By Cody Dulaney and Jill Castellano | inewsource
Last week, a scathing report from San Diego State University shed new light, confirmed previous inewsource reporting and raised questions about the future of a county COVID-19 hotel program.
San Diego County has been using hotels over the past 16 months to house thousands of people who have COVID-19 or have been exposed to it and don’t have a safe place to isolate.
The County Board of Supervisors ordered a review of the program in early March, eight days after an inewsource investigation uncovered poor care and oversight issues at the Crowne Plaza in Mission Valley — the main hotel used in the program. The county later agreed to pay SDSU $140,000 to conduct the review.
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In more than 40 confidential interviews, employees and hotel guests told SDSU that the county’s main contractor, Equus Workforce Solutions, is unqualified to run the program, and staff aren’t trained to work with many of those who are isolating — people who are homeless and might be struggling with mental illness or substance use disorders.
Here are the main issues and questions raised in the report.
1. Confirms previous investigation, including a lack of oversight
The SDSU report praised county staff for their dedication, flexibility and urgency, saying the program likely prevented the spread of COVID-19 across the county. But the review also confirms inewsource reporting over the past year and a half from guests as well as county and contract employees who have exposed neglect and wrongdoing in the sheltering program.
Guests went hungry from small portion sizes and inadequate food. People suffering from COVID-19 symptoms faced delays in getting medication. Providing “adequate, respectful security has been problematic.”
In addition, SDSU corroborated what Equus staff shared in prior inewsource stories: The county wasn’t paying enough attention to the sheltering program. The report found that no county employee is responsible for overseeing all aspects of the program, and couldn’t determine if anyone has ultimate decision-making authority.
“Staff at all levels report confusion about who is responsible for various aspects of the program,” the report said. “Clear answers about program operations and program data were difficult for the evaluation team to obtain.”
2. How did unqualified companies receive multimillion dollar contracts to operate the program?
Multiple employees told SDSU that Equus does not have the credentials to operate a 24/7 facility for people who are sick or have complex behavioral health needs.
Any contractor running this kind of program needed to have extensive experience offering around-the-clock care, with “a team of medical folks, mental health experts and residential experts in place,” an employee told SDSU. But Equus is a staffing agency, and among the services offered on its website are: career, family support, disability determinations, child care solutions and business solutions.
The company employed staff without the proper training, which allowed gaps in services that may have led to overdoses and suicide, the report said.
So how did Equus receive the contract? It was the only company to apply.
County employees told SDSU “that under normal circumstances, many providers would likely have bid on this project but were perhaps unavailable to apply because they were coping with crises caused by the pandemic.”
The SDSU report also found that the company responsible for providing mental health services, Telecare Corp., isn’t equipped to meet guests’ acute, complex or severe mental health needs. One employee called it “behavioral health lite.”
County officials changed an existing $13 million contract it had with Telecare, which had been providing mental health services to San Diegans in the legal system, days after a county employee sent an email “pushing and begging and pleading for additional staff,” according to an email obtained by inewsource last spring.
3. Who is entering and who is leaving?
Jose Angel Gomez-Camacho stayed at the Crowne Plaza in April 2020 after testing positive for COVID-19.
After checking out, the 28-year-old somehow reentered his room, according to San Diego County Medical Examiner records. Housekeepers found him five days later on April 23. He died by suicide.
The SDSU review explains that keeping track of guests has been a recurring problem for the program: Staff have trouble tracking who’s supposed to arrive at the hotel, where they’re coming from and who has already checked in.
Two months after inewsource uncovered the suicide death, county officials hired Equus to take over the hotel sheltering program.
4. Internal conflict
The report highlighted a disagreement among county staff members about the type of program that was needed. Some said the goal was simply to house people and reduce community spread, while others recognized it would become a shelter serving primarily vulnerable people with complex needs.
SDSU seems to agree that additional help is necessary, as four of the nine recommendations listed in the report deal with case management, medical or behavioral health services. The report goes on to say that all similar programs in the future should focus on medical and behavioral health services.
5. County response, future of program
County spokesperson Michael Workman provided a statement that defended the sheltering program, saying it “stood up in response to an unprecedented pandemic.”
But the statement further highlighted the disagreement about how the program should be run: “It was not intended to be a shelter or a hospital.”
Workman added that county staff will continue working with its contractors “to strengthen our response” and will take the report into consideration. But he did not respond to questions about whether staff will follow any of the nine recommendations, one of which included 14 changes that could be made right away to address concerns raised by staff and guests.
County Supervisors haven’t publicly shared their reactions to the report, either. All five have received a copy, but only one has responded to requests for an interview or provided an initial reaction for this story. A spokesperson for Supervisor Joel Anderson, who represents cities and communities in East County, said he hasn’t read the report yet, adding “while it is an important subject, we have many more pressing issues” and declined to comment.
As of right now, there is no plan to discuss this report in a future public meeting.