This spring, governments of all levels issued COVID-19-induced border closures, lockdowns, quarantines, and shelter-in-place orders. For San Francisco, the city that constantly faces a crisis of homelessness found itself at the intersection of two crises. However, much to the surprise of officials, only around 200 positive cases have been recorded from homeless populations in San Francisco, with over 100 of these coming from the same cluster outbreak in a shelter back in April. Compared to San Francisco’s overall count of 12,155 cases and California’s count of 910,847 cases, this count is incredibly low. 

While case counts are subject to data limitations, the overall trend is clear: homeless populations have not experienced the extensive disease spread that was intuitively expected of such a vulnerable population. 

Part of the explanation for this phenomenon is San Francisco’s local Project Roomkey initiative.

Project Roomkey in San Francisco

Announced in March by the state government, Project Roomkey aimed to provide emergency housing for 15,000 homeless individuals in empty hotel rooms. The project involved collaborative efforts across state governments, city governments, local hotels, and various local community organizations serving homeless populations. Project Roomkey is the first large-scale initiative of its kind and the first to emphasize a localized and individualized response by foregrounding community organizations in the implementation of the program. Individuals with a roomkey would have access to food and laundry services, allowing them to follow self-isolation and quarantine measures. 

In San Francisco, Project Roomkey initially promised to house the city’s entire homeless population, an estimated 7,000 individuals. However, the final approved funding allotted for the project only extended hotel housing for 2,000 individuals. Alameda County Health Care for the Homeless​ Organization spearheaded the implementation of the project. 

To enter the program, individuals needed a referral from any partnering health care provider. Referrals were issued on two criteria: 1) the individual did not have a suitable residence (i.e. living on the street), and 2) the individual had underlying medical conditions which made them a population at higher-risk for COVID-19.

Hotels that participated in the program were guaranteed 75% reimbursement for the costs of both rooms and support programs. Still, the program offered a stable, albeit alternative and unconventional, income for a sector hard-hit by the pandemic’s sharp decline in tourism.

Overall Effectiveness

So far, San Francisco’s Project Roomkey currently houses 2,377 individuals in hotel rooms. In total, 3,247 unique individuals have been served by the program, according to the city’s running alternative housing tracker. Uniquely to San Francisco, local organizations have aimed to use Project Roomkey as a means for providing other supportive interventions for individuals in the program including alcohol and drug management initiatives. So far, the effectiveness of these secondary initiatives has not yet been evaluated.

The future of Project Roomkey is currently uncertain as funding extends only through November. While the state government has expressed the desire to turn the emergency housing relief into long-term housing solutions by partnering with local organizations to buy hotel buildings, the implementation of this plan faces significant obstacles and a timeline beyond November’s end-of-funding date. This ongoing uncertainty of the program’s future is one area under substantial criticism.

Within San Francisco, data from March to August shows that the death rate among homeless populations has tripled. The specific causes of these deaths are unknown and subject to many complex variables; however, critics say that San Francisco’s city government did not take enough measures fast enough to protect its homeless populations. The increased death rate is seen as reflective of the project shortcomings.

As a Model for Future Solutions

Despite these criticisms, San Francisco’s Project Roomkey offers some insight for similar initiatives in other cities and for another iteration of the project within San Francisco. The project modeled effective and efficient collaboration among diverse institutions, including governments, businesses, and community organizations. The project also offered a model for integrating multiple programs —emergency housing and substance-abuse recovery initiatives— together. 

Just like the pandemic that spurned its conception, the longer-term consequences of Project Roomkey for San Francisco’s homeless populations will show in the coming months. Regardless, the project has shown substantial effectiveness in helping to keep COVID-19 infection rates low for vulnerable populations on the streets.

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