Homeless outreach work hits ‘another level entirely’

COVID-19 era adds new reasons to worry for the vulnerable

• Los Angeles Times
• 22 Mar 2020
• By Thomas Curwen and Benjamin Oreskes

On a recent morning, Katrina Johnson, Ralph Gomez and Kenya Smith are eager to hit the streets. Outreach workers for a homeless agency serving South Los Angeles, they want to catch up with their clients before the weekend, to make sure everyone is safe for the days ahead.

Standing in their office off Slauson Boulevard, they put together their game plan but pause when they come to the supply closet. Its shelves are close to empty.

The two-ounce containers of hand sanitizer are gone. Wipes are in short supply, and their van needs its daily cleaning. They scrounge for what they can find: granola bars, cookies, crackers, a few personal care items.

The scarcity, they hope, will be temporary, but they can’t be certain. The threat of the novel coronavirus hangs over them, invisible and menacing,

threatening to infect them and their clients — the men and women struggling with homelessness. But they wonder and worry. By hitting the streets each day — assessing needs, delivering food — they know that they represent a possible source for transmitting the virus to a population that is fairly isolated. More than just a fever and cough, the resulting disease, COVID-19, could lead to pneumonia, organ failure and death.

At a staff meeting a day earlier, outreach teams discussed new protocols: social distancing, no transporting of clients, no salad deliveries, placing water or prepackaged snacks on the ground, leaving pens with clients instead of reusing them.

They are a tight group, the employees of Homeless Outreach Program Integrated Care System, or HOPICS, conditioned by months, if not years, of standing on the front line of what was once the city’s most conspicuous public health crisis.

“This is what we’ve always done,” Johnson says. “We just need to take it to another level entirely.”

The simplicity of the measures, the outreach workers say, is what makes them so challenging. They are so basic, they are easy to forget.

But forgetfulness, they know, comes with a price, especially among a population whose health is already compromised by preexisting conditions, stress, addiction and the squalor of the streets.

Age, too, is a risk factor. According to the most recent government-mandated count, 13,600 homeless men and women in Los Angeles County are at least 55 and older. By another estimate, close to 4,000 are older than 65. While COVID-19 infects people of all ages, mortality among seniors has been especially high.

The outreach workers know their jobs will change in the coming weeks, that their focus will be on seniors and the medically vulnerable. But on this day — while they can — they would like to help Orlando get his Social Security card and locate Mary, who has been approved for a bed in a shelter but is missing.

A light rain is falling. The odds are against them. In the rain, clients tend to scatter into fastfood restaurants, libraries, any place to get out of the wet and cold.

But Johnson, Gomez and Smith have to keep trying, even as they stand at this strange confluence of crises where homelessness and disease meet.

In the San Fernando Valley, outreach worker Eric Montoya is ready to start his day. He parks his car in the Sepulveda Basin and heads out.

Earlier this month, Montoya’s employer, the Los Angeles Homeless

Services Authority, released a webinar on the coronavirus. Montoya watched it from LA Family Housing’s North Hollywood office but found his mind wandering.

They were telling him everything he already knew.

Having experienced homelessness himself, he keeps a distance from his clients and is conscientious about washing his hands.

“I try not to think about the risk of getting infected myself,” he says.

“If God wants me to die from the coronavirus, so be it. What can I do? I need to help these people.”

This feeling of responsibility prompts him to strike out on a dirt path edged by wild mustard. He carries five small bags filled with food, water and a hygiene kit. Joggers breeze past him as he sneaks a quick cigarette before skirting the scrub brush on his way to an encampment.

Montoya knows that if he doesn’t check in on its residents, no one else will. He talks to his clients about the principles of social distancing and urges them to sleep one person to a tent if they can. If that’s not possible, he tells them about the risk of sleeping face to face. Feet to face is better.

HOPICS offices. Their employer refers to each team of workers by a specific color, coded to specific neighborhoods. They are the Green Team, assigned to the streets around Leimert Park and Vermont Square.

“We just wiped everything down,” Smith says, looking at the van. He and Gomez had taken Clorox wipes and Lysol disinfectant spray to its doors, the dashboard and seats.

“Good,” Johnson says, “I was going to ask.”

Gomez drives. Johnson rides shotgun, and Smith sits in the back. They pull out of the parking lot of the one-time Weber’s bakery on Slauson Avenue and head west.

“It’s crazy that the virus got started three months ago, and here we are today,” Smith says, as he reflects upon the chaos of the last week. He is surprised city and state agencies hadn’t done more sooner.

Earlier in the week, the Green Team spent three days trying to find hand sanitizer, extending its search into hardware and medical supply stores. Even if it cost more, it would be worth it. But they couldn’t find any.

The supply manager for their agency, Zyanya Martinez, had scoured her usual sources — Smart & Final, 99 Cents Only Stores, Dollar Tree — and had come up empty. Her fallbacks, Target and Walmart, were no better.

The agency was able to get hospital wipes from a medical supply store, but using them requires gloves. And gloves and masks are being rationed.

Even deliveries of bottled water have been cut back or are running late.

“It’s very discouraging that we don’t have the supplies we need to do our jobs,” Smith says.

Within a week, the shortages will have eased. Gloves and masks will arrive from the county Department of Health Services, but more than shortages, Green Team members worry that the new protocols — as necessary as they are — will make their jobs more difficult.

Welcome to the temporary new normal in homeless outreach work.

Last week, Mayor Eric Garcetti announced that the city would convert 42 recreation centers into temporary shelters, providing 6,000 new beds in an effort aimed at slowing the spread of the novel coronavirus among the homeless population.

The new shelters, 13 of which opened Friday, will focus outreach efforts primarily on older clients.

“I want to make sure what resources we use up, are used up on people who are most vulnerable,” said John Helyar, a manager with HOPICS.

‘I try not to think about the risk of getting infected myself. If God wants me to die from the coronavirus, so be it. What can I do? I need to help these people.’ — ERIC MONTOYA, outreach coordinator with LA Family Housing

But when Helyar heard of Garcetti’s plan, his enthusiasm was guarded. Opening doors is easy; getting clients to step inside is tricky.

“We’re seeing a lot of people worried about going into shelters due to the risk of infection, which is understandable,” Helyar said.

He and his staff are putting together a list of their clients in South Los Angeles who are older than 65 or especially vulnerable to illness. With that list in hand, they will start targeting their outreach efforts.

Beyond the challenge of persuading clients to move off the streets and arranging safe transportation, there are “a million considerations,” Helyar said, when it comes to running a shelter.

“Who is going to staff it?” he asked. “What cleaning protocols will be in place? How will security be handled?”

He heard that city employees will be enlisted in order to keep his personnel free for outreach, but the details are still sketchy.

Working his way through brush growing on the side of the Los Angeles River, Montoya meets Patrick Moran, one of the residents of a nearby encampment.

Montoya has been trying to help Moran, 56, who wants housing and needs a hernia operation. But before any of that can happen, Montoya has to get him to the Department of Motor Vehicles so Moran can get a new identification card.

He’s hoping they can make that trip in a day or two, but he has his doubts.

He hands Moran a drawstring bag and makes a point of telling him that there is soap and hand sanitizer inside. Moran’s hands are caked with dirt.

You know about the virus, Montoya asks.

“If you have friends that are sneezing,” he adds, “you might not want to hang out with them.”

With the radio playing low, Gomez wheels the van through the narrow streets of South Los Angeles, lined with low-slung bungalows with broad front porches and green lawns.

The Green Team never knows where its clients might show up.

“We need to put pens in our vans,” Johnson remembers. When getting signatures from clients, from now on they will want to leave the pens behind.

They pass a full shopping cart and slow down.

“That’s David’s,” Johnson says. “I wonder where he is.”

A block later, they see someone lying on the sidewalk under the overhang of a recreation center.

The figure is covered with a purple blanket, black trash bags close by.

Johnson rolls down her window. “David,” she calls out. “David!” The purple blanket jerks, and David abruptly sits up.

The Green Team first met him eight months ago. A bright silver earring catches the light through David’s thick black hair and beard. His fingers are covered with rings, his arms with bracelets and scabs.

Smith explains that David can be delusional: He thinks he is a shaman and burns himself with cigarettes and lighters. Despite the possibility of the wounds getting infected, he waves off a closer examination.

“How’s your skin feeling?” asks Smith, who stands more than six feet away and has to raise his voice. He explains that he is keeping his distance because of the coronavirus.

“You know about the coronavirus?” Smith asks, reminding David to be sure to wash his hands and keep away from others. “Hand sanitizer is in the hygiene kit.”

Johnson places a paper bag on the sidewalk: granola bars, water and the kit.

Gomez speaks to David in Spanish, tosses him a clipboard and a pen. David signs and tosses the clipboard back. Gomez wipes it down.

As they say goodbye, Smith abstains from the fist bump that he and David have always shared.

As a nurse, Smith prides himself on his interactions with his clients. Patting them on the back, shaking hands, handing out a salad — these simple gestures go far toward building trust and a rapport that might one day open the door to housing.

“These protocols sure make interacting with clients a lot more awkward,” he says.

“We have to break old habits,” Johnson says. “We have to retrain ourselves before responding.” how to do their work in this time of pandemic.

“If anyone feels sick,” Montoya tells Moran, “tell them to go to the hospital.”

Calling 911 is another alternative, which is what members of the Green Team will do if they encounter someone with a fever. Smith carries a thermometer.

Their greatest concern is not the virus spreading within the homeless community but outsiders introducing it.

In the Sepulveda Basin, that means police officers, who patrol this urban wilderness and are not always able to respect social distancing, and the do-gooders who don’t understand what the limits of their generosity should be.

In the streets of South Los Angeles, that means anyone passing along the sidewalks where homeless men and women live next to businesses and the neighborhoods that they grew up in.

Montoya heads back to his car, and the Green Team continues to search for clients under the day’s gray and drizzly sky.

Though the city and state have ordered businesses to close and residents to remain at home, they are essential workers.

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