Alameda County Mobilizes to Get At-Risk Homeless Residents Into Hotels

Audrey Fisher, a registered nurse with the Lifelong Medical Care TRUST Health Center's street medicine team, tests a homeless man for COVID-19, Tuesday, March 31, 2020. Increasing testing of people living in camp communities will be critical to ensuring the coronavirus doesn't continue to spread throughout the community, Lifelong's associate medical director, Jason Reinking, said. (Courtesy Lifelong Medical Care TRUST Health Center)

In the span of nine days, public health officials in Alameda County went from negotiating a lease agreement with a hotelier in Oakland to housing their first guest on March 25 — a resident experiencing homelessness who was showing symptoms of COVID-19.

And on Wednesday, April 1, officials opened a second hotel in Oakland for homeless people who are considered at high-risk of complications if they contract the virus. As of Tuesday afternoon, a total of 59 people were housed in both hotels.

The hotels were the first two leased under a state plan to provide up to 15,000 hotel and motel rooms across California to address the coronavirus outbreak among homeless communities. Some of the rooms will also be used to house first-responders.

“While it’s true it took about nine or 10 days to bring the hotels on, they were 18-hour days,” said Kerry Abbott, director of the county’s Office of Homeless Care and Coordination.

It’s the kind of effort Gov. Gavin Newsom says can’t come soon enough, especially in light of the death of a homeless man in Santa Clara County last month and 14 confirmed cases of homeless people contracting the virus across the state – including one reported Thursday in San Francisco and two more announced Monday.

On Friday, Newsom said the state had finalized leases for nearly 7,000 hotel and motel rooms across California with an eventual goal of 15,000 rooms. As of Wednesday, San Francisco had around 1,000 hotel rooms available and had placed people in 123 of them. Santa Clara County has 172 hotel rooms and 105 trailers for people experiencing homelessness who need to quarantine.

"This was the crisis that predated the current crisis in the state of California,” Newsom said. “And we’re doing everything in our power to meet it head on."

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More than 151,000 California residents spend their nights in tents, cars, RVs and shelters. Preventing the spread of the coronavirus within homeless communities is critical to keeping everyone safe, said Dr. Jason Reinking, associate medical director for the LifeLong Medical Care TRUST Health Center.

“This disease does threaten all of us,” Dr. Reinking said. “Given the poor access to sanitation, living in encampments or shelters, there needs to be extra care taken to prevent this disease from breaking out in the homeless community, which then can be a reservoir for it to continue to spread within the rest of our community.”

Advocates for people experiencing homelessness have expressed frustration that the hotel rooms aren't coming online quick enough.

"It's criminal to imagine a world where we have empty hotels, empty buildings, and we say we are concerned about COVID-19 but refuse to open them up to our unhoused neighbors," said Dr. Cesar Cruz, co-founder of Homies Empowerment, an Oakland-based advocacy organization.

It took some time to get the hotels operational, and now that they are up and running, county public health officials are moving medically vulnerable residents into hotel rooms at the rate of 10 to 15 per day, Abbott said.

From Hotel to Quasi-Medical Facility

It was no small feat to turn hotels into quasi-medical facilities staffed with social services for guests confined to their rooms, officials from Alameda County told KQED.

There are a ton of logistics that need to be worked out first: food, linens, cleaning supplies, how to accommodate pets and smoke breaks, addiction treatment, behavioral support, medical care, security, case management and transportation.

Homelessness and Coronavirus

The lessons learned in Alameda County can be applied throughout the state as more and more counties open hotel facilities of their own.

"We had to open before anyone would tell you they were comfortable because there were still a lot of unanswered questions,” said Dr. Kathleen Clanon, medical director for Alameda County. “But we learned that was OK.”

There wasn’t time to think through every possible scenario, she said. They had to act quickly, prioritizing safety and working out a lot of other details on the fly.

Staff from state, county and city departments worked with nonprofit and private organizations to prepare the two hotels in Alameda County for their first guests.

They had to find vehicles large enough to provide appropriate distance between the passengers and the driver — complete with a plastic sheet to act as a partition — and that could be be easily cleaned in between rides, Clanon said. The team settled on commuter vans used to shuttle people from the airport.

Cheers erupted in the room when they secured the contract, Abbott said.

Lining Up Supportive Services

While that was being worked out, Abode Services, a nonprofit that operates transitional and permanent supportive housing programs for people who were formerly homeless, began figuring out how to quickly hire the more than three dozen full-time staffers to be on site 24/7 to provide services to guests staying at the hotels.

Part of Abode’s job is to help anticipate reasons people might need to leave the hotel, including for smoke breaks or to walk their dog or grab a snack between meals. The county is offering support to people with addictions to alcohol or opiates, as well as providing over-the-counter medications for coughs or pain relief.

Vivian Wan, the chief operating officer for Abode Services, said her team had to vet 220 applications.

“We had an HR machine behind the scenes not only finding folks, but training them quickly,” Wan said, “making sure they really understand trauma-informed care, understand what we’re doing, understand all the precautions we need to take.”

Not everyone wants to go into the hotel rooms though, Lifelong's Jason Reinking said. Some of the people his street medicine team have tried to place were concerned about losing their belongings because they could only take a bag's worth with them into the hotel room. Abbott said they do have limited storage available for the belongings residents can't bring into their room.

For the medically vulnerable residents, Abode will be working to figure out long-term housing placements for people staying at the hotels, Clanon said.

On Friday, Newsom said the more recent state-negotiated leases all include a right of first refusal to purchase the hotels when the state no longer needs them to respond to the coronavirus outbreak.

“We are not just thinking short-term,” Newsom said. “We’re also beginning to ... focus our energy around long-term support to get people off the streets in a permanent way.”

Note: This post has been updated to reflect more recent information related to the number of people being housed. 

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