Standard of Care: Legislating Basic Human Rights
Imagine this: You are a woman and have been beaten and traumatized by the people who are closest to you, the people at your own home. You work up the courage to flee and seek out a shelter in the city so that you can rest, clear your head, and take your first step to beginning a new life. On the second day in this shelter, you ask for a towel so that you can take a much needed shower. The response from the shelter staff? “This is not the F-ing Hilton!”
This is not a fictional story: this is a testimonial from Ms. Rogers, one of countless people who are either homeless, have experienced homelessness in th epast, or advocate for better policies regarding homelessness, who stood up before the Board of Supervisors on Wednesday, February 20, to fight for legislation that will set up long-overdue Standards of Care within the city’s shelters.
This legislation comes after a year long process wherein the Coalition on Homelessness worked with the Shelter Monitoring Committee, various City departments, shelter residents, and the shelter providers themselves—most of whom noted that they were looking forward to having more clearly-defined standards that would make it easier to effectively operate their shelters and train their staff.
Before this process began, the Civil Grand Jury, a body of people that investigate various operations within the city and offer recommendations, had conducted their 2001-2002 investigation on “Homelessness in San Francisco.” This report specifically recommended that the City: develop standards of care within the shelters; create a clients’ “bill of rights;” develop system-wide, standardized operating procedures; and develop an integrated board including at least one homeless individual to oversee and hold accountable the (since then defunct) Mayor’s Office on Homelessness, as well as the Local Homelessness Coordinating Board.
In November 2004, the Shelter Monitoring Committee—a product of legislation for which the Coalition on Homelessness successfully advocated—was finally established. since that time, it has been monitoring shelters on a monthly basis, as well as submitting reports about their findings on shelter conditions. After consistently reporting deficiencies within the shelter system, they also recommended the absolute necessity of setting up basic standards of care. This led Supervisor Ammiano to bring this legislation before the Board.
It has been about six years since the Civil Grand Jury’s first strong recommendation, four years since the Shelter Monitoring Committee was set up, and one year since everyone from the Department of Health to shelter service providers themselves began the concerted effort to draft fair, clear, and concise legislation. Considering that person after person points out that these are the utter and complete minimum standards, the absolute basics of care, it is shocking that the process has taken this long.
“This is a moral issue, not a political issue,” said Supervisor Ammiano during the rally outside City Hall before the hearing. “You can’t turn off respect for people like it’s a faucet.”
However, the homeless situation in San Francisco seems to become more and more political each year: It is not the Board of Supervisors that has blocked the road to passing this legislation, it is Mayor Gavin Newsom himself. He sent a signed letter specifically denouncing the passage of this legislation before the hearing, as well as a representative to the hearing who, after asking for more time, caused a final decision to be delayed for the next two weeks. His reasoning—“fiscal prudence.”
“What is the big whoop?… It does not break the City’s back in any way,” said Supervisor Ammiano during the hearing. “Concerning the issue of fiscal prudence… the true cost of this would not go over $700,000.”
Without these standards, shelter residents and members of the Shelter Monitoring Committee have consistently reported not only abuse like that which Ms. Rogers experienced, but also a complete lack of hygiene within the shelters, an inability to meet people’s basic dietary needs, and a failure to comply with Americans with Disabilities Act regulations. No toilet paper, no soap, no paper towels, and dangerously sparking hand-dryers are only a few examples of this negligence. In addition, residents report that they are unable to charge any of their electronics. This complaint may seem small at first, but when someone’s waiting for a call about a doctor’s appointment or a job interview, a phone with a dead battery is a huge barrier.
“Shelters are the only place where people live in a congregated living center where there are no state or Federal regulations,” said a representative from the Department of Public Health during Thursday’s hearing.
Office buildings, hospitals, prisons, and dormitories have standards of care. In 2005, the Board of Supervisors in San Francisco even passed legislation setting up standards of care for dogs that are left outdoors by their owners at night. It is disgusting that there are not Standards of Care within homeless shelters already, and it is even more disgusting that there is even a question about implementing these standards.
Although there is currently language in the contracts between the City and its shelters concerning fair treatment of shelter residents, it has remained just that—language. Any policies regarding shelter operations are not enforceable right now and are not clearly defined, inevitably lending to their being bent, misinterpreted, and often lost in the line of communications from the Human Services Agency (HSA) to the staff at the shelters.
“The contract compliance through HSA is not working,” said Quintin Mecke, a member of the Shelter Monitoring Committee. “Part of this legislation is to make sure that if there are policies in theory, those policies become legislative.”
The Standards of Care legislation places fines on shelters that do not comply with these standards. This fine will only be imposed after giving the shelter adequate time to fix the violation and after assessing the damages of the violation. In addition, shelter providers will be able to appeal this decision within fifteen days of the City’s notification of violation.
However, even written into the language of the legislation, it is noted that a failure to comply comes at an almost unquantifiable cost to the city. It is not just about the conditions in the shelters, it is about the city as a whole. As the representative from the Department of Public Health noted, “The health in one area of San Francisco effects all of San Francisco.”
The Center for Disease Control notes that hand-washing is the easiest and most effective way to prevent the spread of infectious diseases and illness. Not only does the lack of soap within shelters cause the clients to become ill and spread illness more rapidly, it also causes those illnesses to spread around the city as a whole. We do not live in a bubble and we cannot close our eyes to the fact that there are people in this city who are denied access to basic hygiene; this denial is inevitably going to effect the health of the city as a whole. “We shouldn’t have to ask for hygiene,” said shelter resident Calvin Davis.
In addition to effecting the physical health of San Francisco, the inhumane treatment of homeless residents affects the city at large. As Tomas Picarello, who has been helping form the legislation, said, “How people are being treated affects their conduct in the community.”
It is noted in psychological study after psychological study that the way that people are treated and the expectations that are placed on them affect their overall performance. How do we expect to solve homelessness and to keep it from becoming a revolving door if we cannot even put down on paper that people in shelters deserve dignity and respect? How do we expect people not to become bitter, depressed, or disillusioned if we cannot even assure them access to toilet paper or a blanket during their most vulnerable moments? Any one of us can become homeless at any time. A different and harder question to answer is whether or not any one of us would be able to get through this hardship with the system the way that it is.
“We want to elevate people to a working level in San Francisco,” said Supervisor Ross Mirkarimi. “To do anything less would be shameful and reprehensible.”
The City is facing system-wide budget cuts this year and is slashing social programs first. It is important that we push the Mayor toward moral as well as fiscal responsibility while making these decisions. It is important that everyone in San Francisco receive the dignified and respectful treatment that they deserve. It is important that we set up, at the very least, a minimum Standard of Care for all shelter residents.
Katy
