What happened when California tried to fix its homelessness crisis as the pandemic arrived

Before the coronavirus even reached the US, California was already in the midst of a public health crisis.

By March 2020, the Golden State’s homeless population made up more than a quarter of unhoused people in America. Nearly three-quarters of the more than 150,000 homeless people in the state were living unsheltered, oftentimes hard on the streets in encampments that seemed to pop up in cities from north to south.

So when Covid-19 arrived in the spring and the governor, Gavin Newsom, shut California down to curb its spread, the two public health crises of homelessness and coronavirus collided head-on. How do you shelter-in-place if you don’t have shelter? How do you socially distance if you live shoulder-to-shoulder in a homeless camp? How do you wash your hands with no bathroom?

Related: 'It's barely a Band-Aid': life inside San Francisco's first sanctioned tent camp

State officials appeared to recognize the challenges facing the homeless population early on. Their response was Project Roomkey, a “first-in-the nation initiative” announced in April that used funding from the Federal Emergency Management Agency (Fema) to secure hotel and motel rooms for homeless individuals. Newsom has estimated that 22,300 people have been served by Project Roomkey – one-fifth of the state’s homeless population.

In July, the governor announced the state would also be “building on the success of Project Roomkey” by providing federal stimulus funding and state funding for jurisdictions to purchase some Project Roomkey properties and turn them into permanent housing – Project Homekey. In November, with the end of the pandemic nowhere in sight, Newsom approved another $62m to extend Project Roomkey. And in late December, Newsom announced that Fema had committed to funding the program until the pandemic ended.

Advocates and unhoused individuals have applauded the intent of the ventures. “I don’t know where I’d be right now with my medical conditions,” said Marlin Tanner, 70, a resident of a San Francisco shelter-in-place hotel. “This is a blessing.” But nine months since the initiatives’ launch, they argue that just a fraction of those in need received help this year. “The response has actually been quite inadequate, just by a numbers perspective,” said Eve Garrow, the homelessness policy analyst with the American Civil Liberties Union of southern California (ACLU). “It left so many people living unsheltered on the streets or in dangerous shelters that increased the risk of infection.”

And, critics say, by allowing local jurisdictions to interpret the state mandates to some degree, success of the program has varied regionally. Newsom argued that the size and diverse makeup of California meant that a one-size-fits-all approach to policy would never succeed. But in doing so with Project Roomkey, advocates believe the state allowed localized anti-homeless, not-in-my-backyard sentiments to overtake policy.

“In my experience, state level and federal policies that devolve down to the local level are subject to the really vicious homelessness politics and become dangerously distorted, oftentimes harming people who are unhoused. That’s what I feel like happened in Orange county,” said Garrow.

According to advocates, in Orange county, many of the the nearly 600 unhoused individuals in the Project Roomkey program were forced to remain confined in isolation. People were not allowed to leave the hotel unless they had a medical appointment or were being transported by a provider. They could not go for walks, exercise outdoors or do any of the things that health officials told the public to do for their mental health.

“On one hand, people are very grateful to be living in their own motel room,” Garrow said. “There was a mix of a sense of relief of having your own living space, having your own bathroom, your own shower and being able to have control over your own space. But superimposing over this program these unnecessary restrictions on people’s civil liberties was really, really difficult and wearing on people.”

“People started entering the motels in April and they were quarantined all the way through October,” Garrow continued. “People were having mental health breakdowns. People told me they were having suicidal thoughts.”

Jason Austin, director of the Orange county office of care coordination, confirmed that Project Roomkey participants signed a form agreeing to practice “Safer at Home Isolation” measures that included “remaining in [their] room during [their] entire stay with the program”. “It was a combination of public health guidance and operational requirements to manage the motel sites in each of the cities,” Austin wrote in an email to the Guardian. Participants could go to stores and medical appointments “in coordination” with the Illumination Foundation, the non-profit that the county charged with running the program.

Advocates argued that unless individuals tested positive for the virus, the public health guidance had never been to isolate by yourself for long periods of time, let alone six months. “There was no good public health reason for Orange county to implement those protocols,” Garrow said. “Our suspicion was they did it to forestall the Nimbyism backlash of having a motel full of unhoused people in the community, to reassure the community that even though there was a Project Roomkey motel, they would never see unhoused people.”

In San Francisco, a city with an estimated 8,000 homeless individuals, advocates could not understand why the mayor, London Breed, did not house every unhoused person in a vacant hotel room. Breed had the authority to commandeer hotel units under the state of emergency she declared in February. The city had the capacity, advocates said, and Newsom had promised that local jurisdictions would receive up to 75% Fema reimbursement for rooms.

Like most other jurisdictions, San Francisco chose to house only the medically vulnerable, those over the age of 60 or those who had been exposed to the virus. Breed and other city officials cited budget shortfalls, as well as the complicated needs of certain homeless individuals. “I wish it were that easy to help people who are unfortunately struggling with addiction, people who are unfortunately struggling with mental illness,” Breed said in April. “I wish it were that easy to just provide a place for them to be.”

As shelters reduced capacity to enforce social distancing – and outbreaks happened, nonetheless – many unhoused residents at some point in 2020 were forced into the streets, overtaking sidewalks with tents and encampments. The encampment situation got so dire in the Tenderloin neighborhood that the UC Hastings Law School and some local merchants filed a lawsuit against the city to address the issue, which resulted in the fast-tracking of hundreds of unhoused residents into hotel rooms.

Still, thousands remained in the streets, including some who had medical vulnerabilities like tumors in their lungs or had undergone lung surgery. A small handful were allowed to set up tents in “safe sleeping sites”, which provided little respite when wildfire smoke choked the region for weeks starting in late August, and now as the weather grows wet and cold. The city saw a surge in homeless deaths.

City officials said in September that they were beginning to transition hotel residents into more stable housing from their temporary rooms. Some hotel residents, however, told the Guardian that they had not yet spoken to anyone about moving them out, even as officials publicly spoke about the need to close hotels in the coming months.

Others did. Starting in September, the Night Ministry’s Rev Monique Ortiz began hearing from people she counseled on the streets who had been placed in hotel rooms. “I’m back in the shelter, Pastora,” she said they told her. In October, Ortiz’s own family received a call from her 58-year-old brother, Eddie.

Eddie had struggled with alcoholism and mental health issues for some time, and had been in and out of homelessness for several years, she said. She had tried having him live with her family, but during one of his episodes, he became convinced that she had assaulted him and that he hated her. They rented him a room in a single-room occupancy hotel, but one day he never returned.

When they last saw him in February, he was staying at the men’s shelter that experienced one of the largest Covid outbreaks in the country. In the October call, he informed them he was one of the lucky ones who was moved into a hotel – but then was moved back into a shelter in September.

It was then, Ortiz said, that he contracted Covid. “He was intubated, and spent 22 days in the ICU,” she said. Now the family has no idea where he is.

San Francisco has isolation hotels, for people who test positive or are exposed and have nowhere to quarantine, in addition to shelter-in-place hotels for unhoused individuals. Deborah Bouck, a spokeswoman for the city’s department of homelessness and supportive housing, suggested that perhaps Ortiz’s brother was at an isolation hotel – not a shelter-in-place hotel – before he was transferred back to a shelter, where he then contracted Covid. “No one is being exited to the street,” Bouck said.

Bouck said San Francisco had halted all transfers out of shelter-in-place hotels at the moment, and would not answer questions as to how many were transitioned out between the end of September and when the city decided to stop transfers, but interim director Abigail Stewart-Kahn said in a letter last month to local lawmakers that 49 households had transitioned to permanent housing from shelter-in-place hotels.

From the start, Newsom saw the pandemic and Project Roomkey as a way to make serious inroads on the longstanding crisis of homelessness in California. “The terrible pandemic we’re facing has given us a once-in-a-lifetime opportunity to buy all these vacant properties, and we’re using federal stimulus money to do it,” Newsom said in June. “Hand in hand with our county partners, we are on the precipice of the most meaningful expansion of homeless housing in decades.”

But given the scope of now both crises in California, it was never going to be enough. And as the pandemic enters a new year, advocates warn the unhoused population’s challenges aren’t over yet. California has seen an unprecedented rise in infections this month, while Covid fatigue is testing the limits of everyone’s compassion. Several jurisdictions had wound down their Project Roomkey programs and transitioned people out of hotel rooms, despite the state’s financial extension.

“We’re in the middle of a pandemic while we all want to believe we’re at the end,” said Shayla Myers, an attorney with the Legal Aid Foundation of Los Angeles. “On one hand, cases are going up at a rate we’ve never seen, while on the other hand, we are closing down Project Roomkey sites and cleaning up encampments again.”

Meanwhile, more and more cities and counties are passing laws around tents and sleeping in public. Oakland passed an encampment management policy prohibiting tents from existing within a certain distance from schools, homes and businesses. Chico’s city council voted to rescind a directive prohibiting enforcement of camping in public areas.

Keegan Medrano, policy director for the Coalition on Homelessness in San Francisco, thinks the criminalization of homelessness and Project Roomkey are interconnected. “San Franciscans are still looking outside their windows and thinking, ‘I thought we were moving people into hotels. Why are there still people out here?’ And then they email their supervisors and say, ‘I want these people off my streets’,” he said.

Orange county began winding down its program in October. The county was able to move 104 individuals into permanent housing and 324 into temporary housing, while 26 were moved into treatment or healthcare and 91 into emergency shelters. With the commitment from Fema, Orange county will extend its Project Roomkey program to provide an additional 200 more beds, Austin, the spokesperson, said.

In the last homeless count, Orange county had nearly 7,000 homeless individuals.

The Los Angeles Homeless Services Authority identified 15,000 homeless individuals who were are most high-risk, and committed to moving them into permanent housing – an $800m projectAt the height of Project Roomkey, about 4,000 people were housed in Los Angeles county hotel rooms – a little more than a 10th of its homeless population. But before Friday’s announcement about Fema’s commitment, Los Angeles had begun to wind down the program, with plans to wrap up by April. More than 1,100 have transitioned out, with no more transitioning into the program.

With ICU capacities flickering down to 0%, it’s unclear unclear what Los Angeles’s future holds.

“In March in Los Angeles, our city leaders did a very good job of remembering that a pandemic affects unhoused people too,” Myers said. “It is starting to feel, as we go back into lockdown, as we face this incredibly dangerous moment, we as a community have lost our patience in thinking of unhoused people in this moment.”