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very night, some 43,000 people sleep on the streets of Los Angeles County in tents, cars and makeshift structures. So why do thousands of beds run by the biggest homeless agencies go empty at night?

A KPCC investigation found reports of bedbugs, rats, foul odors, poor lighting, harassment, lax care in medical wards and even a "chicken incubator" in a room where homeless people were sleeping.

Public documents -- including monitoring reports from the Los Angeles Homeless Services Authority (LAHSA), health department inspections, coroner reports, surveys from the Department of Mental Health and police reports -- reveal safety and sanitation problems in shelters around the county.

Reviews conducted at 60 shelters funded by LAHSA last year found more than half -- 33 -- were not filling all of their beds. Overall, LAHSA-funded shelters had a 78 percent utilization rate, well below the 90 percent required in their contracts. Monitors also found that 25 of those facilities were failing to meet the minimum standards required by their contracts to get people off the streets for good.

KPCC found that negative monitoring reports, health citations and grievance complaints rarely result in a shelter being shut down.

Some shelters raise philanthropic dollars on their own to improve living conditions in their buildings. Those that don’t receive public dollars operate with little to no public accountability at all.

The lack of accountability for meeting quality and service benchmarks raises questions about what taxpayers are paying for with the hundreds of millions of dollars in Measure H funding now flowing through LAHSA and other public agencies.

Who is looking out for the people officials say they are trying to help?

There are about 16,600 shelter beds in L.A. County. They’re almost always run by private nonprofit and faith organizations. Many have contracts with federal, local, and state government agencies that pay for beds for mental health clients, veterans, and other populations they serve.

The result is a patchwork system of oversight. No single public entity is charged with making sure shelters are clean, safe places to stay.

LAHSA officials told KPCC the agency has plans to improve shelter quality in L.A. The status quo, however, is not pretty.

Rats, Roaches, Bedbugs, Mold

Craig Aslin tried the whole homeless shelter thing, he said.

Specifically, he tried The House of Hope, a boarding home in Jefferson Park.

“It sucked,” he said. “I got [eaten] up with bedbugs.”

So Aslin left and ended up in a tent on a hilly median off Franklin and Vine in Hollywood. Why? He says his tent is cleaner, he doesn’t have to deal with people he doesn’t like, and he can come and go as he pleases.

“I live better now than I did then, I mean for real,” he said.

A 2017 public health inspection of The House of Hope, the shelter Aslin left, did not find bed bugs. It did find 17 other health code violations, including evidence of rats, roaches, suspected mold and issues with waste storage and disposal.

The public health department said it does follow-up inspections and sends compliance letters to shelters. It does not, however, shut shelters down.

“If compliance is not met, enforcement proceeds to the city or district attorney requesting a criminal complaint,” the public affairs department said in an email.

The House of Hope is one of many emergency housing options in the county that does not rely on government dollars; that means it’s operating with very little in the way of oversight.

Even in shelters that do receive public dollars, complaints of unsanitary conditions, vermin and pests are common.

At a shelter run by Volunteers of America on Skid Row, LAHSA monitors found “water leaking from the walls and underneath the toilets” in the bathroom, toilets that were “not secured,” and a broken, leaking faucet.

Another VOA shelter in South L.A. was found to have visible damage on floors and the walls and ceilings.

One center also did not have grievance forms for clients to complain about its conditions -- a requirement of its contract.

Orlando Ward, executive director of external affairs at the VOA-Greater Los Angeles said the organization has made improvements after having recently taken over the shelter space from another organization.

“We house close to 400 people between the two shelters,” he said. "As you can imagine with such high traffic numbers, maintenance and cleaning was and is a resource-intense undertaking."

Sanitation, he said, has improved in the past year. And new funds from Measure H have helped the organization make changes in its shelters, including staying open 24 hours a day and offering more services on site.

At the Russ Hotel in Downtown L.A., a Department of Mental Health client reported bathrooms that were “trashed daily” with toilets that “don’t flush.” Another client reported cockroaches.

A client at the Testimonial Community Love Center in South L.A. complained of cockroaches in August 2017.

In an L.A. Family Housing Shelter, LAHSA monitors found “unacceptable conditions” and “a lack of supervision over rooms.” In one Boyle Heights shelter, monitors found the “walls were covered with Crayola and/or marker writing” and a chicken incubator. Another room was “extremely dirty.” A third had “foul odors” coming from it.

L.A. Family Housing has since cleared those complaints with the agency.

Eve Garrow, who works on homeless issues for the American Civil Liberties Union, said she’s heard complaints of homeless people getting sick in shelters with body lice, head lice and other communicable diseases like MRSA, an infection that is resistant to treatment with many antibiotics.

“Mold in the bathrooms, blood on the walls, just a variety of issues that are really unacceptable,” she said. "People with disabilities may try to use shelters and very quickly decide they’re unable to manage their mental health conditions in those shelter spaces."

'Dangerous as Heck'

Lorenna Taylor went to Samoshel, a Santa Monica shelter that resembles a large tent, in 2016 after having neck surgery.

Almost immediately, she said, another client harassed her. The woman, Taylor said, would follow her to the bathroom and started telling other people in the shelter Taylor was actually a man.

“I would have left, but I could barely walk,” she said.

She complained to staff, but “they told me, you need to be the bigger person,” Taylor said.

Eventually, there was a physical altercation between the two of them outside of the shelter. Neither woman was convicted of a crime in a subsequent court case. But Taylor said the entire experience left her with trauma.

“There’s no safety,” she said.

Living in close quarters can breed conflict, said John Maceri of The People Concern, which runs Samoshel. He said his staff intervened multiple times in Taylor's case.

Many homeless people told KPCC they were victims of theft, harassment and even assault by other clients in shelters, and that staff were either indifferent to or untrained to handle the conflict.

“The shelters are dangerous as heck,” said Pepper Pilar, who rides a bike covered with Dr. Pepper stickers around Hollywood. “At least out here I have friends to watch my back. In there, they [will steal] your stuff.”

Los Angeles Police Department records show that some shelters are visited frequently by officers. A VOA shelter on Broadway in South L.A. had 138 LAPD visits between Jan. 1, 2017 and the end of April 2018. Another VOA shelter had 197 visits.

“The LAPD visits are largely due to client crisis situations as well as calls from shelter staff when client safety is compromised,” said Ward of VOA. “Some would argue that is better that people experience trauma at a staffed facility than on the streets where the outcome is less predictable.”

'No One Noticed'

Safety and violence are just one concern about quality of care. Former shelter residents also told KPCC they didn’t have faith in medical services.

Andria McFerson, a former Samoshel resident, said that clients in the “medical ward” -- where people with severe medical needs are housed in proximity to a staff nurse -- are not checked on regularly.

“My friend died there and no one noticed,” she said.

Her friend was Charles Waldron, a Vietnam War veteran. An L.A. Coroner’s report found that he died of a heart attack at the shelter on Jan. 24, 2016.

Waldron was staying in the medical ward, a room with six metal twin-sized beds. He’d been at the shelter about seven months.

“Staff saw decedent on 1/23/2016 around midnight in the common area of the shelter,” the report said. At noon the next day, “staff discovered the decedent unresponsive and dialed 911.”

Paramedics, who found Waldron with red foam coming out of his mouth, beyond resuscitation, pronounced him dead 11 minutes later.

Maceri of The People Concern said it’s not unusual for clients to skip a meal. He said Waldron’s medical needs were not severe enough where he needed to be checked by medical professionals daily.

“There would not have been a medical reason to force Mr. Waldron to wake up from what staff assumed was him sleeping in after being up late the night before,” he said.

The coroner’s report described his corpse as in the stage of “early decomposition.”

No Recourse and Fears of Retaliation

Other homeless people said shelters didn’t work out for them because they were told to leave, often after running into problems. And they said they had no recourse.

Robbin Nugent was kicked out of Samoshel in March after not showing up at the shelter for 68 of the 170 days she was a client. If she wasn’t going to use her bed, the program told her, they’d need it for someone else.

The problem: her boyfriend, with whom she’s four months pregnant with twins, was also homeless. He’d just graduated from a drug rehab program and was back on the streets.

“If I wasn’t with him at night, I think he would mess up,” she said.

So she left the shelter to stay with him.

“They were like, ‘What’s it going to take to get you back into the program?’ And I was like, ‘Get him off the street!’” Nugent said. “It’s my babies’ dad. If he messes up, then all things go to hell.”

She said Samoshel told her they didn’t have room for him and didn’t offer any referrals to shelters that might.

Nugent, still pregnant, and her boyfriend are now staying in a tent in an alley behind a Santa Monica restaurant.

Maceri said clients are expected to use their beds the majority of nights they're in the program and that shelter "staff spent nearly six months attempting to work with Ms. Nugent to help her be more comfortable in the shelter."

The decision to kick someone out of a shelter should be subject to outside review, said Olga Zurawska.

Zurawska, a filmmaker who found herself homeless several years ago, said she herself was kicked out of Turning Point, a Santa Monica shelter, in 2016.

Now an activist for the rights of homeless people, she said she was targeted for speaking up about shelter quality issues.

People Concern, which runs the shelter, said it helped place her in permanent housing and that her allegations are untrue and have been thoroughly investigated by multiple agencies, which found them to have no merit.

Zurawska said behind the dispute about her stay at Turning Point is a bigger issue: there wasn’t an outside body to step in and provide a neutral assessment.

It goes to the patchwork nature of oversight in an industry -- homeless services -- that is growing rapidly. Because the shelter she stayed in didn’t receive LAHSA funding, the grievance she filed with the agency bounced back. Turning Point did receive Department of Mental Health funding, but Zurawska was not a mental health client. That meant she did not have recourse with that agency. Eventually she complained to the city of Santa Monica, which helps fund Turning Point, but she said that was a dead end.

Alisa Orduña, Santa Monica’s senior adviser on homelessness, said complaints about the shelters it funds are taken seriously. But first clients are required to exhaust whatever internal complaint system the shelter has before turning to the city.

Zurawska said the grievance process was confusing and hard to navigate.

“This population has no rights and no voice, really, and somebody has to do something about it,” she said.

Garrow of the ACLU agrees that clients need an accessible, visible, neutral third party to appeal to if shelters are going to be more effective going forward.

“Staff really have too much power over clients and clients really have no recourse when staff treat them in a denigrating or disrespectful manner other than to submit a complaint to the very organization that’s mistreating them,” she said.

For its part, LAHSA, which administers the majority of homeless service contracts in the county, does not have a uniform policy on when it is appropriate to terminate a client from a program.

The agency does review each shelter’s policy, if it funds the shelter, said Chris Callandrillo, director of procurement and performance management. It does not have reliable data on how many people are kicked out of shelters.

Shelters Do Improve, When They Want To

A startling claim was buried deep inside a client satisfaction report filed on Jan. 5, 2018 by a Department of Mental Health client.

The client gave the shelter run by the nonprofit L.A. Family Housing largely high marks when asked whether to agree or disagree with statements like, “I have generally positive interactions with staff” and “I receive toiletries when I need them.”

Then in the comments section, the client wrote: "Someone got stabbed in their room. This place feels like a jail with an open door."

Stephanie Klasky-Gamer, the president of L.A. Family Housing, confirmed the stabbing.

“It was an incredibly sad — and scary — but sad day here,” she said.

It was also a learning opportunity. The shelter switched security companies -- bags were already searched and people searched with a wand on entry, but a knife had gotten in.

The agency also revamped its procedures for checking clients, from “every person, every day,” to “every room, every day” -- meaning staff members now need to enter every room on the property on a daily basis to check on clients.

“It also allowed us to see things that were getting in that shouldn’t have,” she said.

None of those changes were required by the myriad agencies that monitor L.A. Family Housing: the Veterans Administration, LAHSA, the L.A. County Department of Mental Health, L.A. County Department of Health Services, several individual cities and the U.S. Department of Housing and Urban Development.

Other shelters may also want to improve, she said, but might not have the expertise or resources to do so.

“I would not say that any of our colleagues don’t care,” she said. “I think when you have really limited resources, there are places you cut back.”

Klasky-Gamer said auditors visit the shelters roughly three times a week, generally performing one of three types of check: financial audits, programmatic audits and physical audits. There’s so much monitoring that the space-crunched agency even has a room dedicated to files in its main campus building in North Hollywood.

She said she wishes one agency was tasked with taking the lead on auditing.

"But I don’t begrudge oversight," she said. "These are public dollars and this is a public benefit.”

Some major issues are not addressed, however, in all the monitoring.

LAHSA reports do not directly address safety issues beyond emergency evacuation plans, fire extinguishers and cleanliness. The agency said it requires shelters to report incidents of violence and then passes that information to whatever entity -- like the city or county or federal government -- that funds the shelter’s contract.

Orlando Ward of the VOA said the decentralized system for regulating shelters can be frustrating.

“We may suffer from not only a lack of a uniform set of standards, but differing levels of accountability and, in some instances, a lack of direction,” he said.

New York City, Philadelphia and San Francisco have “cabinet level” officers dedicated to addressing homelessness, he said, which helps them organize and build a common mission and set of best practices.

L.A. has nothing comparable. There's more coordination than ever before in L.A., but not enough.

“We still must build a common vision with 15 council districts, a mayor and five county supervisors,” Ward said.

Callandrillo said such a system would be hard to reproduce in decentralized Los Angeles, with its numerous municipalities, multiple funding sources for shelters and wide geography.

“With the small city of San Francisco, it’s doable,” he said. “Within a region like L.A. County, which is 400 square miles, it’s just not a manageable model. And to do it regionally, like we do other services, would probably cost a lot of money.”

It’s unclear what it takes for a shelter to lose its contract with LAHSA, which works with dozens of agencies. Callandrillo said that it’s happened three times in the past four years. Even as thousands of beds sit empty, the overall number of available beds is too small to risk losing them.

“Typically a shelter provider owns the site or holds the lease for a site, so if we’re cancelling a contract, often we’re cancelling the availability of shelter beds in an environment where we have very few shelter beds,” he said. “We try to work with our providers to not have to do it.”

Callandrillo said the problem of unused beds is “systemic,” and less about an individual shelter than how people get and find beds.

“It’s not for lack of need,” he said. “One of the main issues is connecting people to available shelter beds.”

A person might walk into a shelter in Santa Monica that’s full, while across town, there’s an available bed.

LAHSA is working on a way to better track available beds so that providers can immediately direct clients to them, Callandrillo said.

He said LAHSA has posted a position to create that system, but has not hired for it yet.

What Happens Next?

As these conditions persist, the push is on to rapidly expand L.A.’s shelter system to accommodate a growing population of homeless people -- all amidst a housing market that makes the region’s larger goal of finding everyone a long-term, affordable place to live more challenging by the day.

L.A. County and the city of L.A. -- through Proposition HHH and a new developer fee for affordable housing -- are putting hundreds of millions of dollars into the construction of permanent housing. Providers, however, are still struggling to find enough spots for clients, and construction will take time.

In the meantime, L.A. Mayor Eric Garcetti has proposed funneling $20 million in city funds into creating “temporary” homeless shelters in each of the city’s 15 council districts. A neighborhood that accepts a shelter, in turn, has been promised additional sanitation resources and police attention to ensure that it stays free of encampments.

"Every homeless Angeleno needs a safe, clean, place to sleep at night," Anna Bahr, the mayor's deputy press secretary, said. "Each new site will have unprecedented service delivery: 24/7 security, mental health professionals, employment specialists, and anti-addiction experts. The mayor’s office will be monitoring each site closely, to ensure they remain safe and clean.”

L.A. County is also poised to shift more funds from Measure H, a new quarter-cent sales tax for homeless services, into interim housing like shelters.

LAHSA has recently upped the rate it pays shelters to improve quality. That money is intended to fund more robust services and amenities on site -- what the industry calls “bridge housing.”

It’s a key change if the goal remains finding permanent housing and jobs for as many of the region's homeless people as possible.

The move appears to have merit. LAHSA figures show that for the past year, about 39 percent of those in bridge housing have moved on to permanent homes. For those in traditional shelters, the number was 17 percent.

About 2,000 clients were in bridge housing during that period, while 12,000 lived in standard shelters. In all, close to 60,000 people lack permanent housing in the county.

The ACLU’s Garrow says the goal of getting people back on their feet and into permanent housing is not easy. That makes conditions in shelters that much more important.

“The promise is that they’re temporary, but so often it’s a broken promise,” Garrow said. “We have to ensure that shelters are humane and held to the highest possible standards because people will be living in them for a long time.”

Alex Derosier contributed to this report. This story was made possible with help from the Fund for Investigative Reporting. Support was also provided by the Corporation for Public Broadcasting, which is supporting an investigative reporting collaboration among KPCC, WNYC in New York, WABE in Atlanta, KCUR in Kansas City and APM Reports.