How bureaucracy kept the Bay Area from housing the houseless

Homelessness was top of mind for many when the shelter-in-place took effect in the San Francisco Bay Area in mid-March. Housing and homeless advocates wondered: How can homeless people shelter-in-place if they don't have a shelter?

"It was pretty clear that people experiencing homelessness were going to be [at] much greater risk than the general population of contracting this disease," Margot Kushel, MD, who is the director of University of California–San Francisco's Benioff Homelessness and Housing Initiative and who has cared for the homeless population for 25 years, told Salon. "People who are lucky they can work from home — quite literally you can't do if you're homeless, not to mention the fact that many people who are homeless are people who are doing these essential jobs that put people at such high risk, like working at restaurants or working in fast food."

Notably, the initial statewide stay-at-home order, which was issued after the Bay Area's, excluded homeless people.

Then, in April, California Governor Gavin Newsom announced a statewide initiative, Project Roomkey, which aimed to open up 15,000 hotel rooms to the state's homeless population. As part of the initiative, the state would receive a 75 percent reimbursement rate from The Federal Emergency Management Agency (FEMA), in which California county leaders were supposed to use to work on housing the vulnerable, unsheltered population. As part of Newsom's emergency action, $150 million was set aside for local California governments to purchase trailers and lease rooms in motels, hotels, and other facilities, prioritizing counties with high homeless populations. Kushel was part of shaping this plan.

It was the first initiative of its kind in the nation, hailed as a "win-win," and aimed to prioritize homeless people from the following categories: people over 65 and/or who have certain underlying health conditions, homeless people who have been exposed to COVID-19, and those who are COVID-19 positive, but didn't need hospitalization.

But in Alameda County, home to Oakland, only a small percentage of its homeless population have actually been housed as part of the two countywide programs, Operation Comfort and Operation Safer Ground, that are part of Project Roomkey. According to numbers provided by Alameda County, at least 641 rooms have been leased, but the county itself has at least 8,022 homeless people; 14 percent of whom are over the age of 60, which means that there isn't enough housing for even the most vulnerable of the vulnerable to self-isolate. More than half of Alameda County's homeless people are in Oakland. As of June 19th, 390 homeless individuals in Alameda County have been housed in hotels as part of Operation Safer Ground, which is meant for people over the age of 65 or those with underlying conditions to shelter-in-place. Sixty-three unsheltered people have been transferred as part of Operation Comfort, which is for homeless people who have tested positive for COVID-19 or have symptoms. At least 83 homeless people have been diagnosed with COVID-19.

The pace has motivated three activist groups, The Village of Oakland, East Oakland Collective, and Love and Justice in the Streets, to launch a GoFundMe and create their own program to house the homeless. In the last seven weeks, this initiative has housed 43 people between the ages of 1 month to 78 years.

"Because there was no intervention to shelter people in place to prevent them from getting COVID-19, that is what prompted our efforts," Needa Bee, founder of The Village told Salon. "The first group of folks that we moved in, they were senior citizens 65 and older, and they were literally dying in their tents."

Bee added that unhoused people are helping run the program, which is key to its success.

"Nine times out of 10 the people who are running these programs or coming up with interventions have never been homeless," Bee said. "They have no idea what they're doing, no idea what homeless people need, and whether they want to admit it or not, they have a very deep anti-homeless bias and a very deep anti-poverty bias."

In San Francisco, the number of homeless people housed in hotels as part of Project Roomkey is higher. According to San Francisco's data tracker, 1,450 hotel units have been occupied to shelter the homeless or provide shelter to those who have COVID-19, as of June 19. However, there are 2,532 units that have been acquired by the city. According to data from the city, six percent of San Francisco's coronavirus-positive cases are also experiencing homelessness. Similar to Alameda County, there are an estimated 8,000 homeless people in San Francisco.

"Folks on the streets are being moved excruciatingly slow," Jennifer Friedenbach,  Executive Director of the Coalition on Homelessness, told Salon in an interview. "We've got really crowded streets, filled with tents, folks don't have places to charge their phones or access to water often, and it's a lack of ability to shelter-in-place — we've got a long way to go."

The Bay Area's slow, piecemeal response to housing homeless people raises the question as to why it was so hard for the wealthy Bay Area to house everyone in the first place.

"I think the challenges have been primarily staffing, it's just been hard for them to hire up or redeploy the right staffing and then finances," Kushel explained to Salon. "Even though FEMA should reimburse a lot of the cost, it doesn't . . . . and I think there is a distrust of whether the FEMA will come through . . . .  and the FEMA money isn't upfront, you have to spend the money then get it."

Kushel said it was unquestionable that it would have been ideal to move to house everyone immediately upon the shelter-in-place, especially considering the research she's spearheaded which has found that homeless people experience age-related conditions at a much earlier age than the housed population. For this reason, Kushel said that adding exceptions for underlying conditions was key, as those populations are the most vulnerable.

In San Francisco, Board Supervisor Matt Haney told Salon he believes that some of the eligibility criteria became a bottleneck for the program in San Francisco, limiting its efficiency, adding that it has been interpreted "very narrowly." In San Francisco, homeless people have to be on a list that deems them eligible for a hotel, which is sorted by people over the age of 60 or those who have documented underlying conditions.

"They get a list of names of people that they're looking for, and then they go out and spend all day trying to find those people . . . . and then pass nine people trying to find John when most of those nine people should qualify," Haney said.
 
As reported by Mission Local, such bottlenecks have made it possible for about 20 homeless people to be moved a day. Then, a lawsuit filed by the University of California, Hastings College of the Law over Tenderloin homeless encampments caused a shift in strategy. The settlement agreement stated that the city of San Francisco would remove 300 tents from the Tenderloin neighborhood, where UC Hastings is located, and relocate the people living in them to hotels or other safe places.
"In the Tenderloin starting just this last week, [outreach workers] changed their approach because of the lawsuit with Hastings," Haney said. "They went to a block in the Tenderloin, where there were 4,045 people on this block, and instead of skipping over nine people to try to find John, they went to every single person, and all 45 people accepted the hotel and qualified."
 
Haney said in some cases, it has taken the city of San Francisco months to negotiate terms with a hotel for Project Roomkey.
 
 "Negotiations with a hotel should take a day," he said. Haney added that, despite reports of the challenges of housing homeless people in hotels, his experience as a disaster service worker was really positive.
 
"This is an incredibly well, professionally staffed and effective program," Haney said. "There's more healing happening in these hotels than anyone can imagine."
 
This story was reported with support from the California Fellowship through the USC Annenberg Center for Health Journalism.
 
[This article was originally published by Salon.]