Emergency CalOptima Vote Gets Doctors to Homeless People

SPENCER CUSTODIO, Voice of OC

The CalOptima board of directors at the emergency Feb. 22, 2019 meeting, when it unanimously voted to create medical teams to treat homeless people in the streets of Orange County.

Homeless people will be visited and treated by medical teams on the streets after the CalOptima Board of Directors unanimously voted to immediately begin the program throughout Orange County.

The move at the Feb. 22 meeting comes after U.S. District Judge David. O. Carter, who oversees a federal lawsuit against the county for its homeless policies, met Feb. 20 with some CalOptima directors and top executives.

“I’m not aware that we’re facing any new litigation, but there’s a chance that we may be brought into the county suit. Hopefully not, but there was an indication that could be the case — from the judge,” CalOptima Board Chairman Paul Yost said Monday.

Yost said Carter’s visit helped spur the Friday emergency board of directors meeting “in some ways, yes, but it’s something we have to do. We really want to be ahead of this issue, so coming out of that meeting we challenged ourselves … to deliver healthcare to a specific population.”

He said Carter met with him, County Supervisor Andrew Do, CalOptima CEO Michael Schrader and county HealthCare Agency Director Richard Sanchez on Feb. 20 in Carter’s chambers. Do and Sanchez are also directors on the 10-member CalOptima board.

Supervisor Michelle Steel, also a board member and Ria Berger were absent from the Feb. 22 meeting.

Until Friday, the agency was reluctant to send medical teams — consisting of at least a doctor and a nurse — to various homeless camps throughout the county because CalOptima wasn’t sure how it would get reimbursed for non-members.

“We’re going to manage ourselves and use the FQHCs (Federally Qualified Health Centers)  because when they go into the community, it doesn’t matter if they’re a CalOptima member or not,” the board can get reimbursed, said Yost in an interview after its emergency Feb. 22 meeting.  

As of Monday, Yost said CalOptima has already secured at least two contracts with federal health centers and medical street teams will immediately seek out homeless people and begin treatments, regardless if they’re CalOptima members. The agency is working on more contracts with the federal health centers.

The board’s vote, which also includes staff to look into recuperative care housing, comes after Carter requested homeless death data from the Sheriff-Coroner’s office in a Feb. 19 court filing.  He cited Father Dennis Kriz’s Voice of OC opinion articles in his filing. Kriz listed the names of 257 homeless people who died in 2018, using data collected from the Sheriff-Coroner’s office and homeless service providers.

Homeless Deaths Climbing

Coroner data shows the number of homeless deaths in Orange County skyrocketed, from 53 deaths in 2005 to 164 deaths in 2015, to more than 250 deaths in 2018 – a fourfold increase. In San Diego County, which has roughly the same population as OC, 111 homeless people died in 2018, reported the San Diego Union Tribune.

According to the most recent U.S. Census Bureau estimate, OC’s population is nearly 3.2 million people and San Diego County has 3.3 million people.

“I’m hoping that the meeting today, today’s recognition of emergency, is the first step moving forward,” homeless issue advocate David Duran told the board, adding the death toll shouldn’t climb any higher. “We don’t need this in Orange County.”

During board deliberations, Do also remarked on the homeless deaths.

He said the number of homeless people who died in OC is “higher than the deaths that happened in San Diego and they have the almost identical population we do … I agree with one of the speakers (Duran), that is unacceptable.”

Do said the agency could appear in court and convinced the board to postpone its vote before going into closed session.  

“I can speak about my thought process in closed session is that we don’t want to appear too timid in our actions (to the court) if we are perceived to not live up to responsibilities, we may not find the consequence very enjoyable,” Do said in an interview after the meeting.

During the meeting, he said, “So now we face the prospect of having someone possibly sue us. We may end up in court as an agency … I’m telling you, we are setting ourselves up for a big disappointment one day when we end up in court because we cannot defend the lack of access to the population that deserves our services.”

Kriz told the board that the homeless people who sleep at the St. Philip Benizi Catholic Church in Fullerton, which he oversees, would warm up to shelters if there was some type of medical care offered.

“… there’s 12 to 20 people sleeping on our grounds. One of the reasons is exactly this … the idea of sleeping next to somebody who visibly has the flu deters a lot of people from going to the shelters,” Kriz said, adding that sick people should be taken to a hospital instead of being left in shelters.

Kriz said homeless people’s perceptions of the shelter system could deter them from going. He suggested putting medical teams at the rally points where homeless people are picked up and bussed into shelters.

It would “make the entire system much more credible for the homeless,” Kriz told the board. “You can really make the entire system here much more credible. You can probably double the number of people who go to the shelters.”

Yost said Kriz’s editorial made an impact.

“Thank you for your comments. Your editorial, your piece really had a lot of impact,” Yost told Kriz.

Coroner officials previously provided a database of homeless deaths to Voice of OC in mid-December 2018, covering almost the entire year. Using that spreadsheet, at least 67 people died of “natural” causes. Some of those causes include pneumonia, strokes, diabetes, coronary disease, cardiovascular disease and cirrhosis.

The coroner data show at least 11 homeless people were killed by other people, including seven by police: six were shot by police and one died from cardiac arrest while fighting with officers, according to the data. At least 12 homeless people committed suicide, and at least 39 homeless people died from overdosing on alcohol, drugs, or both.

Carter received updated data Tuesday from the Sheriff’s-Coroner’s, including 2017 and 2018 homeless death information and a report covering homeless deaths from 2014 to 2018.

But the reports or spreadsheets provided to Carter don’t give the amount of detailed information that the 2018 homeless deaths spreadsheet sent to Voice of OC does. For instance, one died of a handgun wound, according to data sent to the court. But, when cross-referenced with the more detailed spreadsheet, it shows the man was shot by an on-duty police officer and died from “multiple gunshot wounds.”

According to the Coroner’s report, 126 homeless people died in 2014 — 56 from “natural” causes and 50 from “accidents,” which include overdoses and traffic accidents. That number jumped to 210 last year, according to the report, including 75 dead from “natural” causes and 76 dead from “accidents” There’s still 32 deaths from 2018 pending a cause. Anaheim, Orange and Santa Ana see the most homeless die in their cities, according to the report. The report doesn’t note which “natural causes” killed the homeless person, like a stroke or diabetes. 

The Coroner’s report of 210 homeless deaths last year conflict with Kriz’s claim of 257.

“Any death is too many deaths. And certainly having a higher death rates than other counties is unacceptable,” Yost said.

Reporter Nick Gerda contributed to this story.

Spencer Custodio is a Voice of OC staff reporter. You can reach him at scustodio@voiceofoc.org. Follow him on Twitter @SpencerCustodio.