Community Resistance to temporary housing and hygiene stations continues as homeless deaths surge

By Gary Walker

Ashley Kinsley, who hangs out among the homeless encampments on Third Avenue in Venice, is reluctant to visit a doctor despite serious health concerns
Photo by Jason Ryan (@JasonRyanPhoto)

This article was produced as a project for the USC Center for Health Journalism’s California Fellowship.

They’re found under freeway overpasses, on county beaches, benches, hillsides and sidewalks. Others wind up in alleys and parking lots while the lucky few spend their last days or hours in hospitals.

And they almost always die alone.

Deaths of the unhoused on the streets of Los Angeles have jumped a staggering 76% over a five- year period, according to a Kaiser Health Foundation analysis gleaned from data from the Los Angele County Coroner’s office and the city is quickly moving toward unprecedented territory with nearly 1,000 deaths of homeless people this year. Causes of death are myriad: from exposure to being outdoors, to untreated illnesses, suicides, accidents and deaths.

In Los Angeles County, the average age of death for homeless people was 48 for women and 51 for men. The life expectancy for women in California in 2016 was 83 and 79 for men — among the best longevity statistics in the nation.

The surge in deaths reflects a growth in the number of people who are chronically homeless and those who don’t typically use shelters, which means more people are living longer on the streets with serious physical and behavioral health issues, experts say.

Medical professionals from Venice Family Clinic operate nine street teams on the Westside, including the Homeless Multidisciplinary Street Team in Santa Monica, which works with the chronic homeless and the C3 Team (City, County and Community) which does outreach in Santa Monica and Skid Row. The first team treats illnesses and physical conditions that without care could eventually become worse or even life-threatening.

Dr. Coley King, the director of homeless healthcare at Venice Family Clinic, says building trust among the homeless population is crucial because so many been promised things that never come to fruition.

“We try and get people the best medical care possible wherever they are. Out here, it’s rare that we don’t find someone who doesn’t have a chronic health condition,” he said.

On a home visit to a formerly unhoused client, Robert Crawford, King asked Crawford a series of questions about his health, checked his blood pressure and heart rate.

Crawford, 56, wearing a black Rod Stewart t-shirt and blue jeans,  mentioned that he had constant chest pains and had fallen and hit his head against a wall the night before.

“I think you better go to the hospital. We can take you right now,” King said.

After Crawford agreed to go the hospital with King’s team and checked into Saint John’s Hospital, it was discovered that he had pneumonia.

Clint Cooper spends much of his day at Christine Emerson Reed Park, formerly Lincoln Park in Santa Monica. A street team visited him one day in September to check in with him to make sure that he was picking up his heart medications.

When he said he can’t make it over to social services center Step Up on Second in Santa Monica get his medication, street team member Katie Holtz offers to get it and bring it to him at the park.

“I’m on blood thinners and beta blockers. I have a couple of stents in my heart.  But I haven’t had a heart attack in two years,” he said.

Cooper, 62, said without the C3 Team he would not be able to pick up his medication.

“My problem is transportation. They bring me my medication when I can’t get it myself,” he said.

The team later visited a man from Riverside, Kevin DeMarco, sitting on a bench near the beach on the Santa Monica – Venice border off of Ocean Avenue.  DeMarco had been complaining for weeks about pains in his abdomen and torso.

He said he said been diagnosed with pancreatic cancer, but King and doctors who work with him are unsure because they don’t have all of DeMarco’s medical records.

“The doctors here think it’s pancreatitis but it’s not. They don’t have my records. They’re in Riverside County,” said DeMarco, who travels with his light brown terrier Digger. “I’m in pain every day.”

Hector Ortiz, a physician’s assistant with the C3 team, says the symptoms that DeMarco presents are similar to pancreatitis.

“But we won’t know for sure until we see his records,” Ortiz said.

According to the Hirshberg Foundation for Pancreatic Cancer Research, for all stages of pancreatic cancer combined, the one-year relative survival rate is 20%, and the five-year rate is 7%.

On Third Avenue in Venice, close to a dozen people living there talked about various personal aliments from heart palpitations, sleep apnea, diabetes and back problems.

Ashley Kinsley, 30, arrived in Los Angeles last year with the hopes of becoming a singer. She spends most of her days and evenings on the Venice Boardwalk and her nights on Third Avenue in Venice in one of the largest homeless populations on the Westside. Sunburned, diminutive and wearing a light blue blouse with pink socks and no shoes, Kinsley only needs one prompt to display her singing style, sounding like a cross between Bonnie Raitt,  a young Joni Mitchell and Rickie Lee Jones, who spent her youth singing in Venice nightclubs.

Kinsley has a number of abscesses in her mouth but hesitates to go to the nearby Venice Family Clinic because of prior bad experiences with doctors.

“They look down on me in hospitals. I know my body better than a doctor does,” she said.

After prodding from local homeless advocate David Busch, Kinsley made a vague promise to visit the clinic.

George Kirkland was sweeping up around his tent on Third Avenue on a day when Los Angeles Sanitation employees power wash the street on weekly sidewalk cleanups. He then began spreading a large amount of rocks on a strip of dirt next to where he pitches his tent on Third.

“Best rat prevention there is. First you pack in the wet dirt with rocks and then you put the big rocks on top,” explained Kirkland, who is receiving treatment for hepatitis C at Venice Family Clinic.

Business organizations and community groups coexisting near large homeless encampments say the unsanitary conditions often seen in these locations are perfect breeding conditions for rats and some are carriers of fleas who in turn carry the virus that leads to typhus.

Health experts are seeing a spike in communicable illnesses such as typhus, an infectious disease that is often spread by rodents. Last year typhus cases soared to 109, 42 more than in 2017, according to the county Dept. of Public Health. As of Sept. 27 this year there were 54 cases.

While the number of typhus cases has increased over the last few years, hepatitis A has decreased since the state outbreak in 2017. According to Public Health, there were 80 cases of hepatitis A recorded in 2017, 40 in 2018 and 19 as of April.

In homeless encampments there were nine, three and three respectively.

According to Public Health, fatalities from typhus are uncommon, occurring in less than 1% of cases.

Despite resistance from many communities, Los Angeles city and county elected officials have forged ahead with plans to bring mobile hygiene stations in an effort to combat the possible spread of communicable diseases. The Los Angeles County Board of Supervisor approved a pilot program last year for hand-washing stations in eight locations throughout the city, and Venice has opened a portion of its restrooms on the beach 24 hours a day so homeless people living nearby can use them instead of using the sidewalks or residents’ yards.

In addition, city officials have contracted with nonprofits sto bring mobile showers to various communities, including Venice, where unhoused residents can shower at least twice a week.

Third District Supervisor Sheila Kuehl, who authored the hygiene measures at the county level, says the short-term goal is to help maintain good public hygiene and provide individuals with a sense of personal dignity. But there is more to these services than just the short-term benefits, the supervisor added, which are stopgap measures until people find permanent housing.

“Over a number of years, our office has sponsored many Homeless Connect Days where people experiencing homelessness can get an array of services including showers and haircuts, new shoes, a meal, and basic medical and legal assistance,” said Kuehl, whose district includes Venice, Santa Monica and Hollywood. “By engaging people and providing basic services, we initiate relationships that help put men and women on a path to bridge housing and permanent housing.

“That is our ultimate goal, because we have learned through experience that the best solution to homelessness is homes.”

Las Vegas, Sausalito, Santa Rosa and St. Louis have all created programs that offer mobile showers to its homeless residents.

That’s not the case in other cities, however, whether its showers or other homeless initiatives.

Last year, Ft. Lauderdale and Pompano Beach turned off the spigots  of a nonprofit that was offering twice a week showers to the homeless. In 2014 the city passed a series of ordinances designed to make it more difficult to feed the homeless.

Local lawmakers have also faced united and vociferous pushback against temporary housing from many communities, including in Venice, where a large group of residents have resisted having bridge housing built in their neighborhoods.

“We have so much unused land in California. The city and state should be building shelters, homes, bridge homes, rehab, mental health, along with basketball courts, gyms, etc. where land needs to be developed. Or just build along the 10 Freeway between LA and Palm Springs,” says Travis Binen, a software executive and Venice homeowner.

“Build where it’s inexpensive and makes economic sense, where it won’t attract more transients, and where it won’t endanger hard-working taxpayers. For the homeless who are working in L.A.,  refurbish buildings so they can stay in L.A. The working homeless aren’t the people trashing our streets, assaulting people, doing drugs, etc.”

Some communities and corporate entities are embracing opposite solutions to reduce homelessness.

The Silver Lake, Echo Park, Los Feliz, Atwater, East Hollywood (SELAH) Neighborhood Homeless Coalition is trying to open a homeless services center in their region. Every first and third Saturday of the month, the nonprofit’s volunteers visit encampments in the area and hand out water, hygiene kits, toiletries, showers and clothing.

“We were all working in our own communities independently and we really weren’t getting anywhere. So we decided to form a nonprofit and work together. These are our neighbors and what we see what we can do to help them,” board member Dorit Dowler-Guerrero, who works with The People Concern, LAHSA, and social services PATH Homeless Health Care Los Angeles.

Cedars-Sinai Medical Center gave $100,000 to The People Concern to expand a “navigator” program that connects homeless patients at Marina del Rey Hospital with community resources and services.

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