COVID-19 Alternative Housing Program
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, city-managed tent sites in adherence with the San Francisco Department of Public Health (DPH) COVID-19 compliance guidelines, and a variety of other types of facilities to establish these safe spaces for residents to isolate, quarantine, or shelter in place.
The page offers information on the COVID-19 Alternative Housing program:
Who does the COVID-19 Alternative Housing program serve?
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.
What is the status of the City's existing congregate shelter system?
Early in the pandemic, the City implemented COVID-informed public health guidance for congregate-style shelters across all existing congregate sites that included prevention and mitigation practices including, but not limited to: social distancing, increased cleaning protocols, and health screenings. As part of the implementation of this guidance, individuals vulnerable to COVID-19 in existing congregate shelters were offered placement into the Shelter-in-Place (SIP) hotels. The implementation of COVID-informed public health policy resulted in a temporary pause of new intakes into congregate shelters as well as a loss of capacity within the congregate shelter process.
Congregate Shelters have and will continue to remain open and operating, although at a lower, COVID-informed capacity. New intakes are accepted at congregate sites that have adopted and implemented COVID-informed public health guidance. Referrals to congregate shelter are managed through the COVID-19 Command Center’s centralized referral process. Referrals are voluntary and limited based on availability. Some individuals experiencing unsheltered homelessness may not be ready to accept a referral to congregate shelter at the time the resource is offered, remaining unsheltered. The City is working to expand congregate shelter capacity by opening two new Navigation Centers in early 2021, the Lower Polk Navigation Center for Transitional Age Youth, and the Bayview SAFE Navigation Center. Additionally, congregate shelters will re-inflate to pre-COVID capacity when and as public health guidance allows.
Shelter-in-Place (SIP) and Isolation & Quarantine (I/Q) Sites
SIP and I/Q: Site Capacity
The City has established a variety of COVID-19 Alternative Housing options, including private hotels, congregate sites, and trailers. 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:
- Occupied and Unoccupied Active Alternative Housing units by site and facility type; and
- The status of Alternative Housing units (Active or In Preparation) by site and facility type.
On the first graph, the green sections of the bar show how many units are occupied. The purple shows how many units are available.
On the second graph, if all bars are yellow in the second graph, all sites are Active; there are no sites In Preparation.
How do individuals move into and out of I/Q sites?
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 and are given medical clearance to leave, they may go back to their original living location or be transferred back to their original SIP congregate shelter. This allows the City to provide rooms for newly diagnosed COVID-19 individuals and persons under investigation.
SIP and I/Q: Demographics
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.
SIP & I/Q: Assessing Unmet Needs
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, 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 congregate shelters, and as part of that effort, has placed nearly all COVID-vulnerable individuals into COVID-19 Alternative Housing sites. These approximately 500 individuals are reflected in the data presented above.
While the City estimates there are approximately 2,200 unsheltered individuals meeting the vulnerability criteria, some people experiencing homelessness may choose 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.
SIP & I/Q: 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 sites under contract.
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. The City worked with hotels through a voluntary contracting process, and did not take any steps to commandeer hotels during this pandemic.
Safe Sleep Sites & Villages
To respond to the crisis, the City and its community partners have taken a human-centered approach to provide people experiencing homelessness with safe and clean places to sleep and access to services and sanitation if other existing resources are not available or desired. One new strategy is the Safe Sleep Program: a low-barrier and COVID-informed component of the Alternative Housing system of care that offers 24/7 access, connects clients to resources and services to help them safely shelter in place, and provides a connection to the Homelessness Response System to work toward an exit to homelessness. The program aims to implement public health guidelines in a dignified way to keep unsheltered individuals safe during the pandemic and maximize the number of residents that have a safe place to shelter in place.
What are Safe Sleep Sites and Villages?
Safe Sleep Sites are designated City managed locations where people can safely sleep in tents off the sidewalks and remain socially distanced from each other. Safe Sleep Sites provide 24/7 access and provide guests have access to garbage services, hygiene (portable restrooms and hand washing stations) and charging stations. There is security at each site, 7 days a week, and service providers regularly visit Safe Sleep Sites to provide outreach and engagement, harm reduction supplies and intervention, medical services and trauma-informed behavioral health services.
Safe Sleep Villages have additional services available including 24/7 staffing by a service provider with experience working with people experiencing homelessness. Staff ensure a safe environment and help support the well-being of guests through regular check-ins and management of inflow/outflow from the site. Safe Sleep Villages provide guests with access to behavioral health and harm reduction services, access to medical attention and benefits, food and water, access to hygiene services, including showers, charging stations, and garbage service.
See the dashboard below for more information on the capacity of the Safe Sleep Program and the individuals served. Please note, some tent spaces allow for more than one individual, resulting in a higher current individual census than the number of tent spaces active.