An Open Letter to Mayor London Breed

Dear Mayor London Breed, 

On Tuesday, April 14, all eleven members of the San Francisco Board of Supervisors voted to pass the Emergency Ordinance – Limiting COVID-19 Impacts through Safe Shelter Options. The Ordinance calls for the City to secure 8,250 private rooms by April 26, 2020, including 7000 rooms for homeless San Franciscans. This would allow us to quickly meet the needs for thousands of homeless residents in our streets and shelters who currently have no way of sheltering-in-place. We urge you to sign the Hotel Ordinance today so that it can be implemented as soon as possible. 

A month into shelter-in-place, fewer than 800 homeless people have been placed in hotel rooms. Your administration has stated that there is only a need for 7,000 hotel rooms to provide quarantine for those who are infected with COVID-19 and do not have a home to self-isolate in, primarily for those among San Francisco’s 9,000 unhoused and 19,000 city SRO residents who may become infected over the pandemic. The administration also plans to make these rooms available for front-line workers and vulnerable unhoused individuals who are over 60 years of age or have underlying conditions. 

In contrast to the administration’s current policy approach, the legislation passed this week charges the city to move 7,000 unhoused individuals, regardless of age or underlying health conditions, into hotels before they become COVID-19 patients as a preventative measure to reduce and slow viral spread. This legislation aligns with the State of California’s Recommended Strategic Approaches for COVID-19 Response for individuals Experiencing Homelessness developed in partnership with Margot Kushel and UCSF’s Benioff Homelessness and Housing Initiative’s recommendation that the “primary strategy for intensive infection prevention efforts is providing single occupancy housing.” More than 100 medical professionals published an open letter to you supporting this plan on March 24.

You have stated previously that while you wish to house homeless San Franciscans in hotel rooms, barriers exist, such as staffing and providing services to residents. The Homeless Emergency Service Providers Association (HESPA), which includes the City’s many shelter and service providers have made clear their willingness and ability to both place their clients directly into hotels and staff those hotels as needed. Medical professionals and essential homeless service providers also provided you with a report on the necessity for such a plan. By utilizing the strength and front-line expertise, we can move people in much more quickly than we are currently capable of using city department staff alone. Two shelters have already done so independently using private donations, safely sheltering their clients in place in hotels with nonprofit staff. 

Rather than selectively triaging vulnerable individuals and COVID-19 patients into hotels, that are required to keep their facilities staffed, while concurrently hiring additional staff for hotels as your administration is currently conducting business is duplicative, costly and inefficient. Instead the more than 1500 San Franciscans who still remain in dangerous congregate shelters as of April 16, could be quickly moved en masse with supportive shelter staff into hotels if the current legislation is approved, unclogging this staffing bottleneck. 

Thousands of other homeless San Franciscans who, which according to the city’s point in time counts, have become homeless only in the past few months and/or have relatively low needs could quickly be placed in hotels. These hotels would not require additional staffing outside of meal delivery, and could simply rehire the pre-crisis hotel staff who are now unemployed. This would allow the city to focus more intensive medical and behavioral health staffing at those hotels where it is most needed. 
We do recognize the extra staffing needs that will be required for hosting those with mental health, substance use, and physical disability challenges. The current criteria the administration is using to bring in only the most vulnerable makes this especially pressing. However, the staffing bottlenecks here should not stand in the way of providing hotels more quickly for the thousands of younger homeless individuals and families for which such extensive staffing is not required.

We have also heard your administration claim that providing hotels for such a large portion of San Francisco’s unhoused would not be fiscally prudent for a city facing a Billion Dollar deficit. While public health and medical experts are in consensus that such a hotel plan will save human lives, we recognize that costs are of concern. First, it’s important to note that a recent Budget Legislative Analyst’s report notes that many of these rooms can be reimbursed by up to 93% with FEMA and Federal stimulus monies. However, even for the rooms which are not reimbursable, it is important to recognize the cost of not acting. 

While we cannot know how many less homeless San Franciscans would require hospitalization or ICU’s if moved into hotel rooms than being left in shelters or the streets, but we do know that a typical 6-day inpatient treatment for COVID-19 is $73,300 per person. A study by Professors at UCLA, University of Pennsylvania, and University of Boston project that based on existing demographic data and COVID-19 risks that homeless individuals are 2-3 times more likely to be hospitalized, 2-4 times more likely to need an ICU, and twice as more likely to die than the general population. Looking beyond costs from an individual lens to the broader public, and that each person with COVID-19 typically infects at least two others, the costs grow quickly. At our current moment when testing is extremely limited, the only way to reduce these costs is through non-pharmaceutical interventions of physical distancing and increased sanitation, which are impossible in congregate shelters and for those residing on the streets.

We are also concerned that the city’s current prices that it is paying for hotels is exorbitantly high, at $166 a night (including meals and staffing). According to the City Attorney the Mayor and Public Health Officer have powers to commandeer hotels during the duration of the public health emergency. According to lawyers at various legal rights organizations “commandeering hotels may be less costly than negotiating contracts.” As such, just compensation for hotel rooms commandeered by the Mayor under the takings clause will be determined by the current rental value of the property for the period of the taking. Hotels will not be able to introduce evidence of lost profits in determining the reasonable value. With drastically reduced hotel demand throughout the ongoing COVID-19 crisis, rental value of the hotel rooms during the pandemic is likely far less than typical market rate. 

Whether you chose to use your powers to commandeer rooms or not, it could be utilized to press hotels for lower pricing as Eric Garceti recently invoked to the hotel industry in Los Angeles. Many predict there will be no tourist season to speak of until at least 2021. Many smaller hotels may close and never reopen in the depth of this crisis, while large chains have already received billions in Trump tax cuts in 2019 and again with the recent stimulus of corporate bailouts. There is no reason the city of San Francisco should be providing corporate profits in these deals and should pay no more than the fair wages for workers, utilities, and costs to keep our most vulnerable safe. 

With the outbreak of COVID-19 at Multi-service Center South Shelter where 63 percent of tested residents were infected with the virus over the course of a week, we believe that the urgency of this situation is more pronounced than ever. As UC Berkeley public health experts have written to your administration, congregate shelters are not appropriate settings for human beings during this COVID-19 outbreak. Yet nearly two weeks since the first tested positive at MSC South, we still have over 1500 people remaining in shelter. With shelters having closed off entry to homeless San Franciscans weeks ago, over 6,000 others are forced to survive on the streets. Nurses at SF General have no place to discharge the unhoused who are not COVID patients except to the streets. They are struggling to survive under the city-wide lockdown that has placed even further limitations on restrooms, indoor spaces, food, and sources of income. These conditions have made it impossible for them to maintain proper hygiene and reduce their contacts as they have to travel even further to access food and toilets.  

We understand there will be crises and challenges within these hotels. However, we believe that the crises and challenges that will arise within these hotels will be far less and easier to manage than the humanitarian disasters we project will occur on our streets and shelters during COVID-19. Homelessness is a long neglected social problem that stretches before your administration and far beyond San Francisco. We have no illusions that hotel rooms during the pandemic will magically make these issues disappear. However, hotel rooms will keep more people our most vulnerable well and alive, slow viral spread, and flatten the curve for all of San Franciscans, particularly for our medical workers and doctors treating this virus on the frontlines.

At a time when there are more than 33,000 vacant hotel rooms in San Francisco, the Safe Shelter ordinance passed by the Board of Supervisors is practical, feasible, and good public health practice. Again, we respectfully ask that you sign and carry out the Emergency Hotel Ordinance so that San Francisco can prevent the spread of COVID-19 for all San Franciscans and protect unhoused residents of San Francisco from falling severely ill or dying from the virus. 

AIDS Legal Referral Panel

Coalition on Homelessness

Compass Family Services

Episcopal Community Services

Eviction Defense Collaborative

Glide Foundation

Homeless Prenatal Program

Hospitality House

San Francisco SafeHouse

San Francisco Aids Foundation

St. Anthony Foundation

Swords to Plowshares

South of Market Community Action Network

The Gubbio Project

United Council for Human Services