long-term care, leading to hardshipfor those who are aging or disabled.

Help could come from medical respite, which would provide short-term beds for people too unwell for the shelter system but not ill enough to be hospitalized. A nationwide coalition of medical and homeless services providers have convened in recent years to develop standards and advocate for these programs. But as they are intended for people being discharged from hospitals and are meant to house people for 30-60 days, this would only minimally help a the homeless population with long-term care needs.

Kliff says it’s hard to know how many people have such problems across the city. She’s found solutions for clients on a case by case basis, with some being transitioned to nursing homes and some provided with vouchers for apartments, but no uniform solution exists. Legal Aid Society and DHS are actively working on the issue, but Kliff says DHS may not be able to resolve the issue its own.

“They’re extremely fact-intensive cases because everybody’s needs are different,” she says, “But we feel that their needs to be a better plan in place.”

‘I’m so tired’

Roshan Abraham

Alvin Peterson with his portable oxygen concentrator.

Checking back in with City Limits in late April, Peterson said the apartment on which his hopes hinged went to someone else. A housing specialist showed him yet another apartment in the Bronx. Again, it was on a hill, not near an ADA-accessible subway. Again, he turned it down. “I don’t think they’re taking it very seriously at all,” he says of DHS disregarding his condition.

The frustrations of being elderly or disabled can magnify that existing stress of navigating a shelter system that confronts residents with what appear to be haphazard rules, over-zealous security screenings and casual disrespect.

The portable oxygen concentrator Peterson carries at all times is a rectangular box strapped around his shoulders, weighing at least 10 pounds. “This here thing is overworked, is on 24 hours, 7 days a week,” he says. “I’ve been using this outside, inside, taking a shower, going to sleep,” he says of the heavy device. While his oxygen concentrator is allowed at the 53rd Street Shelter, he has been asked to remove it repeatedly by a member of security staff when he undergoes a routine wand search. Because other security staff did not make this request, he refused, sensing the guard was being malicious.

He began filing official grievances, making 311 complaints and calling a lawyer at Legal Aid. He spent much of April 18th outside the shelter trying to settle the situation through phone calls. Eventually, a DHS official called Samaritan Village and let them know that Peterson could leave his portable concentrator on his body when he passes through security.

But this was not sufficient for the guard, who asked that Peterson remove the device and hold it so that it is technically still on his person, insisting this satisfied DHS protocol. To Peterson, it feels as though this request was about exerting control and not providing security.

Other problems pile up: In early May his room became infested with ants. He complained to staff at the shelter, who then searched his locker at the shelter. They confiscated a shrink-wrapped apple and package of Chips Ahoy cookies, both of which he says he purchased after the ants had infested and which he had never opened. It is the shelter’s policy that residents can’t keep food in their lockers. He believes staff took his food in retaliation for complaining.

He takes issue with the shelter’s policy that does not allow food, and points out that dinner is served at 5pm, with the next meal not arriving until 7am the following day. “That’s 14 hours away from our last meal. We can’t have a snack in that time?” he says.

Seemingly every day there’s a new conflict with staff, partly owing to the fact that Peterson is not pliant. In prison, he spent time in the law library learning about the rules in his various cases to make sure he was not taken advantage of. Now he learns the ins and outs of the shelter system and the city’s legal requirements. He’s familiar with all the avenues of grievance and is not shy about using them, including 311 and legal complaints. But the constant fighting for respect has been taxing.

“I’m beat, physically beat,” he says. “I’m so tired.”

*Correction: The original version of this article stated that the remediation plan had been due in 2018. While other elements of the settlement were due to be completed in 2018, the remediation plan was due in April.
**Clarification: Updated numbers were inserted.