In summary

California has an extensive program to house the homeless during the COVID-19 pandemic, yet, it is inadequate and reactive in a crisis that requires proactive measures.

By Neil Gong and Chris Herring, Special to CalMatters

Neil Gong is a postdoctoral fellow at the University of Michigan who will be joining the sociology faculty at UC San Diego, ngong@umich.edu. Chris Herring is a PhD candidate of Sociology at UC Berkeley who will be joining Harvard as a postdoctoral fellow and the UCLA sociology faculty, christoph.herring@berkeley.edu. Their research focuses on homeless services in San Francisco and Los Angeles.

Gov. Gavin Newsom announced last month that he would commit $150 million to addressing homelessness during the COVID-19 pandemic. Project RoomKey, in collaboration with local efforts, aims to shelter 50,000 of the state’s more than 150,000 homeless people in hotels. 

No other state has put forward such an extensive program. And yet, this remains inadequate and reactive in a crisis that requires proactive measures.

Newsom’s approach will leave more than 100,000 of those currently homeless, plus tens of thousands who may lose housing in the downturn, to the unsanitary streets and dense shelters — environments public health experts say are ripe for transmission of the coronavirus. Worse yet, the majority of the 50,000 will first have to contract and survive COVID-19 before being placed in a hotel.

Rather than waiting for people to test positive, we must get ahead of the curve and place all unhoused Californians in hotels or comparable units through the duration of the crisis. One city has developed just such a plan. 

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San Francisco’s Board of Supervisors last week voted unanimously to procure 7,000 hotel rooms reserved to house nearly all of the city’s homeless before getting sick. Given an outbreak in a city shelter, the legislation mandates that this be done by April 28.

Would this model work across the state? Absolutely.

California has the hotel rooms; due to travel bans and shelter-in-place orders, there are mass vacancies. San Francisco has more than 30,000 vacancies for a homeless population of 8,000. Los Angeles has more than 36,000 unhoused, and more than 90,000 rooms, with most hotels expected to close or suspend services in the coming weeks. Smaller counties in California have fewer hotels, of course, but also fewer unhoused people.

Leaders also have the legal powers — Newsom’s March 12 executive order allows the commandeering of hotel rooms, and city governments have comparable authority. City attorneys of L.A. and San Francisco have confirmed these powers, and Mayor Eric Garcetti of Los Angeles has even threatened to utilize them if necessary. Yet instead of invoking this authority counties are engaged in a slow moving bidding and contract process reactive to the pace of patient outflow. Consider that Newsom announced a plan to lease hotels on March 18. By April 18, counties had only secured 15,999 rooms and moved in 4,211 people.

In a context of exponential virus transmission, rapid acquisition today will result in saved lives and money. This is because unhoused individuals are projected to be two to three times more likely to require hospitalizations, two to four times more likely to require ICUs, and twice as likely to die as compared to the general population, according to a recent study

In an outbreak across New York City shelters, more than 34% of people have required hospitalization. Given that the average cost of a 6-day inpatient treatment for COVID-19 is $73,000, this will be immensely expensive. Two privately funded pilots in San Francisco have moved entire shelters into hotels for $80 a room — a money saver when rapid placement prevents hospitalization.

To be sure, the first leader to commandeer will draw political controversy. The governor would have the most effective impact. Otherwise, some brave mayor will have to take the first step and the heat, before this process becomes normalized.

It would be difficult to see other leaders criticizing them, though. Such actions seem to have bipartisan public support. A survey from Data for Progress found that 81% of voters — including 79% of Republicans — support measures for the government to purchase or take control of unoccupied housing options for homeless people during the pandemic.

Securing a hotel bed to prevent transmission today may leave a hospital bed and ventilator free for tomorrow. While we have a scarcity of medical supplies, we have a surplus of vacant hotel rooms. This is an industry and public health win-win, and time is of the essence.

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Neil Gong is a postdoctoral fellow at the University of Michigan who will be joining the sociology faculty at UC San Diego, ngong@umich.edu. Chris Herring is a PhD candidate of Sociology at UC Berkeley who will be joining Harvard as a postdoctoral fellow and the UCLA sociology faculty, christoph.herring@berkeley.edu. Their research focuses on homeless services in San Francisco and Los Angeles.

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