San Diego County’s demanding the city immediately bolster access to public restrooms and hand-washing stations in the wake of a growing hepatitis A outbreak hammering the region’s homeless population.

In a Thursday letter, County Administrative Officer Helen Robbins-Meyer directed the city to place hand-washing stations in 30 locations throughout the city, including in more than a half dozen locations downtown, where the outbreak’s been most acute.

The city pledged to expedite its processes to ensure the county can install the stations immediately – demonstrating a sense of urgency that has been lacking for months as the health crisis raged, claiming 15 lives.

“The city continues to stand ready to support the County’s Health and Human Services Agency in its plans to provide vaccinations, sanitation and education to San Diegans as we battle this outbreak,” Mayor Kevin Faulconer said in a Friday statement. “We must continue to work collaboratively to stop this crisis and save lives.”

The letter obtained by Voice of San Diego and the city’s response comes more than two months after the county announced a pilot program to place handwashing stations in areas where homeless San Diegans congregate. Public health experts have said homeless San Diegans’ poor hygiene is fueling the spread of the virus.

In the weeks since that announcement, 11 people have died and the number of reported hepatitis A cases has more than doubled.

We Stand Up for You. Will You Stand Up for Us?

Yet until Wednesday, the county had set up just two hand-washing stations, and both were originally located miles from the downtown streets that are ground zero of the outbreak. County workers moved one of the stations downtown Wednesday.

Now the program appears to have officially moved beyond the pilot stage.

In the Thursday letter to San Diego Chief Operating Officer Scott Chadwick, Robbins-Meyer included a list and map of locations for the hand-washing stations and directed the city to respond within five business days stating when it could comply.

“Action by the city to immediately comply with this directive is essential to prevent the further spread of hepatitis A within the city,” Robbins-Meyer wrote.

A spokesman said the county has proposed an additional 10 hand-washing locations since sending the Thursday letter.

Robbins-Meyer also called for the city to immediately update its protocol for cleaning downtown streets and sidewalks, noting the particular issues in downtown San Diego.

The protocol detailed in a letter the county sent the city last week calls for city sanitation workers to use a bleach solution to clear sidewalks where feces, blood or other bodily fluids are left behind.

A city spokeswoman said earlier this week that the city does not currently use bleach for sidewalk cleaning.

In a statement early Friday, the city committed to implement the new protocol within the next 10 working days.

Mayor Kevin Faulconer’s office also urged the county to declare a state of emergency that might allow it to receive a burst of state and federal money to help address the outbreak.

“Additional funding could go to a variety of programs that could curb the spread of the virus,” Faulconer’s office wrote.

A county spokesman said the county’s now in the process of exploring an emergency declaration.

Faulconer isn’t the only city official to call for an emergency declaration this week.

City Councilman David Alvarez on Thursday asked Faulconer to declare a shelter crisis in light of growing street homelessness and the hepatitis A outbreak, hoping that step would allow the city to cut through regulations and quickly provide more shelter beds.

Faulconer’s new point person on homeless, Jonathan Herrera, has since countered that the mayor’s already declared a homelessness state of emergency two years in a row.

Alvarez, who plans to run for county supervisor in 2020, on Thursday criticized the county’s response on Twitter.

    This article relates to: Government, Health Care, Homelessness

    Written by Lisa Halverstadt

    Lisa writes about San Diego city and county governments. She welcomes story tips and questions. Contact her directly at or 619.325.0528.

    barb graham
    barb graham subscriber

    I have to wonder how much time Mayor Faulconer wasted on sports baloney while this problem was simmering...

    His priorities are not the same as ours, I suspect. 

    michael-leonard subscriber

    kudos to Ms. Halverstadt for doggedly persuing this story and those behind it to final satisfaction. there can be no better reward for a journalist than to see your reporting actually cause change -- and FAST, too. the U-T cited your efforts, and the emergency declaration even got a mention on the NPR news from Washington.

    Molly Cook
    Molly Cook

    Perhaps the tourist industry decided an outbreak of hepatitis A was bad for their business and put some pressure on to get this resolved.

    merlot4251 subscriber

    "“The city continues to stand ready to support the County’s Health and Human Services Agency in its plans to provide vaccinations, sanitation and education to San Diegans as we battle this outbreak,” Mayor Kevin Faulconer said in a Friday statement."  

    Translation:  I don't own this problem.

    barb graham
    barb graham subscriber

    @merlot4251 Remember this, should Faulconer wind up running for governor.

    Major League Sports is higher on his priority list than the health and well-being of San Diego citizens.

    This outbreak doesn't surprise me. It's partly due to the city's attempt to shove the homeless problem under a rug.

    La Playa Heritage
    La Playa Heritage subscribermember

    Great news that our Strong Mayor Faulconer has confirmed the ongoing existence of the Homeless Emergency Shelter Crisis Declaration since 2013, that annual re-approvals to the Declaration are not required, and that the Shelter Crisis shall continue until terminated by the City Council.

    The acknowledgement of a continuous Shelter Crisis means that Conditional Use Permit (CUP) limitations may not apply, with approval by Strong Mayor Faulconer and/or the City Council.  If they wanted the City could open the Neil Good Day Center (NGDC) 24/7 all the time, instead of being closed on after 4 pm to allow Homeless use of public Restrooms, Showers, and Hot water for hand washing.  

    Assembly Bill AB-932 Homeless Shelter Crisis coauthored by Assembly Member Gonzalez Fletcher unanimously passed the California Senate Appropriations committed on September 1, 2017.

    AB-932 will create new Government Code Section 8698.4 for the Cities of San Diego, Berkeley, Emeryville, Los Angeles, Oakland, and City and County of San Francisco that would allow Tiny Home and Camping Cabin communities outside of Special Occupancy Park.  Huge deal to get rid of impediments to Fair Housing Choice for the poor and Homeless. 

    The Portland Loos were the Pilot projects to site downtown Restrooms for the Homeless.  However, Sabotage by the City Attorney and Civic San Diego mistakenly stated that the $20+ Million in hoarded Parking Revenue Funds can only be used for Maintenance and Cleaning of the Portland Loos, not Security to stop illegal activities and neighborhood complaints.

    Purposeful Set-Up for Failure of the Portland Loos, by City Officials not following Recommendation for Security and Restroom Attendants in the Mayor's Taskforce on Downtown Public Restrooms. Sad.

    The County does not need Permits for Temporary Hand Washing stations from the City.  Also if a Shelter Crisis was still ongoing from the 2013-2015 Declarations, then Health and Safety Codes have already been waived. Another reason why the months long delays for Permits for Hand Washing stations were not needed.

    On July 26, 2017 at SGLU City Council Committee, I spoke with Jonathan Herrera, Mayor Faulconer's Homeless advocate. 

    I asked Jonathan Herrera if the City of San Diego is currently under an official Declared Emergency Shelter Crisis for Homeless in this FY-2018 in accordance with Government Code Section 8698. 

    Jonathan Herrera stated:  "No."

    Prior, annually on June 25, 2013 Item S504, October 7, 2014 Item 332, April 28, 2015 Item 331 at the Direction of Bill Fulton. and at the request of the San Diego Housing Commission (SDHC), the City Council Officially Declared an Emergency Shelter Crisis to help the Homeless and poor.

    SDHC deleted the annual Shelter Crisis Declarations that are usually part of SDHC's Fiscal Year FY Budget Documents starting in FY-2017, and now into FY-2018.  

    Great news that the Emergency Homeless Shelter Crisis is ongoing, and was never terminated.  After AB-932 is passed, City staff cannot no longer say they want to help create Tiny Home communities but it would be illegal.