[Federal Register Volume 86, Number 21 (Wednesday, February 3, 2021)]
[Notices]
[Pages 8020-8025]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-02243]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention


Temporary Halt in Residential Evictions to Prevent the Further 
Spread of COVID-19

AGENCY: Centers for Disease Control and Prevention (CDC), Department of 
Health and Human Services (HHS).

ACTION: Agency Order.

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SUMMARY: The Centers for Disease Control and Prevention (CDC), located 
within the Department of Health and Human Services (HHS) announces the 
extension of an Order under Section 361 of the Public Health Service 
Act to temporarily halt residential evictions to prevent the further 
spread of COVID-19.

DATES: This Order is effective January 31, 2021 through March 31, 2021.

FOR FURTHER INFORMATION CONTACT: Tiffany Brown, Acting Deputy Chief of 
Staff, Centers for Disease Control and Prevention, 1600 Clifton Road, 
NE, MS H21-10, Atlanta, GA 30329. Phone: 404-639-7000. Email: 
[email protected].

SUPPLEMENTARY INFORMATION: 

Background

    This Order extends the original temporary eviction moratorium Order 
published on September 4, 2020 and extended by the Consolidated 
Appropriations Act, 2021 and further extends the Order with 
modifications through March 31, 2021. The conditions that originally 
necessitated the original Order continue to exist and, in many 
jurisdictions, have significantly worsened. With the convergence of 
COVID-19, seasonal influenza, household crowding and transmission, and 
the increased risk of individuals sheltering in close quarters in 
congregate settings such as homeless shelters, which may be unable to 
provide adequate social distancing as populations increase, extending 
the temporary halt on evictions, subject to further extension, 
modification, or rescission, is appropriate. Additionally, the Order 
now applies to American Samoa. At the time of publication of the 
September 4, 2020 Order, no cases had been reported in American Samoa. 
Cases have now been reported there.
    A copy of the Order is provided below. A copy of the signed Order 
and the Declaration can be found at: https://www.cdc.gov/coronavirus/2019-ncov/covid-eviction-declaration.html

Centers for Disease Control and Prevention Department of Health and 
Human Services

Order Under Section 361 of the Public Health Service AcT (42 U.S.C. 
264) and 42 Code of Federal Regulations 70.2

Temporary Halt in Residential Evictions to Prevent the Further Spread 
of Covid-19

Summary

    Subject to the limitations under ``Applicability,'' a landlord, 
owner of a residential property, or other person \1\ with a legal right 
to pursue eviction or possessory action, shall not evict any covered 
person from any residential property in any jurisdiction to which this 
Order applies during the effective period of the Order.
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    \1\ For purposes of this Order, ``person'' includes 
corporations, companies, associations, firms, partnerships, 
societies, and joint stock companies, as well as individuals.
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Definitions

    ``Available government assistance'' means any governmental rental 
or housing payment benefits available to the individual or any 
household member.
    ``Available housing'' means any available, unoccupied residential 
property, or other space for occupancy in any seasonal or temporary 
housing, that would not violate Federal, state, or local occupancy 
standards and that would not result in an overall increase of housing 
cost to such individual.
    ``Covered person'' \2\ means any tenant, lessee, or resident of a 
residential property who provides to their landlord, the owner of the 
residential property, or other person with a legal right to pursue 
eviction or a possessory action, a declaration under penalty of perjury 
indicating that: (1) The individual has used best efforts to obtain all 
available government assistance for rent or housing;
    (2) The individual either (i) expects to earn no more than $99,000 
in annual income for Calendar Year 2021 (or no more than $198,000 if 
filing a joint tax return),\3\ (ii) was not required to report any 
income in 2020 to the U.S. Internal Revenue Service, or (iii) received 
an Economic Impact Payment (stimulus check) pursuant to Section 2201 of 
the CARES Act;
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    \2\ This definition is based on factors that are known to 
contribute to evictions and thus increase the need for individuals 
to move into close quarters in new congregate or shared living 
arrangements or experience homelessness. Individuals who suffer job 
loss, have limited financial resources, are low income, or have high 
out-of-pocket medical expenses are more likely to be evicted for 
nonpayment of rent than others not experiencing these factors. See 
Desmond, M., Gershenson, C., Who gets evicted? Assessing individual, 
neighborhood, and network factors, Social Science Research 62 
(2017), 366-377, http://dx.doi.org/10.1016/j.ssresearch.2016.08.017, 
(identifying job loss as a possible predictor of eviction because 
renters who lose their jobs experience not only a sudden loss of 
income but also the loss of predictable future income). According to 
one survey, over one quarter (26%) of respondents also identified 
job loss as the primary cause of homelessness. See 2019 San 
Francisco Homeless Point-in-Time Count & Survey, page 22, available 
at: https://hsh.sfgov.org/wp-content/uploads/2020/01/2019HIRDReport_SanFrancisco_FinalDraft-1.pdf.
    \3\ According to one study, the national two-bedroom housing 
wage in 2020 was $23.96 per hour (approximately, $49,837 annually), 
meaning that an hourly wage of $23.96 was needed to afford a modest 
two bedroom house without spending more than 30% of one's income on 
rent. The hourly wage needed in Hawaii (the highest cost U.S. State 
for rent) was $38.76 (approximately $80,621 annually). See National 
Low-Income Housing Coalition, Out of Reach: The High Cost of Housing 
2020, available at: https://reports.nlihc.org/oor. As further 
explained herein, because this Order is intended to serve the 
critical public health goal of preventing evicted individuals from 
potentially contributing to the interstate spread of COVID-19 
through movement into close quarters in new congregate, shared 
housing settings, or though homelessness, the higher income 
thresholds listed here have been determined to better serve this 
goal.
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    (3) the individual is unable to pay the full rent or make a full 
housing payment due to substantial loss of household income, loss of 
compensable hours of work or wages, a lay-off, or extraordinary \4\ 
out-of-pocket medical expenses;
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    \4\ An extraordinary medical expense is any unreimbursed medical 
expense likely to exceed 7.5% of one's adjusted gross income for the 
year.
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    (4) the individual is using best efforts to make timely partial 
payments that are

[[Page 8021]]

as close to the full payment as the individual's circumstances may 
permit, taking into account other nondiscretionary expenses; and
    (5) eviction would likely render the individual homeless--or force 
the individual to move into and live in close quarters in a new 
congregate or shared living setting--because the individual has no 
other available housing options.
    ``Evict'' and ``Eviction'' means any action by a landlord, owner of 
a residential property, or other person with a legal right to pursue 
eviction or possessory action, to remove or cause the removal of a 
covered person from a residential property. It also does not include 
foreclosure on a home mortgage.
    ``Residential property'' means any property leased for residential 
purposes, including any house, building, mobile home or land in a 
mobile home park, or similar dwelling leased for residential purposes, 
but shall not include any hotel, motel, or other guest house rented to 
a temporary guest or seasonal tenant as defined under the laws of the 
state, territorial, tribal, or local jurisdiction.
    ``State'' shall have the same definition as under 42 CFR 70.1, 
meaning ``any of the 50 states, plus the District of Columbia.''
    ``U.S. territory'' shall have the same definition as under 42 CFR 
70.1, meaning ``any territory (also known as possessions) of the United 
States, including American Samoa, Guam, the Northern Mariana Islands, 
the Commonwealth of Puerto Rico, and the U.S. Virgin Islands.''

Statement of Intent

    This Order shall be interpreted and implemented in a manner as to 
achieve the following objectives:
     Mitigating the spread of COVID-19 within congregate or 
shared living settings, or through unsheltered homelessness;
     Mitigating the further spread of COVID-19 from one state 
or territory into any other state or territory; and
     Supporting response efforts to COVID-19 at the Federal, 
state, local, territorial, and tribal levels.

Background

    There is currently a pandemic of a respiratory disease (``COVID-
19'') caused by a novel coronavirus (SARS-COV-2) that has now spread 
globally, including cases reported in all fifty states within the 
United States plus the District of Columbia and U.S. territories. As of 
January 21, 2021, there have been over 96 million cases of COVID-19 
globally, resulting in over 2,000,000 deaths. Over 24,400,000 cases 
have been identified in the United States, with new cases reported 
daily, and over 400,000 deaths due to the disease. On January 8, 2021, 
over 300,000 COVID-19 cases in the U.S. were reported to CDC, 
representing a peak approximately 7 times the highest daily cases in 
April, 2020 and approximately 4 times the highest daily cases in July, 
2020.
    The virus that causes COVID-19 spreads very easily and sustainably 
between people who are in close contact with one another (within about 
6 feet), mainly through respiratory droplets produced when an infected 
person coughs, sneezes, or talks. Some people without symptoms may be 
able to spread the virus. Among adults, the risk for severe illness 
from COVID-19 increases with age, with older adults at highest risk. 
Severe illness means that persons with COVID-19 may require 
hospitalization, intensive care, or a ventilator to help them breathe, 
and may be fatal. People of any age with certain underlying medical 
conditions, such as cancer, an immunocompromised state, obesity, 
serious heart conditions, and diabetes, are at increased risk for 
severe illness from COVID-19.\5\
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    \5\ CDC, People with Certain Medical Conditions, https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html (accessed August 26, 2020).
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    COVID-19 presents a historic threat to public health, and COVID-19 
cases have been detected in every county in the continental United 
States.\6\ Through December 2020 and January 2021, the number of deaths 
per day from COVID-19 consistently exceeded any other cause.\7\ 
Additionally, in recent months, new variants of SARS-CoV-2 have emerged 
globally, some of which have been associated with increased 
transmissibility.\8\ To respond to this public health threat, the 
Federal, state, and local governments have taken unprecedented or 
exceedingly rare actions, including border closures, restrictions on 
travel, stay-at-home orders, mask requirements, and eviction moratoria. 
Despite these significant efforts, COVID-19 continues to spread and 
further action is needed.
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    \6\ USAFacts. https://usafacts.org/visualizations/coronavirus-covid-19-spread-map/.
    \7\ Woolf SH, Chapman DA, Lee JH. COVID-19 as the Leading Cause 
of Death in the United States. JAMA. 2021;325(2):123-124. 
doi:10.1001/jama.2020.24865
    \8\ Emerging SARS-CoV-2 Variants. https://www.cdc.gov/coronavirus/2019-ncov/more/science-and-research/scientific-brief-emerging-variants.html.
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    In the context of a pandemic, eviction moratoria--like quarantine, 
isolation, and social distancing--can be an effective public health 
measure utilized to prevent the spread of communicable disease. 
Eviction moratoria facilitate self-isolation by people who become ill 
or who are at risk for severe illness from COVID-19 due to an 
underlying medical condition. They also allow state and local 
authorities to more easily implement stay-at-home and social distancing 
directives to mitigate the community spread of COVID-19. Furthermore, 
housing stability helps protect public health because homelessness 
increases the likelihood of individuals moving into close quarters in 
congregate settings, such as homeless shelters, which then puts 
individuals at higher risk to COVID-19.
    On September 4, 2020, the CDC Director issued an Order temporarily 
halting evictions in the United States for the reasons described 
therein. That Order was set to expire on December 31, 2020, subject to 
further extension, modification, or rescission. Section 502 of Title V, 
Division N of the Consolidated Appropriations Act, 2021 extended the 
Order until January 31, 2021. This Order further extends and modifies 
the prior Orders until March 31, 2021 for the reasons described herein. 
Much of the content of the September 4, 2020 Order has been 
incorporated into this Order. To the extent any provision of this Order 
conflicts with prior Orders, this Order is controlling.
    In addition to extending the effective period of the September 4, 
2020 Order, as further extended by the Consolidated Appropriations Act, 
2021, this Order includes newly available modeling projections and 
observational data from COVID-19 incidence comparisons across states 
that have implemented and lifted eviction moratoria, which clearly 
demonstrate the need for this Order. The Order now also applies to 
American Samoa because cases of COVID-19 have now been reported there.

Applicability

    This Order does not apply in any state, local, territorial, or 
tribal area with a moratorium on residential evictions that provides 
the same or greater level of public-health protection than the 
requirements listed in this Order. In accordance with 42 U.S.C. 264(e), 
this Order does not preclude state, local, territorial, and tribal 
authorities from imposing additional requirements that provide greater 
public-health protection and are more restrictive than the requirements 
in this Order.
    This Order is a temporary eviction moratorium to prevent the 
further spread of COVID-19. This Order does not relieve any individual 
of any obligation to pay rent, make a housing

[[Page 8022]]

payment, or comply with any other obligation that the individual may 
have under a tenancy, lease, or similar contract. Nothing in this Order 
precludes the charging or collecting of fees, penalties, or interest as 
a result of the failure to pay rent or other housing payment on a 
timely basis, under the terms of any applicable contract. Nothing in 
this Order precludes evictions based on a tenant, lessee, or resident: 
(1) Engaging in criminal activity while on the premises; (2) 
threatening the health or safety of other residents; \9\ (3) damaging 
or posing an immediate and significant risk of damage to property; (4) 
violating any applicable building code, health ordinance, or similar 
regulation relating to health and safety; or (5) violating any other 
contractual obligation, other than the timely payment of rent or 
similar housing-related payment (including non-payment or late payment 
of fees, penalties, or interest).
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    \9\ Individuals who might have COVID-19 are advised to stay home 
except to get medical care. Accordingly, individuals who might have 
COVID-19 and take reasonable precautions to not spread the disease 
should not be evicted on the ground that they may pose a health or 
safety threat to other residents. See What to Do if You are Sick, 
available at https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html.
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    This Order now applies to American Samoa. At the time of 
publication of the September 4, 2020 Order, no cases had been reported 
in American Samoa. Cases have now been reported there.\10\
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    \10\ https://www.who.int/americansamoa.
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Eviction and Risk of COVID-19 Transmission

    Evicted renters must move, which leads to multiple outcomes that 
increase the risk of COVID-19 spread. Specifically, many evicted 
renters move into close quarters in shared housing or other congregate 
settings. According to the Census Bureau American Housing Survey, 32% 
of renters reported that they would move in with friends or family 
members upon eviction, which would introduce new household members and 
potentially increase household crowding.\11\ Studies show that COVID-19 
transmission occurs readily within households; household contacts are 
estimated to be 6 times more likely to become infected by an index case 
of COVID-19 than other close contacts.\12\
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    \11\ United States Census Bureau. American Housing Survey, 2017. 
https://www.census.gov/programs-surveys/ahs.html.
    \12\ Bi Q, Wu Y, Mei S, et al. Epidemiology and transmission of 
COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, 
China: a retrospective cohort study. Lancet Infect Dis 2020, https://doi.org/10.1016/S1473-3099(20)30287-5.
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    Preliminary modeling projections and observational data from COVID-
19 incidence comparisons across states that implemented and lifted 
eviction moratoria indicate that evictions substantially contribute to 
COVID-19 transmission. In mathematical models where eviction led 
exclusively to sharing housing with friends or family, lifting eviction 
moratoria led to a 40% increased risk of contracting COVID-19 among 
people who were evicted and those with whom they shared housing after 
eviction (pre-peer review).\13\ Compared to a scenario where no 
evictions occurred, the models also predicted a 5-50% increased risk of 
infection even for those who did not share housing as a result of 
increased overall transmission. The authors estimated that anywhere 
from 1,000 to 100,000 excess cases per million population could be 
attributable to evictions depending on the eviction and infection 
rates.\14\ An analysis of observational data from state-based eviction 
moratoria in 43 states and the District of Columbia showed significant 
increases in COVID-19 incidence and mortality approximately 2-3 months 
after eviction moratoria were lifted (pre-peer review).\15\ 
Specifically, the authors compared the COVID-19 incidence and mortality 
rates in states that lifted their moratoria with the rates in states 
that maintained their moratoria. In these models, the authors 
controlled for time-varying indicators of each state's test count as 
well as major public-health interventions including lifting stay-at-
home orders, school closures, and mask mandates. After adjusting for 
these other changes, they found that the incidence of COVID-19 in 
states that lifted their moratoria was 1.6 times that of states that 
did not at 10 weeks post-lifting (95% CI 1.0, 2.3), a ratio that grew 
to 2.1 at >=16 weeks (CI 1.1, 3.9). Similarly, they found that 
mortality in states that lifted their moratoria was 1.6 times that of 
states that did not at 7 weeks post-lifting (CI 1.2, 2.3), a ratio that 
grew to 5.4 at >=16 weeks (CI 3.1, 9.3). Although there may be 
additional factors that the authors were unable to adjust for, the 
authors estimated that, nationally, over 433,000 cases of COVID-19 and 
over 10,000 deaths could be attributed to lifting state moratoria.\16\
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    \13\ Sheen J, Nande A, Walters EL, Adlam B, Gheorghe A, Shinnick 
J, Tejeda MF, Greenlee A, Schneider D, Hill AL, Levy MZ. The effect 
of eviction moratoriums on the transmission of SARS-CoV-2. medRxiv 
[Preprint]. 2020 Nov 1:2020.10.27.20220897. doi: 10.1101/
2020.10.27.20220897. PMID: 33140067; PMCID: PMC7605580.
    \14\ Id.
    \15\ Leifheit, Kathryn M. and Linton, Sabriya L. and Raifman, 
Julia and Schwartz, Gabriel and Benfer, Emily and Zimmerman, 
Frederick J and Pollack, Craig, Expiring Eviction Moratoriums and 
COVID-19 Incidence and Mortality (November 30, 2020). Available at 
SSRN: https://ssrn.com/abstract=3739576 or http://dx.doi.org/10.2139/ssrn.3739576.
    \16\ Id.
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    Shared housing is not limited to friends and family. It includes a 
broad range of settings, including transitional housing, and domestic 
violence and abuse shelters. Special considerations exist for such 
housing because of the challenges of maintaining social distance. 
Residents often gather closely or use shared equipment, such as kitchen 
appliances, laundry facilities, stairwells, and elevators. Residents 
may have unique needs, such as disabilities, cognitive decline, or no 
access to technology, and thus may find it more difficult to take 
actions to protect themselves from COVID-19. CDC recommends that 
shelters provide new residents with a clean mask, keep them isolated 
from others, screen for symptoms at entry, or arrange for medical 
evaluations as needed depending on symptoms.\17\ Accordingly, an influx 
of new residents at facilities that offer support services could 
potentially overwhelm staff and, if recommendations are not followed, 
lead to exposures.
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    \17\ See CDC COVID-19 Guidance for Shared or Congregate Housing, 
available at: https://www.cdc.gov/coronavirus/2019-ncov/community/shared-congregate-house/guidance-shared-congregate-housing.html.
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    Congress passed the Coronavirus Aid, Relief, and Economic Security 
(CARES) Act (Pub. L. 116-136) to aid individuals and businesses 
adversely affected by COVID-19. Section 4024 of the CARES Act provided 
a 120-day moratorium on eviction filings as well as other protections 
for tenants in certain rental properties with Federal assistance or 
federally related financing. These protections helped alleviate the 
public health consequences of tenant displacement during the COVID-19 
pandemic. The CARES Act eviction moratorium expired on July 24, 
2020.\18\ The protections in the CARES Act supplemented temporary 
eviction moratoria and rent freezes implemented by governors and local 
officials using emergency powers.
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    \18\ Because evictions generally require 30-days' notice, the 
effects of housing displacement due to the expiration of the CARES 
act are not expected to manifest until August 27, 2020.
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    Researchers estimated that this temporary Federal moratorium 
provided relief to a material portion of the nation's roughly 43 
million renters.\19\

[[Page 8023]]

Approximately 12.3 million rental units have federally backed 
financing, representing 28% of renters. Other data show more than 2 
million housing vouchers along with approximately 2 million other 
federally assisted rental units.\20\
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    \19\ See Congressional Research Service, CARES Act Eviction 
Moratorium, (April 7, 2020) available at: https://crsreports.congress.gov/product/pdf/IN/IN11320.
    \20\ See HUD, A Picture of Subsidized Households General 
Description of the Data and Bibliography, available at: https://www.huduser.gov/portal/datasets/assthsg/statedata98/descript.html.
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    The CARES Act moratorium, however, did not reach all renters. 
Neither does the more recently enacted Emergency Rental Assistance 
Program under the Consolidated Appropriations Act, 2021, as 
administered by the Department of Treasury.\21\ Many renters who fell 
outside the scope of the moratorium were protected under state and 
local moratoria. In the absence of state and local protections, as many 
as 30-40 million people in America could be at risk of eviction.\22\ A 
wave of evictions on that scale would be unprecedented in modern 
times.\23\ A large portion of those who are evicted may move into close 
quarters in shared housing or, as discussed below, become homeless, 
thus contributing to the spread of COVID-19.
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    \21\ https://home.treasury.gov/policy-issues/cares/emergency-rental-assistance-program.
    \22\ See Emily Benfer, et al., The COVID-19 Eviction Crisis: An 
Estimated 30-40 Million People in America are at Risk, available at: 
https://www.aspeninstitute.org/blog-posts/the-covid-19-eviction-crisis-an-estimated-30-40-million-people-in-america-are-at-risk/.
    \23\ As a baseline, approximately 900,000 renters are evicted 
every year in the United States. Princeton University Eviction Lab. 
National Estimates: Eviction in America. https://evictionlab.org/national-estimates/.
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    The statistics on interstate moves show that mass evictions would 
likely increase the interstate spread of COVID-19. Over 35 million 
Americans, representing approximately 10% of the U.S. population, move 
each year.\24\ Approximately 15% of moves are interstate.\25\
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    \24\ See U.S. Census Bureau, CPS Historical Migration/Geographic 
Mobility Tables, available at: https://www.census.gov/data/tables/time-series/demo/geographic-mobility/historic.html.
    \25\ Id.
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Eviction, Homelessness, and Risk of Severe Disease From COVID-19

    Evicted individuals without access to housing or assistance options 
may also contribute to the homeless population, including older adults 
or those with underlying medical conditions, who are more at risk for 
severe illness from COVID-19 than the general population.\26\ In 
Seattle-King County, 5-15% of people experiencing homelessness between 
2018 and 2020 cited eviction as the primary reason for becoming 
homeless.\27\ Additionally, some individuals and families who are 
evicted may originally stay with family or friends, but subsequently 
seek homeless services. Among people who entered shelters throughout 
the United States in 2017, 27% were staying with family or friends 
beforehand.\28\
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    \26\ See CDC, Coronavirus Disease 2019 (COVID-19), People Who 
Are at Increased Risk for Severe Illness, available at https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-increased-risk.html (accessed August 26, 2020).
    \27\ Seattle-King County. Point in Time Count. https://regionalhomelesssystem.org/wp-content/uploads/2020/07/Count-Us-In-2020-Final_7.29.2020.pdf.
    \28\ United States Department of Housing and Urban Development. 
The 2017 Annual Homeless Assessment Report (AHAR) to Congress: Part 
2. Available at: https://files.hudexchange.info/resources/documents/2017-AHAR-Part-2.pdf.
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    People experiencing homelessness are a high-risk population. It may 
be more difficult for these persons to consistently access the 
necessary resources in order to adhere to public health recommendations 
to prevent COVID-19. For instance, it may not be possible to avoid 
certain congregate settings such as homeless shelters, or easily access 
facilities to engage in handwashing with soap and water.
    Extensive outbreaks of COVID-19 have been identified in homeless 
shelters.\29\ In Seattle, Washington, a network of three related 
homeless shelters experienced an outbreak that led to 43 cases among 
residents and staff members.\30\ In Boston, Massachusetts, universal 
COVID-19 testing at a single shelter revealed 147 cases, representing 
36% of shelter residents.\31\ COVID-19 testing in a single shelter in 
San Francisco led to the identification of 101 cases (67% of those 
tested).\32\ Throughout the United States, among 208 shelters reporting 
universal diagnostic testing data, 9% of shelter clients have tested 
positive.\33\
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    \29\ Mosites E, et al, Assessment of SARS-CoV-2 Infection 
Prevalence in Homeless Shelters--Four U.S. Cities, March 27-April 
15, 2020. MMWR 2020 May 1;69(17):521-522.
    \30\ Tobolowsky FA, et al. COVID-19 Outbreak Among Three 
Affiliated Homeless Service Sites--King County, Washington, 2020. 
MMWR 2020 May 1;69(17):523-526.
    \31\ Baggett TP, Keyes H, Sporn N, Gaeta JM. Prevalence of SARS-
CoV-2 Infection in Residents of a Large Homeless Shelter in Boston. 
JAMA. 2020 Apr 27;323(21):2191-2. Online ahead of print.
    \32\ Imbert E, et al. Coronavirus Disease 2019 (COVID-19) 
Outbreak in a San Francisco Homeless Shelter. Clin Infect Dis. 2020 
Aug 3.
    \33\ National Health Care for the Homeless Council and Centers 
for Disease Control and Prevention. Universal Testing Data 
Dashboard. Available at: https://nhchc.org/cdc-covid-dashboard/.
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    CDC guidance recommends increasing physical distance between beds 
in homeless shelters.\34\ To adhere to this guidance, shelters have 
limited the number of people served throughout the United States. In 
many places, considerably fewer beds are available to individuals who 
become homeless. Shelters that do not adhere to the guidance, and 
operate at ordinary or increased occupancy, are at greater risk for the 
types of outbreaks described above. The challenge of mitigating disease 
transmission in homeless shelters has been compounded because some 
organizations have chosen to stop or limit volunteer access and 
participation.
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    \34\ Centers for Disease Control and Prevention. Interim 
Guidance for Homeless Service Providers to Plan and Respond to 
COVID-19. https://www.cdc.gov/coronavirus/2019-ncov/community/homeless-shelters/plan-prepare-respond.html.
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    In the context of the current pandemic, large increases in 
evictions resulting in homelessness could have at least two potential 
negative consequences. One is if homeless shelters increase occupancy 
in ways that increase the exposure risk to COVID-19. The other is if 
homeless shelters continue to limit new admissions, leading to 
increases in unsheltered homelessness. Neither consequence is in the 
interest of the public health.
    Recently published data suggest that those experiencing unsheltered 
homelessness may have a lower risk of contracting COVID-19 compared to 
those staying in shelters.\35\ Data are not yet available to evaluate 
the risk of COVID-19 among people who are staying unsheltered compared 
to the general population. However, increases in unsheltered 
homelessness may lead to further strains on the healthcare system, 
impacting the availability of COVID-19 care. People experiencing 
homelessness have been estimated to use the emergency department almost 
5 times the rate of the general population,\36\ and those who are 
unsheltered are estimated to use the emergency department twice as 
often as

[[Page 8024]]

those who are sheltered.\37\ In the context of the pandemic, increased 
emergency department use is untenable given the existing strains on the 
healthcare system.\38\
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    \35\ Yoon JC, Montgomery MP, Buff AM, Boyd AT, Jamison C, 
Hernandez A, Schmit K, Shah S, Ajoku S, Holland DP, Prieto J, Smith 
S, Swancutt MA, Turner K, Andrews T, Flowers K, Wells A, Marchman C, 
Laney E, Bixler D, Cavanaugh S, Flowers N, Gaffga N, Ko JY, Paulin 
HN, Weng MK, Mosites E, Morris SB. COVID-19 Prevalence among People 
Experiencing Homelessness and Homelessness Service Staff during 
Early Community Transmission in Atlanta, Georgia, April-May 2020. 
Clin Infect Dis. 2020 Sep 8:ciaa1340. doi: 10.1093/cid/ciaa1340. 
Epub ahead of print. PMID: 32898272; PMCID: PMC7499502.
    \36\ Amato S, Nobay F, Amato DP, Abar B, Adler D. Sick and 
unsheltered: Homelessness as a major risk factor for emergency care 
utilization. Am J Emerg Med. 2019 Mar;37(3):415-420. doi: 10.1016/
j.ajem.2018.06.001. Epub 2018 Jun 2. PMID: 29891125.
    \37\ Raven MC, Tieu L, Lee CT, Ponath C, Guzman D, Kushel M. 
Emergency Department Use in a Cohort of Older Homeless Adults: 
Results From the HOPE HOME Study. Acad Emerg Med. 2017 Jan;24(1):63-
74. doi: 10.1111/acem.13070. PMID: 27520382; PMCID: PMC5857347.
    \38\ https://www.wsj.com/articles/covid-19-surge-strains-hospitals-once-again-11605100312.
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    Additionally, research suggests that the population of persons who 
would be evicted and become homeless would include many who are 
predisposed to developing severe disease from COVID-19. Five studies 
have shown an association between eviction and hypertension, which has 
been associated with more severe outcomes from COVID-19.\39\ Also, 
people experiencing homelessness often have underlying conditions that 
increase their risk of severe outcomes of COVID-19.\40\ Among patients 
with COVID-19, homelessness has been associated with increased 
likelihood of hospitalization.\41\
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    \39\ Hugo Vasquez-Vera, et al. The threat of home eviction and 
its effects on health through the equity lens: A systematic review. 
Social Science and Medicine. 175 (2017) 199e208.
    \40\ Fazel S, Geddes JR, Kushel M. The health of homeless people 
in high-income countries: descriptive epidemiology, health 
consequences, and clinical and policy recommendations. Lancet. 
2014;384(9953):1529-1540.
    \41\ Hsu HE, et al. Race/Ethnicity, Underlying Medical 
Conditions, Homelessness, and Hospitalization Status of Adult 
Patients with COVID-19 at an Urban Safety-Net Medical Center--
Boston, Massachusetts, 2020. MMWR 2020 Jul 10;69(27):864-869. 
Historically, African Americans and Hispanic Americans are 
disproportionately represented in evictions compared to other races. 
They are more likely to experience severe outcomes of COVID-19. Id.
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    These public health risks may increase seasonally. Each year, as 
winter approaches and the temperature drops, many persons experiencing 
homelessness move into shelters to escape the cold and the occupancy of 
shelters increases.\42\ At the same time, there is evidence to suggest 
that the homeless are more susceptible to respiratory tract 
infections,\43\ which may include seasonal influenza. While there are 
differences in the epidemiology of COVID-19 and seasonal influenza, the 
potential co-circulation of viruses during periods of increased 
occupancy in shelters could increase the risk to occupants in those 
shelters.
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    \42\ See, generally, the Annual Homeless Assessment Report to 
Congress (2007), available at: https://www.huduser.gov/Publications/pdf/ahar.pdf (acknowledging the seasonality of shelter bed use).
    \43\ Ly TDA, Edouard S, Badiaga S, et al. Epidemiology of 
respiratory pathogen carriage in the homeless population within two 
shelters in Marseille, France, 2015-2017: Cross sectional 1-day 
surveys. Clin Microbiol Infect. 2019; 25(2):249.e1-249.e6.
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    In short, evictions threaten to increase the spread of COVID-19 as 
they force people to move, often into close quarters in new shared 
housing settings with friends or family, or congregate settings such as 
homeless shelters. The ability of these settings to adhere to best 
practices, such as social distancing and other infection control 
measures, decreases as populations increase.

Findings and Action

    For the reasons described herein, I am extending and modifying the 
September 4, 2020 Order, as further extended by Section 502 of Title V, 
Division N of the Consolidated Appropriations Act, 2021. I have 
determined that extending the temporary halt in evictions in this Order 
constitutes a reasonably necessary measure under 42 CFR 70.2 to prevent 
the further spread of COVID-19 throughout the United States. I have 
further determined that measures by states, localities, or territories 
that do not meet or exceed these minimum protections are insufficient 
to prevent the interstate spread of COVID-19.\44\
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    \44\ In the United States, public health measures are 
implemented at all levels of government, including the federal, 
state, local, and tribal levels. Publicly-available compilations of 
pending measures indicate that eviction moratoria and other 
protections from eviction have expired or are set to expire in many 
jurisdictions. Eviction Lab, COVID-19 Housing Policy Scorecard, 
available at: https://evictionlab.org/covid-policy-scorecard/.
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    Based on the convergence of COVID-19, seasonal influenza, household 
crowding and transmission, and the increased risk of individuals 
sheltering in close quarters in congregate settings such as homeless 
shelters, which may be unable to provide adequate social distancing as 
populations increase, all of which may be exacerbated as winter 
continues, I have determined that extending the temporary halt on 
evictions, subject to further extension, modification, or rescission, 
is appropriate.
    Therefore, under 42 CFR 70.2, subject to the limitations under the 
``Applicability'' section, the September 4, 2020 Order is hereby 
modified and extended through March 31, 2021. Accordingly, a landlord, 
owner of a residential property, or other person with a legal right to 
pursue eviction or possessory action shall not evict any covered person 
from any residential property in any state or U.S. territory in which 
there are documented cases of COVID-19 that provides a level of public-
health protections below the requirements listed in this Order.
    This Order is not a rule within the meaning of the Administrative 
Procedure Act (``APA'') but rather an emergency action taken under the 
existing authority of 42 CFR 70.2. The purpose of Sec.  70.2 is to 
enable CDC to take swift steps to prevent contagion.\45\
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    \45\ Chambless Enters., LLC v. Redfield, No. 20-1455, 2020 WL 
7588849, (W.D. La. 2020).
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    In the event that this Order qualifies as a rule under the APA, 
notice and comment and a delay in effective date are not required 
because there is good cause to dispense with prior public notice and 
comment and the opportunity to comment on this Order and the delay in 
effective date. See 5 U.S.C. 553(b)(3)(B). Considering the public-
health emergency caused by COVID-19, it would be impracticable and 
contrary to the public health, and by extension the public interest, to 
delay the issuance and effective date of this Order.
    In the September 4, 2020 Order, the previous CDC Director 
determined that good cause existed because the public health emergency 
caused by COVID-19 made it impracticable and contrary to the public 
health, and by extension the public interest, to delay the issuance and 
effective date of the Order. The previous Director also found that a 
delay in the effective date of the Order would permit the occurrence of 
evictions--potentially on a mass scale--that would have potentially 
significant consequences. One such potential consequence would be that 
evicted individuals would move into close quarters in congregate or 
shared living settings, including homeless shelters, which would put 
the individuals at higher risk for COVID-19. Another potential 
consequence would be if evicted individuals become homeless and 
unsheltered, and further contribute to the spread of COVID-19. For 
these reasons, the previous Director concluded that the delay in the 
effective date of the Order would defeat the purpose of the Order and 
endanger the public health and, therefore, determined that immediate 
action was necessary. As a result, the previous Director issued the 
Order without prior notice and comment and without a delay in the 
effective date. Because these conditions continue to exist--indeed, 
have worsened--and because the extension granted in section 502 of 
Title V, Division N of the Consolidated Appropriations Act, 2021 is set 
to expire on January 31, 2021, I hereby conclude that immediate action 
is again necessary without prior notice and comment and without a delay 
in the effective date.

[[Page 8025]]

    The rapidly changing nature of the pandemic requires not only that 
CDC act swiftly, but also deftly to ensure that its actions are 
commensurate with the threat. This necessarily involves assessing 
evolving conditions that inform CDC's determinations.
    The conditions that existed on September 4, 2020 have only 
worsened. As of January 21, 2021, there have been over 24,400,000 cases 
and over 400,000 deaths. Data collected by Princeton University show 
that eviction filings are occurring; it is therefore expected that 
large numbers of evictions would be processed if the Order were to 
expire. [https://evictionlab.org/eviction-tracking]. Without this 
Order, there is every reason to expect that evictions will increase 
significantly, resulting in further spread of COVID-19. It is 
imperative is to act quickly to protect the public health, and it would 
be impracticable and contrary to the public interest to delay the 
issuance and effective date of the Order pending notice-and-comment 
rulemaking.
    Similarly, if this Order qualifies as a rule under the APA, the 
Office of Information and Regulatory Affairs (OIRA) has determined that 
it would be a major rule under the Congressional Review Act (CRA). But 
there would not be a delay in its effective date. The agency has 
determined that for the same reasons, there would be good cause under 
the CRA to make the requirements herein effective immediately
    If any provision of this Order, or the application of any provision 
to any persons, entities, or circumstances, shall be held invalid, the 
remainder of the provisions, or the application of such provisions to 
any persons, entities, or circumstances other than those to which it is 
held invalid, shall remain valid and in effect.
    This Order shall be enforced by federal authorities and cooperating 
state and local authorities through the provisions of 18 U.S.C. 3559, 
3571; 42 U.S.C. 243, 268, 271; and 42 CFR 70.18. However, this Order 
has no effect on the contractual obligations of renters to pay rent and 
shall not preclude charging or collecting fees, penalties, or interest 
as a result of the failure to pay rent or other housing payment on a 
timely basis, under the terms of any applicable contract.

Criminal Penalties

    Under 18 U.S.C. 3559, 3571; 42 U.S.C. 271; and 42 CFR 70.18, a 
person violating this Order may be subject to a fine of no more than 
$100,000 if the violation does not result in a death, or a fine of no 
more than $250,000 if the violation results in a death, or as otherwise 
provided by law. An organization violating this Order may be subject to 
a fine of no more than $200,000 per event if the violation does not 
result in a death or $500,000 per event if the violation results in a 
death or as otherwise provided by law. The U.S. Department of Justice 
may initiate criminal proceedings as appropriate seeking imposition of 
these criminal penalties.

Notice to Cooperating State and Local Officials

    Under 42 U.S.C. 243, the U.S. Department of Health and Human 
Services is authorized to cooperate with and aid state and local 
authorities in the enforcement of their quarantine and other health 
regulations and to accept state and local assistance in the enforcement 
of Federal quarantine rules and regulations, including in the 
enforcement of this Order.

Notice of Available Federal Resources

    While this Order to prevent eviction is effectuated to protect the 
public health, the states and units of local government are reminded 
that the Federal Government has deployed unprecedented resources to 
address the pandemic, including housing assistance.
    The Department of Housing and Urban Development (HUD) has informed 
CDC that all HUD grantees--states, cities, communities, and 
nonprofits--who received Emergency Solutions Grants (ESG) or Community 
Development Block Grant (CDBG) funds under the CARES Act may use these 
funds to provide temporary rental assistance, homelessness prevention, 
or other aid to individuals who are experiencing financial hardship 
because of the pandemic and are at risk of being evicted, consistent 
with applicable laws, regulations, and guidance.
    HUD has further informed CDC that:
    HUD's grantees and partners play a critical role in prioritizing 
efforts to support this goal. As grantees decide how to deploy CDBG-CV 
and ESG-CV funds provided by the CARES Act, all communities should 
assess what resources have already been allocated to prevent evictions 
and homelessness through temporary rental assistance and homelessness 
prevention, particularly to the most vulnerable households.
    HUD stands at the ready to support American communities take these 
steps to reduce the spread of COVID-19 and maintain economic 
prosperity. Where gaps are identified, grantees should coordinate 
across available Federal, non-Federal, and philanthropic funds to 
ensure these critical needs are sufficiently addressed and utilize HUD 
's technical assistance to design and implement programs to support a 
coordinated response to eviction prevention needs. For program support, 
including technical assistance, please visit www.hudexchange.info/program-support. For further information on HUD resources, tools, and 
guidance available to respond to the COVID-19 pandemic, state and local 
officials are directed to visit https://www.hud.gov/coronavirus. These 
tools include toolkits for Public Housing Authorities and Housing 
Choice Voucher landlords related to housing stability and eviction 
prevention, as well as similar guidance for owners and renters in HUD-
assisted multifamily properties.
    Similarly, the Department of the Treasury has informed CDC that the 
funds allocated through the Coronavirus Relief Fund and the Emergency 
Rental Assistance Program may be used to fund rental assistance 
programs to prevent eviction. Visit https://home.treasury.gov/policy-issues/cares/state-and-local-governments for more information about the 
Coronavirus Relief Fund and https://home.treasury.gov/policy-issues/cares/emergency-rental-assistance-program for more information about 
the Emergency Rental Assistance Program..

Effective Date

    This Order is effective on January 31, 2021 and will remain in 
effect, unless extended, modified, or rescinded, through March 31, 
2021.

Authority

    The authority for this Order is Section 361 of the Public Health 
Service Act (42 U.S.C. 264) and 42 CFR 70.2.

    Dated: January 29, 2021.
Sherri Berger
Acting Chief of Staff, Centers for Disease Control and Prevention.
[FR Doc. 2021-02243 Filed 1-29-21; 4:15 pm]
BILLING CODE 4163-18-P