COVID-19 Alternative Housing

The City’s response to COVID-19 includes establishing the COVID-19 Alternative Housing Program to provide emergency, temporary housing and shelter options for the City's most vulnerable populations, a vast majority of which are for people experiencing homelessness. The City is using private hotel rooms, as well as a variety of other types of facilities, to establish these safe spaces for residents to isolate, quarantine, or shelter in place.


Who is the Alternative Housing program for? 

The City has several priority populations for COVID-19 Alternative Housing:
Front-Line City Workers
In addition to prioritizing the vulnerable populations described above, the City launched a Front Line Worker Housing program at the onset of the coronavirus public health emergency. The program aimed to meet the emergency health care and COVID-19 Alternative Housing program workforce demands, should San Francisco face a workforce shortage; to prevent the spread of the virus by safely isolating City and City-funded community partners from their household members; and to provide respite for those who may be working extended hours in the face of the pandemic.  From March through early August, this program served 1,128 front-line workers at a dedicated hotel site. The Front Line Worker Housing program has now transitioned to an on-demand, flexible hotel accommodation model that can address the critical emergency needs of  first responders and employees who test positive for COVID-19 or are suspected of having COVID-19 and are unable to safely self-isolate/quarantine due to their housing situation.  


COVID-19 Alternative Housing Capacity

The City has established a variety of COVID-19 Alternative Housing options, including private hotels, congregate sites, trailers and recreational vehicles (RVs). Many sites have on-site medical and behavioral health staff as needed for guests. Public health and human service officials assess and determine the most appropriate housing option and on-site services to meet the needs of the different populations.
The interactive dashboards display (1) Occupied and Unoccupied Active Alternative Housing units by site and facility type; and (2) the status of Alternative Housing units (Active or In Preparation) by site and facility type. As of October 2020, all acquired sites are Active status, so there are no sites with an In Preparation status.
How do individuals move in and out of the different Alternative Housing site types? 
There is a flow into and out of sites used for individuals isolating with COVID-19 at the Isolation & Quarantine (I/Q) Sites. When people with COVID-19 recover from the disease, they may go back to their home, or be transferred to a post-COVID congregate space or another hotel site. This allows the City to provide rooms for newly diagnosed COVID-19 individuals and persons under investigation. Congregate settings are used for both COVID-19 positive or COVID-19 recovered persons experiencing homelessness.
For asymptomatic persons experiencing homelessness, the City is actively developing new sites to ensure the most vulnerable have safe spaces to shelter in place for the duration of the emergency. Sites for this purpose include hotels and Trailer/RV sites.

Demographics by Alternative Housing Site Types  

The data below provides demographic information for individuals accessing the City’s COVID-19 Alternative Housing Program. The filters at the top of the table display demographics based on the setting where individuals are served. For COVID-Positive/PUI sites, the graph in the bottom left corner reports the prior living situation of each guest. The chart on the bottom right expands that information: for all those who reported their prior living situation was experiencing homelessness, the percentage who were sheltered or unsheltered; and of those who were sheltered, the percentage from each type of sheltered living situation. 


Assessing Unmet Needs for COVID-19 Alternative Housing

Isolation & Quarantine (I/Q) Sites for COVID-Positive/PUI: current COVID-19 Alternative Housing supply is sufficient
The need for additional I/Q Sites can be influenced by external factors. For example, an outbreak in a congregate homeless shelter or a large-scale testing initiative may create a new surge in need for isolation sites for patients diagnosed with COVID-19 who are homeless or marginally housed. Subsequently, while some of these individuals could return home after isolating, individuals who are homeless will need a safe shelter option that is separate from asymptomatic individuals who may still be at risk of contracting COVID-19.

Shelter-in-Place (SIP) Sites for Vulnerable Persons Experiencing Homelessness: 
  • Sheltered: current COVID-19 Alternative Housing supply is sufficient
  • Unsheltered: estimated 2,200 individuals meeting vulnerability criteria
Asymptomatic people experiencing homelessness who are 60 or older or have been diagnosed with a COVID-vulnerable medical condition are prioritized for placement into a hotel room to safely shelter in place. The Department of Homelessness and Supportive Housing (HSH) has followed CDC guidance to safely space the beds within existing homeless shelters, and as part of that effort has moved nearly all vulnerable individuals who want to move into COVID-19 Alternative Housing sites. These individuals are reflected in the data presented above.
While HSH estimates there are approximately 2,200 unsheltered individuals meeting the vulnerability criteria, some people experiencing homelessness will prefer to remain on the street or within HSH’s Temporary Shelter sites (shelters and/or navigation centers) despite the efforts of nonprofit service providers, the Homeless Outreach Team, Shelter Health and street-based health care providers.

Sites for Individuals who are Marginally Housed: unknown need for COVID-19 Alternative Housing  
Individuals living in single-room occupancy hotels (SROs) often share bathrooms, kitchens and other common areas. In the event of a COVID-19 case detected in a specific SRO, the Department of Public Health's Contact Tracing and Epidemiology teams will make a case-by-case determination of which residents should be offered space at a COVID-19 Alternative Housing site. Visit our page on residents of SROs to find out more about the impact of the pandemic on these residents

Housing Pipeline

The City developed a variety of hotel, congregate, and RV/trailer options to fulfill emergency sheltering needs. The Human Services Agency (HSA) solicited interest from hotels in March 2020 and over 80 hotels responded. See the data above for the current pipeline of sites under contract. The City focused on developing contracts with hotels:
  • with less than 150 rooms, because these are programmatically easier to manage, and
  • with ventilation systems where air does not travel between rooms, to diminish the risk of clients infecting each other. 
Many hotels were interested in working with the City on COVID-19 Alternative Housing, though some preferred to only provide services to front-line workers. As programmatic needs change over the course of the City’s response to COVID-19, new types of hotels may be needed, and the City may need to explore whether and how to use larger hotel sites or find others not currently in the pipeline.
The City works with hotels through a voluntary contracting process, and has not taken any steps to commandeer hotels at this time.