Service provider calls local COVID-19 hotel ‘useless’ because some people can’t get in
More people are using a Pierce County hotel set aside for those with COVID-19 than ever before, but homeless service providers have said those with mental or behavioral health illnesses have faced difficulty getting in the door.
Pierce County’s Temporary Care Center opened in April last year at the Holiday Inn on South 84th and Hosmer streets in Tacoma. As of Jan. 26, 436 people had been admitted. January 2021 alone saw more than 158 people stay there.
Five homeless service providers told The News Tribune they have struggled to place people with mental or behavioral illnesses in the center.
Gerrit Nyland, director of operations for the Tacoma-Pierce County Coalition to End Homelessness, said if someone isn’t “a perfect candidate,” it’s been challenging to get them admitted.
“It’s been a useless operation since it started,” Nyland told The News Tribune. “It’s pretty frustrating on our side.”
Those who are not accepted at the center are sent to a King County COVID-19 facility, put up for a few days at a motel by service providers or forced to live on the streets, the coalition said in a statement.
The Pierce County Emergency Management Department said the center’s admission policy is based on who could be supported.
“It was determined through our policy that we were not able to support people with acute mental health and acute substance abuse issues since it is not a medical facility,” department spokesperson Mike Halliday said.
Tacoma Rescue Mission’s executive director Duke Paulson said his homeless shelter is doing all it can to avoid a COVID-19 outbreak, but that’s been difficult without a space to send everyone who tests positive.
“Getting people in the Temporary Care Center should be one easy fix,” he said. “At this point, we need to have this figured out. The county and the health department need to step up and take responsibility. I don’t have staff to take care of this.”
The Temporary Care Center
The center was intended to help those who have tested positive for COVID-19 to isolate while they recover and those who have been in close contact with someone with COVID-19 to quarantine if they do not have their own space to do so.
MultiCare, the Tacoma-Pierce County Health Department and Pierce County’s Emergency Management are involved in the center.
The center comprises 60 rooms but has surge capacity to use up to 120 rooms, Pierce County’s Emergency Management director Jody Ferguson told the Pierce County Council in a study session on Jan. 26. Those who have tested positive and those who are waiting for test results are kept on separate floors.
She described the level of care as what one would expect quarantining or isolating at home. Guests get a room to themselves, meals, laundry and internet access. No one has been transferred to the hospital after admittance, Ferguson told the council.
MultiCare medical staff provides medical assessment and referrals. MultiCare does not set admission criteria, spokesperson Marce Edwards said.
They were provided a list of disqualifying factors by Pierce County, Edwards said, which includes “unstable medical behavior and or behavioral health conditions.”
Other disqualifiers are ongoing vomiting and diarrhea, having undergone surgery in the last two weeks and particularly concerning vital signs, like abnormal temperature, blood-sugar levels or blood pressure, Edwards said.
Tacoma-Pierce County Health Department’s director of communicable disease, Nigel Turner, said meeting the needs of all those affected by COVID-19 is a challenging issue.
“The FEMA funding determined the Temporary Care Center would have individual rooms, making it impossible to provide close monitoring of people with significant underlying health conditions or behavioral health challenges,” Turner said in an email to The News Tribune.
Ferguson said no one has been kicked out of the center. Those in need of more advanced care are referred to other medical providers.
“Since the facility is not a medical or behavioral health facility, we are not able to serve those with acute mental health conditions, vitals outside of acceptable ranges, and drug use within the last 72 hours,” Ferguson said in an email.
Ferguson told the council how many guests were admitted by month:
May: 10
June: 14
July: 14
August: 44
September: 41
October: 24
November: 38
December: 93
January: 158
Joint Base Lewis-McChord has sent 104 soldiers and their families who are on international duty to the center to isolate and quarantine, Ferguson said.
Asked how many people checked into the center who are experiencing homelessness, the county said, “we do not track guests based on their housing status.”
King County’s COVID-19 Kent Isolation and Quarantine Facility does not have any disqualifiers on who stays, as long as the guests are able to perform their activities of daily living, King County deputy director of communications Chase Gallagher said in an email. King County defines daily living activities as “eating, bathing, getting dressed, toileting, mobility and continence.”
The Temporary Care Center has cost Pierce County $11 million to run, Ferguson said. The Federal Emergency Management Agency (FEMA) has given the county $1,175,115 in reimbursement, and more federal funds are anticipated.
“There is indication that the reimbursement for eligible expenses will shift from 75 percent to 100 percent, but the details are still being finalized,” Ferguson said in an email.
The county’s contract with the hotel ends in March.
“The county will assess the continued need for this facility and make a renewal decision based on that,” Ferguson said.
For five months, the county provided space for those who test positive for the coronavirus and have a behavioral health illness.
Pierce County Department of Emergency Management paid $590,480 to Recovery Innovations in Fife from April to September to set aside beds for COVID-19 patients with behavioral illnesses, Halliday said.
Medical professionals at the Temporary Care Center identified those who needed more advanced care in the screening process and Recovery Innovations was an option.
Contact tracers told people exposed to COVID-19 or tested positive to seek care coordination teams to determine care options, which could have included Recovery Innovations, Halliday said.
“The site closed when the contract ended,” he said.
Turner with the health department said the service operated for several months with a very low number of users, which did not support its continued operation.
Nyland said he and other homeless service providers were not aware of the facility when it existed.
The Department of Emergency Management said the care coordination team would have informed the shelter provider and the person with COVID-19 of the facility if needed.
“This option for medical/behavior health services would have been shared with service providers by care coordination teams helping shelter residents who tested positive for COVID-19,” Halliday said.
Providers’ experiences
Paulson runs Pierce County’s largest network of shelters, the Tacoma Rescue Mission. He said he has had at least two clients denied a room at the Temporary Care Center in recent months. At the beginning of the pandemic, he said it was easier to get someone checked-in.
“The first couple of months there was not a lot of screening, and it’s become a really long questionnaire. It asks if anyone has mental health history, history of drug use or if you have any criminal offenses of any sort, you’re not allowed to stay there,” he told The News Tribune.
When asked about the criteria for admittance and addressing the concerns of the homeless service providers, the Department of Emergency Management responded by saying:
“The site is not equipped as a medical facility, and site staff were not hired for the purpose of running a medical facility. People who need additional medical care that requires more assistance than they can provide themselves need to stay in another location for their safety and well-being.”
Paulson said he doesn’t have staffing to hold isolation or quarantine centers, but he has used a conference room at the Tacoma Rescue Mission as an isolation room for those who test positive for COVID-19.
“Can we send someone outside in some 40-degree weather or do we put them in a conference room?” Paulson asked.
Mike Boisture, the shelter manager for the East Side Community Center and the Center at Norpoint, said he has had a few instances of the center not admitting people.
He recalled one case of a couple, a man who tested positive for the coronavirus and woman who was his partner. The man was her caregiver, because she had mental health needs, Boisture said. The center would admit the man, but not the woman.
“He takes care of her, and they have to go together,” he said.
Boisture paid for a four-day stay in a motel room for the couple until he said he convinced the TCC staff to admit the couple. Now, when he calls to send someone, they have to get their vitals checked by a health provider or urgent care, he said. Vitals are also checked by staff at the center before admittance.
“Eventually they all get in there, but it’s not speedy,” he said.
He wants an alternative space or hotel for those who are not accepted into the center because he doesn’t have space for people to quarantine or isolate in the shelters.
Even if he places people with the coronavirus in a motel, there is no one checking up to ensure quarantine and isolation protocol is being followed.
“If you don’t get in, we say, ‘OK fine, what’s my alternative?’” he said. “I’m not set up to do quarantine or isolation. I don’t have staff to check in on them.”
Boisture said the Temporary Care Center is a community center, and it should serve the entire community.
Kim Zacher, the CEO of Comprehensive Life Resources, said two clients at its Young Adult Shelter tested positive for COVID-19 on New Year’s Eve, and the nonprofit wanted to take quick action to prevent further spread.
They began the process of placing 18 people in the Temporary Care Center but faced roadblocks.
Zacher said she understands that the center might not have the resources to support people with serious mental illness, but there needs to be some barriers removed and more support for the highly vulnerable populations in our community.
“Our conversations with TCC staff gave us the sense the facility was not designed for people experiencing homelessness or mental illness,” she said in a statement. “The entry process created some barriers to entry for young adults experiencing homelessness, including answering personal questions about mental illness and past substance use.”
Halliday said there are no active plans to open a second site, but the county is working with the health department and homeless provider community on how to serve the homeless population during the pandemic, with expanded shelter capacity, access to testing and access to vaccines for eligible individuals.
