Tag: California

Featured, Health, homelessness, housing, Mayor Durkan

As COVID-19 Rages, Cities Struggle to Move People from Shelters into Safer Housing
Outside DESC’s main shelter in Pioneer Square.

This excerpt is from a piece I wrote for Huffington Post, where you can read the entire story.

Ordinarily, the atmosphere in the Downtown Emergency Service Center’s main shelter in Seattle was just this side of chaos. During the day, men and women crowded into the community room and hung out in a narrow corridor known as the “bowling alley,” arguing, sleeping and jockeying for space.

At night, the clients settled into metal bunks without pillows or sheets, trying to sleep through the sounds and smells of dozens of other people all around them.

These days, though, the space is quiet. Shortly after the coronavirus pandemic began, DESC began reducing capacity, and in early March, the city moved the remaining 129 residents to an exhibition hall near the Space Needle. One month later, King County moved them to a Red Lion hotel in Renton, a suburb just southeast of Seattle. The move gave them access to real beds, private showers, and three meals a day ― amenities that were unimaginable before COVID-19.

For some, it’s the first time they’ve slept in a bed, in a room with four walls and a door that locks, in years. The difference, both physically and psychologically, is profound. “Staying at the shelter downtown, you’re always at risk. People are stealing from you. There’s junkies shooting up by you. People just want to attack you,” said Michael C., who asked HuffPost to use his first name and last initial only to protect his privacy. “And here it’s a safe place.”

“I can lay on a queen-size bed. I can relax. I have the opportunity to work on myself, recalibrate, and have some perspective.”

Dan Williams, DESC’s shelter operations manager, said that after staying in the hotel for just a week or so, Michael was unrecognizable ― so much so that Williams followed him down the hallway when he walked in one day, thinking he wasn’t supposed to be there.

“To see this individual, compared to the way that I knew him a month ago, I didn’t know who he was,” Williams said. “His whole presentation was different. He felt comfortable to shower, because it wasn’t in this group setting where anybody could blow through that door at any second.”

Marcus M., another resident who asked to use his first name and last initial only, said the biggest difference is that he doesn’t have to fight for space or deal with the constant threat of confrontation. He would normally sleep in the shelter’s day room because he found the cavernous bunk room too noisy and chaotic. In the hotel, “I can lay on a queen-size bed. I can relax. I have the opportunity to work on myself, recalibrate, and have some perspective.”

Across the country, local governments are engaged in a debate about the most effective way to shelter people experiencing homelessness during the pandemic. Some have moved people to larger spaces, such as rec centers and convention halls, where they can sleep farther apart in order to reduce the spread of COVID-19. Other places, including Baltimore, New Orleans and San Francisco, have also begun moving homeless people into hotels, usually focusing on those who are over 60 or have underlying health conditions that make them more vulnerable.

“What he needed was to be treated with dignity. That was it. And congregate homeless shelters do not do that.”

It’s not just about what’s safer. At the core of the debate is the question of cost ― hotels are generally more expensive than shelters ― and what it will mean when the pandemic is over.

Shelters have problems that extend beyond the spread of COVID-19. If it turns out that cities could have mobilized quickly to house people all along, it may be hard to justify putting people back in shelters once the immediate crisis is over.

For now, cities are beginning to move toward a hotel model for housing people. But many have struggled to do so efficiently. In late March, the city of San Francisco announced that it would open the George R. Moscone Convention Center as a shelter for 400 people, with mats placed six feet apart and divided by lines of tape ― an arrangement that opponents derided as an indoor concentration camp.

After a week of protests from homeless advocates and city supervisors, the city switched gears, downsizing plans for the shelter and committing to moving more unsheltered people into hotels to meet physical distancing directives. On April 10, the city publicly acknowledged a major COVID-19 outbreak at the Multi-Service Center-South Shelter, the largest shelter in the city.

San Francisco counted more than 17,000 people experiencing homelessness last year using a new method that more than doubled the 8,000 found in the most recent traditional one-night count. Mayor London Breed said in early April that the city would secure 7,000 hotel rooms as temporary shelter, and on April 15, the San Francisco Board of Supervisors unanimously adopted an ordinance directing Breed to increase that to 8,250 hotel rooms. Breed refused to sign the ordinance, saying it didn’t “acknowledge the challenges of operating these sites.”

As of late last week, the Coalition on Homelessness in San Francisco said that fewer than 700 homeless people had moved into hotels. At a press conference last Wednesday, Breed said that “it’s difficult to project a timeline” for moving more people into hotels.

“We can’t fight a plague while exempting more than 10,000 people from any ability to stay inside and protect themselves,” said Matt Haney, a member of the San Francisco Board of Supervisors.

In Seattle, where dozens of COVID-19 cases have been linked to homeless shelters, Mayor Jenny Durkan has resisted the idea of leasing or buying hotels for homeless residents. The city government is separate from that of King County, which contains Seattle and which has invested in hotel rooms like those at the Red Lion.

Durkan spokesperson Ernesto Apreza says the Federal Emergency Management Agency would only reimburse the city for hotel rooms for people who have been exposed to COVID-19, are over 65, or are otherwise vulnerable. “FEMA requires most sheltering support to be in a congregate setting,” Apreza said.

In fact, numerous states have already requested, and some have received, reimbursement for hotel rooms for the general homeless population, not just those who are “vulnerable.” In Connecticut, where FEMA already expanded reimbursement once to include domestic violence victims, Gov. Ned Lamont (D) made all shelter residents eligible for hotel rooms and is asking FEMA to expand its reimbursement qualifications again. New York, which is moving people into hotel rooms regardless of whether they’re “vulnerable” under the early federal guidelines, has already received FEMA reimbursement. According to the National Low-Income Housing Coalition, states that take the initiative by expanding eligibility and requesting funds under the new criteria have a good chance of being reimbursed.

Read the rest of the story at HuffPost.

Addiction, Courts, Featured, homelessness, housing, human services, Mental Health, South Seattle Emerald

Involuntary Treatment Bill, Modeled on California Law, to be Resurrected Next Session
Rep. Steve O’Ban, R-28

This story originally appeared in the South Seattle Emerald.

A state senate bill aimed at taking people with severe behavioral health issues off the street and putting them into involuntary treatment is off the table for this year, but its sponsor, Tacoma Republican Steve O’Ban (R-28) says he plans to resurrect it next session, because the problem of untreated mental illness and addiction isn’t going away.

“The reason for this bill is really the parents who have these kids … who devolve into a worse and worse condition and by the nature of their condition, they don’t think they need care,” O’Ban says. Under current law, people can only be detained and put under guardianship if a court determines that they’re incapacitated by a “mental disorder” and pose an imminent threat to themselves or others.

O’Ban’s proposal would allow judges in three counties—King, Pierce, and Snohomish—to appoint executors for people who have been involuntarily held for psychiatric evaluation five or more times in a 12-month period under the state Involuntary Treatment Act. That law allows people to be held in psychiatric hospitals (or emergency rooms if no psychiatric beds are available) for up to 180 days if a judge determines that they are incapacitated by mental illness. The proposed new involuntary guardianship, or “executorship,” would last one year unless the executor filed for an extension.

The program is modeled on a similar set of bills that passed in California in 2018 and 2019, which authorized three counties—San Francisco, San Diego, and Los Angeles—to create a new “conservatorship” program for people with both severe mental illness and addiction. California state senator Scott Wiener (D-San Francisco), who sponsored both bills, says his legislation is intended to address “a very small percentage of homeless people … who are severely debilitated and not capable of accepting voluntary services.”

“One of the areas that’s been a particular concern is the lack of structure and necessary accountability for these patients who come out of involuntary treatment, or they’re in jail, where they should not be, and by the nature of their condition they don’t think they need care and they refuse the needed services.” – State Sen. Steve O’Ban (R-28)

Wiener says the new California laws create a “very narrow conservatorship to reach this small population so that we can save their lives. It is incredibly inhumane, and certainly not progressive, to allow people to die on the streets.” He estimates that the legislation would apply to as many as 100 people in San Francisco, but advocates who opposed the bill say the number is probably much smaller.

O’Ban’s bill, in contrast, would initially be limited to 10 people in each county.  Patients placed under executorship would cede most of their legal rights to a “court appointed resource officer,” or CARE officer, including the right to refuse treatment or choose their own medical providers, the right to decide where to live, and the right “to make decisions regarding social aspects of life,” according to a staff analysis of the legislation.

“One of the areas that’s been a particular concern is the lack of structure and necessary accountability for these patients who come out of involuntary treatment, or they’re in jail, where they should not be, and by the nature of their condition they don’t think they need care and they refuse the needed services,” O’Ban says.

At a hearing on the bill earlier this month, parents whose kids had died on the streets due to lack of housing and treatment testified that if the law had been in place when they were trying to get help for their children, they might still be alive today. Jerri Clark, the founder of Mothers of the Mentally Ill, told the committee that her son, who died last year at the age of 23, “cycled through hospitals that kept him just long enough that he wasn’t dangerous anymore” before releasing him.

“If you look at the big picture, we’ve completely divested from mental health care and we’ve put people out on the streets where they’re completely disintegrating… and then the only care that they’re getting is in the back of police cars.” – Jen Flory, Western Center on Law and Poverty

But critics of the legislation, including advocates for people with disabilities and people who have struggled with mental illness themselves, say that taking away people’s civil rights is inhumane and doesn’t solve the underlying issues: An acute lack of funding for treatment, housing, and intensive case management.

“We do have concerns that adding another layer of legal process to compel people into care, rather than adding new treatment or housing resources, will mainly restrict civil liberties while not actually getting to the desired outcomes,” the Department of Community and Health Services said in a statement about the bill. “Instead of adding another layer of court involvement, we think a middle of the road approach – focusing on expanding flexible, community-based intensive services and added supportive housing resources – will more effectively meet the needs of this population.”

Laura Van Tosh, a behavioral health care advocate who testified against the bill, says the fact that people are involuntarily committed again and again “points to a problem that has nothing to do with people’s mental health. How can people be committed that many times in one year and nobody has ever talked about why the system didn’t work well enough the first time?” She says the current involuntary commitment system “is like going to a restaurant and getting E. coli over and over again, and never figuring out that you should go to a different restaurant.”

California’s conservatorship law requires treatment and housing to be available before people can be placed under conservatorship, although opponents say cities may meet this requirement by simply putting people in the new program at the front of the line for scarce treatment and services. “San Francisco will not conserve people unless they have somewhere to place them,” Wiener says. “In San Francisco, we’re expanding our mental health bed capacity and our shelter bed capacity, we’re building more supportive housing, but it’s definitely a challenge.”

Similarly, O’Ban’s bill says that a county could only implement the program if there are sufficient resources, including mental health treatment and housing, to serve potential clients. The loopholes will likely be the same, if a version of O’Ban’s bill passes in the future, as those in places like San Francisco. There are always beds in Seattle for some people—the question is who gets priority.

Jen Flory, a policy analyst at the Western Center on Law and Poverty, says that by putting people in involuntary treatment and stripping them of their rights, “we’re kind of skipping from A to Z. If you look at the big picture, we’ve completely divested from mental health care and we’ve put people out on the streets where they’re completely disintegrating… and then the only care that they’re getting is in the back of police cars being brought to psych emergency [wards]. And at the end of this journey, they’re like, ‘Okay, there’s something wrong with you and we need to force this care on you.’”

David Lord, the public policy director for Disability Rights Washington, says that before the state authorizes counties to appoint guardians for people struggling with mental illness and addiction, they should actually fund the services O’Ban’s bill enumerates, which include supportive community housing, outpatient counseling and treatment, peer support services, and substance use treatment.

“If you provide services, make them available, and do it in a way that is attractive to people, they’re much more likely to accept those services than if you try to force them,” Lord says.

Neither California’s law, nor O’Ban’s proposal, specifically focuses on people experiencing homelessness. But the subtext of both bills is that they will help put people exhibiting visible symptoms of severe mental illness and addiction—shouting, acting out, and behaving in ways that make other people uncomfortable—out of sight.

In our conversation, O’Ban referred to the 100 “prolific offenders” identified in a report by former Seattle City Attorney candidate Scott Lindsay as a group that might be eligible for executorships under his proposal. And he acknowledged that while his bill is “not exclusively for those who are homeless, I think many of the people who are eligible would be” homeless.

“I can tell you that there are familiar faces, frequent flyers, people who are well-known to the law enforcement community and in emergency rooms,” O’Ban says. “If you start focusing on that population, by identifying the top 100 who are heavily utilizing all those …. you would save the system literally hundreds of thousands of dollars a year.” And “clean up” downtown streets in the process.