The waters from a burst pipe earlier this year at Father Joe’s Village Health Center have long since receded. The damaged exam rooms, administrative offices, dental clinic, laboratory and other areas have been repaired since July. Today, the unhoused people the clinic serves fill the waiting room of the reopened center. 

However, something still feels amiss. Since the city’s crackdown on homeless encampments, the men and women the staff were accustomed to seeing no longer take up the nearby sidewalks with their tents and scant possessions. It was as if they had vanished.

“Driving around, we’ve seen normal locations of where homeless people stayed closed out,” said Jennifer Wilkens, supervisor of outreach at the health center. “It’s difficult to provide follow-up. Some will call us and say, ‘Hey, I’m over here now.’”

The outreach team uses a van to carry medical and hygiene supplies, clothing and food among other essentials to address immediate survival needs. The team includes a case management specialist, a nurse, a medical assistant and a drug and alcohol counselor. A psychiatrist goes out on Mondays.

“We do a lot of wound care and prescription refills,” Wilkens said. “Abscesses, broken fingers from fighting, infections, scabies, you name it.”

Last month, the outreach team saw homeless people being cleared from three camps.
“When an area is being cleared out there is much too much going on for them to engage with us,” Wilkens said. “They are moving their stuff from street to street, trying to avoid being arrested. Sometimes, when we don’t know the streets are being cleared, we’ll go out the next day and we’ll have no idea where  they are or where they went.”

Clinic director and registered nurse, Mary Jo Scarpitti, wonders where some of the homeless people she used to see have gone.

“We had people all around the facility and now we don’t,” Scarpitti. “Being close to resources here was a safe place for people. I can say people aren’t as accessible for our outreach services.”

The clinic sees about 30 or more patients a day, she said. Many of them have substance abuse disorders. The clinic provides medication-assisted treatment to help clients recover from addiction.  

“It takes a lot out of you seeing people struggling,” Scarpitti said. “We respond to overdoses. What we do is really challenging. We’re a scrappy bunch but we see a lot of things on a daily basis that most people never see. We see men and women that society can sometimes shut its eyes to.” 

The health center, Scarpitti said, will pay attention to the impact of the street sweeps. “Walking to our car every day we knew the person right there, have a good night so and so and now they just aren’t there,” she said. “Where do they go?”

The health center is one of a few Father Joe’s facilities that has struggled with maintenance issues in a strained system. After the center reopened in July, Voice of San Diego revealed the Housing Commission is closely monitoring four Father Joe’s city contracts which have faced client complaints and maintenance issues. In addition, the San Diego Housing Commission officials found that the region’s largest homeless service provider had barred a disproportionate number of Black people from receiving services.

In a statement, the shelter provider said, “Though rare, there are times where Father Joe’s Villages must suspend or debar a client’s access to services at our shelters and other facilities. This occurs when clients behave in ways that threaten the health and safety of others at our facilities, such as physical battery, sexual assault, attempted kidnapping, arson, drug sales and threats of serious violence or mass murder.”

Father Joe’s said it is committed to working with the housing commission to address the large number of Black clients suspended from accessing services. The controversies come as the city begins implementing its crackdown on camp sites in many public areas.

Lister Lane, a formerly homeless man who has been coming to the health center since 2018, believes the amount of time clients have been homeless will impact their lives far more than street sweeps. A stint in jail and subsequent health problems, he said, put him on the street off and on for 20 years. 

“I had heart problems, kidney problems, thyroid problems, you name it,” he said. “This place saved my life.”

He now lives in Benson Place, a former motel developed into affordable housing by Father Joe’s Villages in partnership with the Chelsea Investment Corporation. He continues to attend support group meetings at the health center and sees a psychiatrist.

Life on the streets, he said, is hard but some people struggle to adjust to an alternative.

“After I got off the street, the hardest thing to do for me was to follow rules and stay inside,” Lane, 64, said. “I wanted to roam. That’s what I knew.”

Parissa Baiera, the dental director at the health center, doesn’t know how the sweeps will affect her clients.

“I haven’t noticed much of a change yet,” she said. “But I feel the patients are going to be more irritable because I don’t know where they will move on to.” 

The dental clinic includes two dentists, three dental assistants and a hygienist, and sees clients Monday through Friday. They provide full exams for adults and children. 

“Homelessness is devastating on the body and the teeth really take a toll,” Baiera said. “We tend to see a lot of toothaches and they have to have a tooth pulled or a crown put in or a root canal. We also make a lot of dentures.”

Much of the problems homeless people face with their teeth, Baiera said, result from the priorities they set. For many, those priorities focus on food and shelter. Their health, dental and otherwise, becomes secondary.
“They let their teeth go because they are on survival mode,” she said.

Baiera sees a big difference in her patients when they start seeing a dentist. With their teeth fixed, they can do what most people take for granted: chew food, get a job and talk better.

“I think it’s night and day in how they see the world,” she said. “Patients with a plan to fix their teeth and in particular get dentures seem to be the most motivated.”

Baiera hoped the removal of tent cities does not disrupt plans her patients have for their healthcare.

“Just like with COVID,” she said, “I feel people will get more agitated because they are being pushed into corners. It’s too early to tell but that may be where I think it might be headed.”