SF fails to meet deadline of leasing enough hotel rooms for homeless during coronavirus pandemic
The
city was supposed to lease 8,250 hotel rooms for the homeless,
frontline workers and those living in densely populated apartment
buildings by Sunday, according to an April 14 emergency ordinance
unanimously passed by the Board of Supervisors.
On
Monday, the city had leased a total of 2,741 rooms— 1,130 of which were
empty or inactive for reasons such as a lack of staffing or other
necessary preparations. There is no formal punishment for failing to
meet the deadline.
The requirement set by the supervisors is 1,250
more than the Human Services Agency was initially working on, though
there was no deadline for the department’s efforts. In a previous
interview with The Chronicle, Mayor London Breed said that the emergency
ordinance by the supervisors was unrealistic and that the city was not
going to meet the goal.
“I want to be clear,” she said earlier this month. “It’s not going to happen.”
While several supervisors acknowledged the ordinance
is ambitious, some said Monday that they at least expected the city to
be further along by the deadline. Supervisor Aaron Peskin said the
longer San Francisco takes to move its homeless and most vulnerable
indoors — the harder it will be for the city to combat the virus.
There
are many logistics involved in moving a homeless person or other
vulnerable people into a hotel room, such as providing enough food and
hiring enough security, staff, cleaning services and case managers for
those who may be suffering from mental illness or drug addiction.
“I
realize it’s not as easy as snapping your fingers ... but no matter how
you slice it or dice it, the city has been halting in this effort,” he
said, adding that the city’s reasons for the delays — like hiring enough
staff — should be overcome.
A
group of supervisors, medical professionals and homeless advocates plan
to hold a virtual news conference Tuesday to denounce the
administration’s failure to adhere to the law.
San
Francisco has been applauded nationally for its early response to the
pandemic, but many worry the progress might unravel if the city does not
take more dramatic and sweeping measures to protect its 8,000-plus
homeless population.
More
than 100 people have tested positive for the virus at the city’s
largest shelter, MSC South, and neighborhoods like the Tenderloin,
Mission and Bayview are crowded with people living in tents and
congregating on the streets. Meanwhile, dozens of people have also
tested positive for the virus in single-room occupancy hotels, which are
densely populated apartment buildings for low-income residents.
Some inside the hotels told The Chronicle
that, for the most part, they are pleased with the accommodations,
where they have a clean space to their own and three meals a day.
Breed
defended the city’s progress at a Monday news conference. She said the
city was moving as fast as it could. Getting people to follow the rules
inside the hotel rooms and to follow the proper social distancing
guidelines has been challenging, she said. She cited staffing as one of
the biggest hurdles to getting more people inside.
Aria Bendix
May 21, 2020, 5:03 AM
homeless coronavirus los angeles
Julie Mariane, who has been living in the street for one and a half years, at a motel room provided to homeless people through Project Roomkey on April 26, 2020. Apu Gomes/AFP/Getty Images
California counties are sheltering homeless residents who are infected with COVID-19, or at high risk of getting infected, in hotels and motels.
In the Bay Area, San Francisco and Contra Costa counties are offering alcohol to guests who might otherwise experience withdrawal.
San Francisco is also allowing guests to purchase their own medical cannabis, while Contra Costa is purchasing tobacco for guests out of its own budget.
The programs are part of a "harm reduction" strategy that aims to keep homeless residents from leaving the hotels to retrieve substances.
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Those who sleep outdoors lack access to sanitation facilities, making it difficult to wash their hands or practice other forms of basic hygiene that lower the risk of getting and transmitting the coronavirus. Traditional homeless shelters, however, can create breeding grounds for outbreaks. Because of this, the Centers for Disease Control and Prevention recommends setting aside individual rooms for homeless people who have COVID-19, are awaiting test results, or have been exposed to the virus.
So California procured thousands of hotel and motel rooms for this purpose, through a program called "Project Roomkey." Three-quarters of the funding comes from the Federal Emergency Management Agency, while the remaining quarter — around $150 million — is financed by the state government.
Gov. Gavin Newsom announced the program on April 3. Within a couple weeks, the program had secured more than 10,000 hotel and motel rooms across 42 counties.
But one aspect of San Francisco's operation of the hotels has stirred controversy: The city's Department of Public Health is giving alcohol to guests struggling with addiction and facilitating the delivery of cannabis.
"I just found out that homeless placed in hotels in SF are being delivered alcohol, weed, and methadone because they identified as an addict/alcoholic for FREE," Thomas Wolf, a drug counselor in San Francisco, tweeted on May 1. "You're supposed to be offering treatment. This is enabling and is wrong on many levels."
According to San Francisco's health department, which staffs the hotels, funding for these substances in the hotels comes from private donations. But Contra Costa County, about an hour outside the city, has spent up to $1,000 in public funding so far on substances for vulnerable residents sheltering in hotels. 
Officials from both health departments say the practice of administering drugs and alcohol has prevented people from leaving the hotels to retrieve substances, thereby limiting the potential for the virus to spread.
"This program was put in place in order to support isolation and quarantine practices for patients under investigation or those who were positive for COVID-19, so that they do not break their isolation and expose other members of the community," Dr. Ori Tzvieli, Contra Costa county's deputy health officer, told Business Insider. 
Distribution of alcohol, weed, and cigarettesSo far, San Francisco's isolation and quarantine hotels have given alcohol to less than a dozen guests to prevent withdrawals, according to Jenna Lane, a spokeswoman for the city's public health department. Around 10% of guests are provided with tobacco at any given time, she added.
The conservative nonprofit Turning Point USA suggested that funding for these substances came at taxpayers' expense, but Lane said that's not true in San Francisco. She estimated that alcohol and tobacco donations so far have totaled around $3,000. Some hotel guests can also purchase their own medical cannabis — Lane said five people have used that service.
Contra Costa county, meanwhile, has set aside more than 300 hotel rooms with funding from Project Roomkey. Around 150 vulnerable residents have temporarily moved in so far, according to the county health department's website. Tzvieli said five of those people have used the drug and alcohol program.
"We bought small individual (airplane style) vodka bottles and beer," Tzvieli said. "Patients with alcohol use disorder get a choice of one or the other." The Contra Costa health department has also purchased one brand of cigarettes for guests, he added.
"It may sound odd for a health department to give people alcohol and cigarettes, but we do it in order to maintain isolation and quarantine and help protect the community from COVID," Tzvieli said. "It's a trade-off."
The 'minimum possible quantity and quality' to prevent withdrawal
homeless motel coronavirus
Julie Mariane gathers her belongings in her motel room. Apu Gomes/AFP/Getty Images
Project Roomkey gives funding priority to counties like San Francisco with significant coronavirus outbreaks and large homeless populations. Mayor London Breed announced on April 29 that San Francisco had access to about 25% of the rooms available for occupancy under the statewide program.
As of May 13, around 211 individuals without a safe place to shelter — people who either had COVID-19 or are vulnerable to catching it — were being temporarily housed in San Francisco hotels. More than half are homeless, Lane said.
Guests entering hotels in San Francisco through Project Roomkey are "screened multiple times to determine what substances they would be uncomfortable without," the health department said in a statement to Business Insider. For guests who require alcohol or tobacco, the department's medical staff calculates the "minimum possible quantity and quality" to prevent withdrawals. It then administers these substances under the guidance of licensed physicians. Hotel guests are also given the option to receive support for reducing or stopping their drug and alcohol use. Those trying to quit have access to addiction specialists, who can prescribe medications like gabapentin to prevent withdrawal. 
"This period in our care has allowed some people to connect for the first time with addiction treatment," the department said in a statement. The department also facilitates the delivery of methadone from local clinics for guests that already receive treatment for opioid addictions.
Guests who use medical cannabis, meanwhile, can purchase it from a local dispensary, Lane said: "Patients order their own for delivery, and pay however they usually would." Contra Costa, too, provides medications like suboxone for opioid addicts. Tzvieli said alcohol and cigarettes are given to those who decline medical treatment. A controversial 'harm reduction' strategy homeless San Francisco Coronavirus.....
Josh Edelson/AFP/Getty Images
The practice of offering drugs and alcohol to those who might otherwise experience life-threatening withdrawals — an approach known as "harm reduction" — is often seen as an exercise in compassion for people struggling with addiction. There's evidence that the strategy promotes safer practices among alcohol users: A Seattle housing program that recruited homeless individuals with severe alcohol problems from November 2005 and March 2007 found reduced alcohol consumption among the residents, who were still permitted to drink in their rooms. It's also a way to relieve the burden on hospitals by administering substances in a controlled environment.
"Addiction doesn't stop because there's an infectious disease pandemic," the National Health Care for the Homeless Council wrote in an April memo. "Failure to accommodate substance use disorders will likely mean increases in fatal overdoses/dangerous withdrawals, higher rates of vulnerable people leaving isolation and quarantine against medical advice, and compromised individual and public health." But critics of the approach worry that it enables addicts and normalizes drug use.
The World Federation Against Drugs has maintained that harm-reduction approaches "do not help drug users to become free from drug abuse." In a 2016 statement, the International Task Force on Strategic Drug Policy said harm-reduction strategies "promote the false notion that there are safe or responsible ways to use drugs."
"Harm reduction has been the policy of the San Francisco Department of Public Health for well over a decade and is ingrained in all of our work," Lane said. 
She added that she didn't have a way of quantifying how much the strategy costs as a line item in her department's budget, but said thus far, the program has at least prevented drug and alcohol users with COVID-19 from leaving the hotels.
"Guests who have used the managed alcohol and tobacco and/or received prescription medications while in isolation and quarantine have told our medical staff that access to these things has influenced their decision to stay," Lane said.
Tzvieli said Contra Costa has seen similar results: None of the hotel guests have broken their isolation or quarantine. Of the five guests who participated in the harm-reduction program, he added, "each received only a one-day supply until their test results came back negative." After that, they were discharged from the hotel.
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California Gov. Gavin Newsom Calls California secures nearly 7,000 hotel rooms for homeless during coronavirus pandemic
In this Tuesday , June 30, 2020, California Gov. Gavin Newsom updates the state’s response to the coronavirus outbreak, at the Governor’s Office of Emergency Services in Rancho Cordova, Calif. Citing the unprecedented challenges created by the coronavirus pandemic, city officials across California are asking Newsom to suspend or delay numerous state laws, saying they can’t comply with everything from environmental regulations to public records laws that allow the public to see how the government spends public money.
The governor hopes ultimately to bring that number to 15,000 rooms as part of an initiative he is calling “Project Roomkey,” he said Friday, while standing in front of a Sacramento motel where 30 rooms are currently sheltering vulnerable homeless residents.
“This has been a point of real concern for all of us for a number of months,” Newsom said. “A top priority since the COVID crisis began to manifest.”
Newsom also released new details about how Project Room Key will be funded. FEMA has agreed to reimburse cities and counties — which largely have been responsible for setting up the hotel rooms — for 75% of the costs, he said. Local officials can get the other 25% from the state — either using the $150 million Newsom has made available in emergency coronavirus funding for the homeless, or from prior homelessness funds the governor already has distributed.
These new hotel leases also include an option to purchase, either by a right of first offer or a right of first refusal — potentially creating an option for longer-term housing for the homeless.
These efforts are saving lives, Newsom said.
“If left unaddressed, we allow our most vulnerable residents in the state of California to be exposed to the virus,” he said.
Newsom’s announcements Friday come a day after San Francisco reported what appears to be the city’s first case of a coronavirus infection in a homeless shelter. The resident, who had been living at Division Circle Navigation Center, has been moved into an isolation room in a hotel, and city staffers are screening other shelter residents for symptoms. The death of a homeless Santa Clara County resident due to COVID-19 was reported last month, but county officials have released few details on the case.
Experts worry coronavirus could sweep through unsanitary homeless encampments or crowded shelters and sicken medically vulnerable residents, prompting Newsom last month to throw $150 million at the problem. He promised to send $100 million to local governments for homeless shelter support and emergency housing, and use another $50 million to buy trailers and lease hotel rooms that will be used to isolate homeless residents.
Santa Clara County had 15 trailers allocated by the state before the pandemic. When the virus hit, county officials intended to set them up at the Santa Clara County Fairgrounds — but they ran into a snag when they realized the water and power hookups at the fairgrounds don’t work.
Officials also have leased hundreds of hotel rooms across the Bay Area, and slowly have begun moving in homeless residents. San Francisco had leased 479 rooms as of Wednesday, and moved in 123 people — 95% of whom were homeless. The city hoped to secure 2,555 rooms by the end of the week. Santa Clara County had 172 rooms as of Wednesday, and had housed 105 people. Another 39 people were pending placement. Alameda County officials have leased two hotels in Oakland, and as of Tuesday had moved in five homeless residents showing signs of COVID-19.
To reduce capacity at crowded existing shelters and allow space for residents to practice social distancing, officials also are opening new shelters. San Jose opened Parkside Hall at the Convention Center this week, to house 75 homeless adults who don’t have COVID-19. The city hopes to open South Hall next. And San Francisco planned to open Moscone West to 394 homeless residents this week. The city also hoped to open two additional shelter sites — with a planned capacity of up to 510 beds — by next week.
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