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Marine veteran Steven Spittle, 62, had just been discharged from a local hospital after he said he was assaulted over the weekend. He’s lived on the streets for years, so he said hospital staff paid for a cab to drive him to the temporary shelter at the Convention Center on Sunday afternoon.
But there wasn’t a bed available for Spittle, who was in pain and too weak to stand. He laid outside the Convention Center, confused and unsure what to do.
Lacking other options, an officer from the Police Department’s Homeless Outreach Team called activist Amie Zamudio, who has teamed with another local activist, Tasha Williamson, to put up vulnerable homeless San Diegans in hotel rooms, to ask if she could take in Spittle for the night. Zamudio said yes and rushed to the Convention Center.
The situation captures the desperation playing out as homeless San Diegans seek shelter that’s in limited supply during the coronavirus pandemic and local governments and activists scramble to respond. The mayor and other elected leaders have touted the decision to open the Convention Center to homeless residents as a significant step toward protecting the homeless community during the pandemic. Mayor Kevin Faulconer even called it “a centerpiece of our fight against the coronavirus,” when he announced the facility would open to the homeless. But Spittle’s experience demonstrates that the need for shelter is still greater than the capacity.
In the absence of resources, advocates like Zamudio and Williamson, who have temporarily housed more than 50 homeless San Diegans in a Midway hotel – an effort that’s separate from the county’s plan to house vulnerable residents in hotel rooms – have sometimes filled gaps.
While the Convention Center has started taking in unsheltered homeless San Diegans in the past week, more than three-quarters of the 975 people staying at the Convention Center as of Tuesday had moved in from other shelters rather than directly off the street. The city has limited the number of new people moving in each day, which it has said it’s done to ensure there are ample resources to serve everyone staying there. City officials have said also said homeless San Diegans who want shelter at the facility should be directed there by outreach workers rather than show up on their own, a process Spittle was not able to follow despite being directed there by hospital staff. It’s unclear whether hospital staff checked with an outreach team or providers at the Convention Center before sending Spittle there. Hospital staff ensured Spittle got to the Convention Center but may not have directed him there through an official process – bureaucratic distinctions that can be confusing to both homeless San Diegans and others who want to help them.
The county has also amassed dozens of motel rooms for vulnerable homeless San Diegans that the Regional Task Force on the Homeless has mostly filled. Another 1,500 rooms are specifically for people who have or may have the coronavirus, making them off limits to many homeless San Diegans who haven’t been tested or shown symptoms.
Meanwhile, many homeless shelters are full or not taking in new clients.
On Sunday, Spittle and the Police Department’s Homeless Outreach Team faced the lack of immediate resources head on. They decided their best option to get Spittle help was not an official channel operated by the government but a bootstrap activist effort. Over the years, Zamudio and Williamson have focused many of their activism efforts on police reform – now the police are turning to them for help.
After the officer called her on Sunday, Zamudio said she found Spittle, who she has known for a couple years, sitting on the ground. She noticed the former Marine had sores all over his body and that a toe that was recently amputated looked infected.
“I saw a very frail, frail old man that physically appears much older than 62,” Zamudio said.
Spittle later told Zamudio and Voice of San Diego he had been released from Scripps Memorial Hospital in La Jolla after being assaulted in Pacific Beach over the weekend. He believes he has a broken rib and said he was initially unable to walk more than a couple feet.
After hospital staff discharged Spittle on Sunday, he said they paid for his cab ride to the Convention Center.
Scripps Health spokesman Keith Darcé said he could not comment on Spittle’s case for privacy reasons but said the hospital system follows SB 1152, a 2018 state law requiring hospitals to establish plans for discharging homeless patients. The law also mandates that hospitals provide meals, ensure patients are ambulatory before they are released and offers transportation to the destination homeless patients choose.
“Patients are only discharged once their physician has determined they are medically stable,” Darcé wrote in an email to VOSD.
Darcé said a federal privacy law prevents Scripps from saying whether staff checked to see if there was an open bed at the Convention Center before sending Spittle there.
Spittle said he had begged Scripps staff to allow him to remain at the hospital before they called the cab. Upon his arrival at the Convention Center, Spittle said he collapsed outside.
“I got out of the cab and I laid there,” Spittle said. “I didn’t know where I was or what to do.”
Zamudio told the officer who called her she could only afford to put Spittle up in a hotel room for the night. She said the officer promised to pick up Spittle the next morning to try again to get him into the Convention Center.
It wasn’t the last time police would call Zamudio for help.
Susan Machlitt, 62, a homeless woman who said she had been discharged from Sharp Grossmont Hospital in La Mesa on Saturday following treatment for an abscess on her hand later needed a safe haven too.
Machlitt told VOSD that a security guard patrolling near the St. Vincent de Paul homeless service campus in East Village called the Homeless Outreach Team on Sunday after Machlitt said she didn’t have a place to stay.
Zamudio’s cell phone soon started ringing again.
“(The officer) called me and said, ‘This woman can’t be out on the street,’” Zamudio recalled.
Zamudio said the officer told her that Machlitt, who was not intoxicated, was struggling to stand and walk. Zamudio said she could put Machlitt up for a night.
Machlitt told VOSD that a nurse at Sharp Grossmont had given her cash when she was discharged the day before but did not direct her to a shelter.
John Cihomsky, a spokesman for Sharp Healthcare, said he could not comment on Machlitt’s experience for privacy reasons but said Sharp hospitals follow a thorough discharge process that complies with state law when releasing homeless patients.
Early Monday morning, Zamudio said, police picked up Spittle and Machlitt to take them to the Convention Center.
Ashley Bailey, a spokeswoman for Mayor Kevin Faulconer, said homeless outreach officers pull on every resource they have to respond to the need, even if that now means sometimes relying on non-traditional partners.
“This is a difficult time for everyone, and we will continue to work with our many community partners, from hospitals to homeless service providers, to provide this essential care for our most vulnerable neighbors,” Bailey wrote in an email to VOSD.
She said hospitals should not send homeless San Diegans to the Convention Center without conferring with the outreach teams and providers working there to see if the facility can take them in, and if they would be a good fit for the Convention Center.
“It is important that these individuals get assessed to determine whether a shelter is an appropriate environment in which to receive care,” Bailey wrote.
Indeed, the predicament facing Spittle and Machlitt spotlights an existing gap that’s even more urgent during the coronavirus pandemic.
The city lacks an adequate supply of so-called recuperative care beds where homeless patients can recover once they are released from the hospital.
Discussions about opening up additional step-down resources that began long before the pandemic have continued in recent weeks.
Jonathan Castillo, chief regional officer at homeless-serving agency PATH, said last week that the nonprofit has been exploring whether it could provide recuperative care services at its downtown facility but has struggled to find a medical partner during a time many are already overtaxed.
County Supervisor Nathan Fletcher has said that the city and county may be able to use a recently created $25 million behavioral health impact fund to help pay for new resources. He said this week that multiple local government including the San Diego Housing Commission and nonprofit agencies are investigating how they could quickly add recuperative care beds.
“Everyone’s trying to look at what they may be able to do to increase that supply and capacity,” Fletcher said.