The COVID-19 pandemic highlighted the importance of housing and homelessness services as public health infrastructure. To understand how different communities across the United States adapted their homelessness responses during the pandemic to keep people safe and housed, we explored the steps taken in six places. This case study summarizes the response in Richmond, Virginia, which focused on providing safe shelter space to anyone who needed it and helping people stay in their housing using emergency rental assistance and diversion services. Robust coordination with the primary local health care provider expanded COVID-19 testing and vaccination access and made new connections to primary care. This further integration of the homelessness response and health care systems will continue beyond the pandemic, including by maintaining telehealth stations within shelters and health-focused outreach to people enduring unsheltered homelessness.