CalOptima Unveils Medical Care Street Teams for Homeless, Commits $100 Million to Homeless Services

SPENCER CUSTODIO, Voice of OC

U.S. District Judge David O. Carter, who oversees several lawsuits over homeless policies against the county, speaks with former Santa Ana Riverbed resident Ronald Heatley about going to a motel and getting him set up with social services during Carter’s tour of the riverbed Feb. 14, 2018.

Homeless people across Orange County will begin receiving medical treatment on the street Wednesday after CalOptima rolls out its first medical field teams amidst pressure from U.S. District Judge David O. Carter.

“So it’s going to be limited when we launch Wednesday, but it’s going to build quickly … and we’re going to continue to talk to other [health clinics] about their participation as well,” CalOptima CEO Michael Schrader said during the April 4 board meeting.

CalOptima — the county’s insurance plan for the poor — will start with one medical field team Wednesday and will have at least three more teams in the field by the end of April, Schrader told reporters after the meeting.

Carter, who’s presiding over several lawsuits against the county for homeless policies, repeatedly expressed concerns about the rising homeless deaths in the county during the April 2 court hearing. He called the deaths a “public health crisis” in a February court request to the OC Sheriff’s department for data on homeless deaths in 2018 and 2019.  At least 250 homeless people died last year.

Schrader, along with CalOptima board chairman Paul Yost appeared before Carter at the hearing. The agency isn’t part of the lawsuits, but was requested to appear by Carter.  

“We are determined … to find a way to deliver healthcare to the homeless camps where the homeless people are,” Yost, a medical doctor, told Carter.

Carter replied, “That’s going to save a lot of lives.”

The medical street teams will consist of either a physician or physician’s assistant, medical assistants and social workers and will also work with OC Healthcare Agency field workers, commonly known as “blue shirts.” The teams will be able to prescribe medicine and set up transport for homeless patients to hospitals and clinics also.

CalOptima also committed to spending $100 million on homeless services over three years, despite Carter’s urging the agency to budget $140 million at the court hearing.

In the $100 million approved by the board April 4, $60 million is earmarked for new homeless services, which are not created yet. Carter wanted an additional $40 million set aside for new services.

Although Carter, at the April 2 court hearing, encouraged CalOptima to earmark an additional $40 million for homeless services for a total of $140 million, CalOptima board chairman Paul Yost said the $100 million is not a cap and the board can increase it.  

“I think that people felt that $60 million … that has yet to be allocated, that’s quite a bit to get started,” Yost said in an April 5 phone interview.  

He said the board would first like to know what the $60 million can provide before committing more money.

“I don’t think the board would have any problem approving that in the future,” Yost said. “It’s an ongoing commitment.”

The funds were originally going to be spent over five years, until the April 2 court hearing.

When Yost and Schrader told Carter CalOptima was going to spend the $100 million over the course of five years, Carter cut them off and insisted on three, while wiggling three fingers at them.

“He did that in open court with me, he said, ‘look at my fingers,’” Yost said while waving three fingers at the CalOptima board meeting.

The board reduced the timeframe to three years.

The nine-member CalOptima board also moved to streamline hospital communications with each other and healthcare providers for homeless patients, including creating a discharge plan — which means homeless people won’t simply be released from the hospital with nowhere to go anymore. Depending on the medical condition, they can be moved to recuperative care so they can finish healing. As part of the $100 million, the board allocated $11 million to recuperative care and $10 million for hospital communications.

“The judge has raised this issue as well. He’s talked about having a good solid data connection,” CalOptima board member Ron DiLuigi said. “I think we need to be on the same page as the judge as well…”

Assemblywoman Sharon Quirk-Silva (D-Fullerton), during public comment, said she wanted to put a human face on the issue and recalled the story of her brother who was hit and killed by a car in Buena Park last October.

“My mother, who’s 81, spent many nights looking for him, trying to help him. He had chronic alcoholism,” Quirk-Silva said. “Sometimes they make a step forward and sometimes go back three steps.”

“Sometimes we think that families don’t care, but the people who have died on the streets of Orange County are our brothers and sisters,” she said, becoming visibly upset. “We know that there’s some who refuse help.”

She then started to recall the Fullerton police beating-death of mentally ill homeless man Kelly Thomas in 2011 — the officers involved were acquitted of all charges, including second-degree murder. The city eventually settled a $4.9 million wrongful death suit November 2015 with his father, Ron Thomas.

“I was in Fullerton on the Council with the Kelly Thomas — oh gosh,” Quirk-Silva said, abruptly stopping and starting to cry. ”I just hope that we can continue working, because we can’t continue to see people die on our streets. That’s it, thank you.”

Anaheim resident and advocate for the homeless, Mike Robbins, told the board volunteers and advocacy groups need to be included in CalOptima’s homeless treatment efforts because the experience they have with helping homeless people. Robbins is part of Housing is a Human Right homeless advocacy group based in Anaheim.

“I see a bunch of suits behinds desks put some stuff together. This is not from the people who know … who spend thousands of hours,” Robbins said. “If you don’t have input on this (from advocates), you’re going to do exactly what’s out there now and you’re going to fail.”

CalOptima board member Nikan Khatibi, a medical doctor, said the agency should partner with various organizations, including the advocate group and nonprofits, to deliver services to homeless people.

“We would love to partner with organizations that are in the trenches, in the fields, in the parks, in the shetlers — trying to figure out ways to help this population,” Khatibi said. “Everybody on this board is very sensitive to the issue of homelessness.”

Other board members also supported the idea of partnering with advocates and nonprofits who work with the homeless daily.

Alexander Nguyen, also a medical doctor, said the board wants to hear feedback.

“If you’re on the riverbed back then (early 2018) and not being listened to … if you guys honestly don’t feel like you’re being heard, then we want to hear about it,” Nguyen said to the advocates in the audience.

Nguyen also said the $100 million may not be enough.

“This is a healthy conversation we’re having up here,” Nguyen said. “This is a big commitment, maybe this is not big enough. It should’ve been done a long time ago.”

Spencer Custodio is a Voice of OC staff reporter. You can reach him at [email protected] Follow him on Twitter @SpencerCustodio.