Housing Commission Under Pressure for Not Informing City of Deaths at Hotels
Several deaths at city-owned hotels have provoked questions from city leaders while providers struggle to maintain services with too few workers.
The city rushed late last year to move hundreds of homeless San Diegans into two hotels it purchased with the help of state dollars, an effort seen as an unprecedented opportunity to reduce homelessness.
Nearly a year later, a series of deaths at both hotels have provoked questions from officials overseeing the effort. At the same time, the service provider running one of the hotels in Kearny Mesa is leaving the project for reasons it says aren’t related to challenges at the facility. And the nonprofit overseeing a Mission Valley hotel acknowledged to Voice of San Diego it hasn’t been able to hire and retain the number of employees it envisioned to help stabilize extremely vulnerable people.
Amid the turmoil, the state announced last month it will deploy another $1.45 billion for cities and counties to buy even more hotels. San Diego wants a part of it.
Since December, 10 residents of the hotels — four at Kearny Mesa and six at Mission Valley — have either been found dead in their rooms, or died in hospitals after suffering injuries at the hotels.
Those deaths have led Mayor Todd Gloria, councilmembers and multiple Housing Commission board members to demand more information on the state of services at the hotels as they mull future purchases. Those questions followed inquiries from VOSD.
Multiple outside experts told VOSD that housing projects like this often see more frequent deaths than the general population because they serve people, many of them seniors, who are medically fragile.
Housing commissioners will receive an update on the hotels Friday.
The transaction of the Mission Valley hotel, meanwhile, is now the subject of litigation and a criminal investigation, following the revelation that the broker who negotiated the Housing Commission’s purchase made a large financial investment in the hotel’s owner prior to the sale.
It’s unclear what changes commissioners or city leaders might recommend for the hotel program’s second year.
Several residents who live in each hotel who spoke with VOSD described differing experiences in their new homes. Some spoke in glowing terms about their apartments and Father Joe’s Villages and People Assisting the Homeless staff working at the two hotels, while others said they have been disappointed with the services there. One Mission Valley hotel resident told VOSD he has been without an assigned case manager for weeks and has questioned how long it would take PATH staffers to discover him in his room if he had a health issue. A Kearny Mesa hotel resident said residents need to advocate for themselves to receive services. Another resident there said he tried to set up community BBQs and Narcotics Anonymous or Alcoholics Anonymous meetings, but neither effort went anywhere. (A Father Joe’s executive told VOSD that concerns about gatherings during COVID may have been the reason for that.)
By three outside experts’ standards — and even that of one of the nonprofits operating a city-owned hotel — the hotels may not provide a service level commensurate with the needs of an especially vulnerable population.
The nonprofits hired by the San Diego Housing Commission to run the hotels have been operating with case management loads of 24-to-1 for the Kearny Mesa hotel and 22-to-1 for the Mission Valley hotel — ratios that the Commission says are adequate for a population with varying needs since not all need the same level of care.
But former U.S. Interagency Council on Homelessness chief Barbara Poppe told VOSD that such projects should try to have one case manager for every 12 to 15 clients. Ben Henwood, director of USC’s Center for Homelessness, Housing and Health Equity Research suggested a 10-to-12-to-1 ratio.
Cindy Manginelli of the National Health Care for the Homeless Council said a 15-to-20 to-1 ratio could be appropriate depending on needs.
Jonathan Castillo of PATH, the nonprofit running the Mission Valley hotel, said the agency’s other housing projects typically maintain a ratio of 12 to 15 clients per case manager.
Castillo said that wasn’t possible at the Mission Valley hotel because the nonprofit learned late in the game that some units in the hotel would house two residents rather than one as it hurried to accommodate those moving in. He said longstanding workforce issues worsened during the pandemic and compounded the challenge.
“We weren’t able to get fully staffed up,” Castillo said.
Workforce shortages in the homeless service sector this year inspired Gloria to allocate $300,000 in the city budget to help expand local training programs for the industry.
Father Joe’s Villages, the Kearny Mesa operator, is leaving the project at the end of the year, the nonprofit acknowledged via a Housing Commission statement. The group has also struggled to hire and retain staff at the facility this year.
Bill Bolstad, Father Joe’s chief strategy officer, separately told VOSD that staff go “above and beyond” to meet clients’ needs and advocate for them despite those issues but that the agency would advocate a “lower ratio of case managers to clients” based on the higher needs it’s seen.
“The frequency with which staff check in on residents is dependent on their desired level of interaction, their level of need and their self-sufficiency,” Bolstad wrote in an email to VOSD. “For residents with a higher level of need, case managers often meet or engage with them several times a week. Of course, our case managers are also available at residents’ request.”
Like Castillo, Bolstad also acknowledged the rapid hotel acquisition and move-in process presented challenges for his agency.
Per state Project Homekey grant mandates, cities including San Diego were required to spend funds they received for hotel purchases by the end of last year — and for a time, city officials hadn’t committed funds to keep the Convention Center shelter open past mid-December. Those deadlines led to a scramble to move hundreds out of the Convention Center and into the hotels at a faster clip than the typical turnaround time for housing projects.
Castillo said the deadlines essentially halved the time PATH had to ramp up services at the hotel before residents began moving in.
Lisa Jones, the Housing Commission’s executive vice president of strategic initiatives, acknowledged the fast pace has not been easy, and presented challenges the agency has had to address on the fly. But she also said it’s been worth it — and that the commission expects more lead time for future potential acquisitions.
“Let’s not be afraid to admit that this isn’t going to be easy, but it’s still the right work. We have people in housing that may not have easily gotten into other (permanent supportive housing) programs, and it might be hard for them and for staff some days, but we don’t shy away from that work,” Jones said. “We just figure out what else needs to be pulled together and we pull it together.”
A year ago, city and county officials scrambled to purchase and prepare the two Residence Inn hotels after receiving word the state had awarded the city nearly $38 million to transform more than 330 hotel rooms into apartments.
The properties would become permanent supportive housing, apartments that come with services and amenities meant to support people who previously lived on the street for years and who are particularly vulnerable. Supportive housing is considered the gold standard solution for ending chronic homelessness in the homeless service industry.
A 2020 UC San Francisco study and an array of others have documented the model’s effectiveness when it comes to “housing the most complex chronically homeless people,” as UCSF put it when it released the results of its research last fall. The UCSF study found that 86 percent of formerly homeless people whose experiences were tracked by researchers remained in their permanent supportive housing units for several years. The study, though, also found “extremely high death rates” among those who were successfully housed.
Around the time of the state announcements, San Diego County officials committed to deploy $5.4 million to back services at the two hotels.
By late November, the Housing Commission had inked contracts with Father Joe’s Villages and PATH and bought the hotels. Homeless San Diegans started moving in within a few weeks.
Christian Hart, 49, told VOSD he has thrived since moving into the Mission Valley hotel. Hart said he has since completed probation and a drug treatment program.
Hart said his PATH case manager checks in with him at least every few days and the harm reduction specialist assigned to him has provided crucial support and guidance.
“This is the first time I’ve had peace of mind, probably for about 15 years,” Hart said.
Kearny Mesa hotel resident Donald Dunlap, 50, said he has also enjoyed his new home, especially his small kitchen. He has found his Father Joe’s case manager to be available when he needs her and said she regularly checks in with him. Dunlap is considering signing up for a cooking program on the hotel’s ground floor.
“They’re providing a pretty good service for us,” Dunlap said. Ed Bidwell, 62, has been less satisfied since he moved into the Mission Valley hotel in March.
Bidwell said his case manager disappeared weeks ago. He questions whether others are getting the aid they need. He’s also frustrated by vandalism and the lack of nearby amenities such as grocery stores.
“We’re getting ignored,” Bidwell said.
Hanan Scrapper of PATH said the nonprofit makes a point to periodically check in with residents though some prefer to be left alone. To try to make up for staffing challenges, Scrapper said PATH has assigned employees to sit in the hotel lobby so residents who need assistance can easily flag them with requests. The nonprofit has also arranged rides to grocery stores, appointments and Balboa Park.
Most residents have accessed the services the nonprofit has offered, Scrapper said.
Despite the challenges, Housing Commission data shows about 88 percent of formerly homeless people who moved into the Kearny Mesa hotel have remained there. About 94 percent have remained at the Mission Valley hotel.
But deaths at the facility have recently caused some city and Housing Commission leaders to question whether improvements are needed.
The 10 residents who have died in the hotels or after suffering injuries there since December have suffered primarily from drug overdoses or health issues they had developed before moving into the hotels.
On Aug. 21, 68-year-old Stephen Brooks was found in his apartment after he died from complications related to liver cirrhosis. In the eight weeks since, three additional residents have died at the property, the San Diego Housing Commission confirmed, though details on the deaths were not yet available from the county medical examiner. The two residents who died at the property most recently, on Oct. 7 and Oct. 12, were found during welfare checks.
Kearny Mesa hotel resident Joe Brown was shaken by one of the recent deaths.
She was a friend, he said, who had started decorating posters to remember other deceased residents “to make sure they had a proper sendoff.”
“It’s pretty scary here, with more people dying, it’s getting hard to keep track,” Brown said. “I cringe every time I walk outside because I’m afraid that I’m going to get news of another. I feel unsafe, very unsafe.”
The Mission Valley deaths have not been so concentrated in recent weeks. On Jan. 13, a 55-year-old man was found in his room after dying from an overdose of methamphetamine. The medical examiner’s report could not say how many days prior the overdose had occurred. Since then, at least five other people have either died at the hotel, or in the hospital due to injuries suffered at the hotel. A 66-year-old man was found in his room in February after he died of heart disease. A 61-year-old man was found in his room in May after he overdosed on methamphetamine an unknown number of hours earlier. A 63-year-old man died in a hospital in June of health complications after he fell and suffered a hip injury in his home at the Mission Valley hotel. A 40-year-old man was found in his apartment in July, and the cause of death is still pending investigation. In August, a 44-year-old man was found deceased in his home at the hotel, and the cause of death is still pending investigation.
It is not possible to say if those deaths could have been prevented. Outside experts, like local officials, reiterated that homeless and formerly homeless residents suffer from elevated death rates.
Both Poppe and Henwood also noted that deaths are often more common in homeless housing projects because they target medically fragile people.
“It is not unusual for people to move into permanent supportive housing and die soon thereafter,” Poppe said. “This phenomena has been reported on in other projects because there’s a prioritization of the sickest people to get into permanent supportive housing.”
Gloria said he has concluded that there’s at least some “room for improvement” at the hotels.
“We’re sort of in data collection mode and really wanting to understand from the providers, from the commission, from other relevant parties, what is their sense of the situation (to) help me and the council and other folks to provide some clear direction,” Gloria said.
As Gloria and others seek more information, Mission Valley hotel service provider PATH and Telecare Corp. – the winning bidder for the Kearny Mesa hotel in a recent request for proposals process this time led by the county – are negotiating new service contracts at the two hotels.
It’s unclear how those contracts might differ from current ones.
A county spokeswoman and PATH declined to elaborate on the ongoing negotiations though Castillo said the nonprofit is focused on ensuring its model meets the needs of residents and that they can offer competitive wages to recruit and retain staff.
Father Joe’s Villages, which has served residents at the Kearny Mesa hotel, is expected to soon end its work on the project.
Bolstad told VOSD that the nonprofit’s decision to depart the Kearny Mesa hotel wasn’t due to challenges it has faced there but instead a result of demands expected along with a new housing project it plans to open early next year and a new county contract requirement set to increase administrative burdens.
Yet news that Father Joe’s was departing the contract caught housing commissioners including Mitch Mitchell off guard.
Mitchell, who is also a VOSD board member, began questioning Housing Commission CEO Rick Gentry and others about the state of the hotel projects after he learned of the deaths and the coming contract change.
Mitchell said he has been focused on understanding the lessons the city should learn from its first hotel experience. He has concluded that more preparations will be necessary if the city applies for more state funds.
“We were not focused on doing an assessment of who exactly are we putting in beds and what is the level of service that is going to be necessary to address all of their needs,” Mitchell said. “That’s something we need to discuss going forward as we consider buying more hotels.”
Regional Task Force on Homelessness CEO Tamera Kohler said she is hopeful that another funding round that provides more time for planning and the new county contracts will help address the challenges the hotel projects faced in their first year.
“I hope we take the successes — which is the doors, the housing stock — (and) we take the learned experience from the people we housed through it and do a good listening session around that, how do we get the property management and the case management that we need as we move forward with more projects like this,” Kohler said.
Sandy Myskowski, 42, who lived in the Kearny Mesa hotel for four months, hopes the city learns from its experience in the hotels too.
Myskowski, who moved out after roommate challenges in April, had high praise for her Father Joe’s case managers, but said the experience convinced her that both city-owned hotels needed more case managers and security patrols.
“To be straight, I don’t think any service provider has enough case management for services, because, as a city, we have not made case management a service priority,” Myskowski said. “Case management is the most important service priority.”