Easing Unhealthy Homeless People Off San Diego Streets Can Be A Daunting Process
Friday, August 3, 2018
Photo by Kris Arciaga
On a recent hot July afternoon, outreach workers Angelica Garcia and Camille Cross set off, clipboard in hand, on a search for a homeless couple near a riverbed in Chula Vista. The man and woman were on their list of 1,050 unhealthy homeless people in need of intensive care management.
Garcia and Cross knew who they were looking for. They had met with the couple several times before, taking them to doctor appointments and bringing them clothing and supplies.
The couple used to hunker down in a nearby park where they were easy to find. Now, they were supposedly somewhere in a vast abandoned industrial space, littered with graffitied cinder blocks and debris. The pair had called Garcia and Cross the night before letting them know of their new location after disappearing off the radar a few weeks earlier.
“Julie? Julie?” Garcia and Cross called out toward a homeless encampment. “She’s next door,” a woman answered back.
Garcia and Cross walked around a bend where they found a shack made of scraps of plywood. The handmade structure was surrounded by grocery carts, clothes and a boogie board. It was the new "home" of Julie Black, 46, and Phillip Wright, 52.
“Hi, Julie! How are you doing, girl? How’s your hip?” asked Cross. “Oh it’s OK today,” Black replied.
“Phillip, what’s up, bro?” Cross said to Wright, whose wrist was wrapped in gauze. “Your hand is so swollen.”
“It’s an infection,” Wright said, holding up his red, enlarged hand. “From a sticker from tumbleweeds.”
Like the others on the list, Black and Wright were frequent users of emergency rooms, racking up nearly $20,000 or more in Medi-Cal costs over the last year. Wright had visited the ER just hours ago for his infection. Now he needed a ride to pick up his prescription — it’s the reason he contacted Garcia and Cross with PATH — People Assisting the Homeless.
“I go to the doctor a lot because if I have something wrong, I go to the doctor,” Wright said.
Wright and Black said they both struggle with drug addictions and chronic illnesses. For years, they had avoided homeless shelters, just like many of the 5,000 other people in the county who sleep on the streets, hidden from everyday life.
“We came down to the river bottom to be out of sight, out of mind,” said Black, a thin, blond woman who said she struggles with social anxiety.
Black said her first encounter with the outreach team three months before didn’t go well.
“I was hostile,” Black said, laughing. “I screamed at them to get away from me.”
Now, after a dozen visits from Garcia and Cross, the couple is warming up to the idea of getting help. They realize their unhealthy lifestyle has reached a critical point.
“They keep us up on hygiene, clothing and appointments and just do everything for us pretty much,” Wright said.
Connecting with people like Wright and Black is the goal of the county’s new Whole Person Wellness program. Dozens of outreach teams were recently hired to work patiently and persistently to help the most desperate people in the population transition from sleeping on the streets to finding mental health care and addiction treatment, and eventually, supportive housing.
The county’s Health and Human Services Agency contracted with PATH and Exodus Recovery to run the three-year pilot program, targeting people identified as being chronically homeless and suffering from a severe mental illness, substance abuse disorder or physical illness. It is funded by a $22 million federal grant, which the county is matching.
“The list is just over 8,000 potential folks that are eligible,” said Andrew Barajas, with PATH, who oversees some of the teams.
The first step is meeting people where they are, he said, and creating face-to-face relationships. In addition to the list, referrals often come from hospital emergency rooms, psychiatric providers and homeless outreach teams.
“If you can imagine experiencing a severe mental health issue or a substance use disorder or addiction, it can be very challenging to open up to someone who’s a complete stranger,” Barajas said.
Building trust can take weeks or months, he added.
“Some of our most intense cases, we’re able to meet with them three times per day,” Barajas said. “And there are cases that are in crisis where you have suicidality, where you have extreme polysubstance use issues, where you’ve got extreme mental health symptoms that maybe aren’t treated yet.”
During the process, the team of case managers and health workers conduct a comprehensive assessment while connecting people to appropriate medical care, and stability.
“We’re very good at empathizing and empowering,” Barajas said. “So that we’re teaching and looking for skill building opportunities so that someone can become self-sufficient.”
Jacquelyn Vanallen, 48, started the program a few months ago. She recalled when outreach workers encouraged her to leave her corner on an El Cajon street.
“At first I go, ‘Oh my gosh, I don’t want to go,’ Vanallen said. “Like I was afraid to go. And then I told myself, ‘I’m going through this, I’m going to do this.’”
She moved into her permanent supportive housing apartment in El Cajon in July after two decades of sleeping on streets and in cars with mental and chronic illnesses.
“I can’t tell you how blessed I feel,” Vanallen said, tears streaming down her cheeks as she showed off her kitchen and bedroom.
She said getting to this point has included classes to help her transition into society, medical care and counseling and encouragement from her outreach team. She'll receive support for up to two years.
“I wouldn’t have done it without any of them,” Vanallen said. “All of them had a place in my recovery into living in a home.”
Julie Black and Philip Wright said they are hopeful about moving forward in the program. The PATH team planned to pick up Wright later that afternoon to help him get his prescription and assist the couple in applying for further benefits.
“Getting us into a place to live back inside,” Wright said. "I could do this alone if I wasn't married. For me it's easy, but for her, not so much."
Hundreds of unhealthy homeless people who have recently racked up $20,000 or more in Medi-Cal costs are the target of a new San Diego County pilot program.
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