The streets are no place to die

The streets are no place to die

By: Craig Dresang, CEO

Earlier this year, one of YoloCares’ sister hospices received a call from a hospital discharge planner who asked if they were equipped to provide care for a homeless woman named Mary. Mary was being released from the hospital with an especially aggressive and incurable form of cancer that had spread to her lungs, liver and bones.

Mary wasn’t always homeless. She was a longtime favorite waitress at a family-owned restaurant in South Natomas where she earned just enough money to pay her rent and a small pile of monthly bills. Living lean was challenging but doable. Then, COVID-19 swept across the globe, putting both lives and livelihoods at risk.

When the restaurant closed during the earliest days of the pandemic, Mary thought she could find other work, however, most businesses were struggling just to keep their current staff employed. The idea of hiring new staff was off the table, especially in the restaurant industry.

Not long after Mary was laid off, she began feeling overly tired and too weak to continue a job search. She thought her symptoms could be the result of depression, so she scheduled an appointment to see her doctor. After a series of tests, procedures and appointments with specialists, her medical team was faced with delivering exceptionally bad news …  stage-four breast cancer. 

It was not long before Mary could no longer pay her rent and became too sick to search for work. Her landlord sold the building she lived in, and the new owner gave notice that she and all the other tenants would need to leave. Left with no other options, and feeling completely helpless, Mary found a place underneath a giant oak tree near the American River to spend her nights and to rest during the day.

This seemed like a cruel fate for a previously hard-working woman whose family had lived for three generations in the Northgate community of Sacramento. The neighborhood was her home and her life, yet there was no safe or comfortable place for her to be when she needed a safety net for her final days.

Providing care for someone in a tent along the river or underneath an overpass is impossible. So, the hospice’s first order of business was to find Mary safe housing so that she could receive care. Unfortunately for Mary, the hospice could not find options soon enough. Just weeks after her release from the hospital, she was found dead near a parking lot on Truxel Avenue. Sadly, it was a group of 12-year-old children who discovered her body.

Mary’s story is not unique. In Sacramento County, an unhoused person dies on the streets every two days. On this side of the causeway, in Yolo County, homelessness has increased nearly 14 percent since 2019. When YoloCares receives a referral to care for a person who is unhoused, the care team must find the patient a facility to live in before care can be provided. Placing unhoused patients is no small feat.  Routinely, staff spend hours or days convincing (sometimes pressuring) facilities to accept unhoused individuals. If and when the person is placed, care can be provided in an environment that is safe and comfortable for the otherwise unhoused patient.

Recognizing this unmet need for folks who are both unhoused and terminally ill, the YoloCares Board of Directors recently voted in favor of accepting ownership and operations for Joshua’s House in Sacramento. However, YoloCares will not take over until the project is finished and paid for. Although not yet open, Joshua’s House will become the West Coast’s first and only residential program for unhoused individuals who qualify for hospice care. Lawmakers and healthcare leaders have indicated that Joshua’s House may become a model for other California communities.

After seven years of fundraising and building city support, Marlene von Friederichs-Fitzwater, a former professor at the UC Davis School of Medicine and founder of Joshua’s House, says the facility should be open by the end of 2023. To date, she has raised more than $2 million which has covered the cost of building six three-bedroom modular homes. The homes will be placed on leased city of Sacramento property near the intersection of Truxel and I-80. Although the city has agreed to a 50-year no-cost lease, Joshua’s House will need to pay annual property taxes. 

Construction crews began site work this month to lay foundations, hook up utilities, create parking lots, install fencing and lighting, and begin landscaping. The property will be a gated community with 24/7 security and around-the-clock staff seven days a week.

Von Friederichs-Fitzwater selected the name Joshua’s House in honor of her grandson Joshua who died while living on the streets in 2014. She describes him as “extremely smart and very loving.” Her own personal experience, along with 30 years of teaching and public service led her to this project. At Sacramento State and UC Davis School of Medicine, she taught health communication and trained medical students. She also founded a nonprofit called the Health Communications Research Institute, dedicated to reducing health care inequalities.

“I have learned much from my interviews with hundreds of unhoused individuals in Sacramento,” says Von Friederichs-Fitzwater. “For almost all of them, their greatest fear is dying on the street and vanishing off the face of the planet as if they never existed. That was disturbing. They all want to spend their final days in a place where they will be loved and comforted and cared for.”

To get involved, or for more information on Joshua’s House, contact Chris Erdman, director of Joshua’s House and the Center for Loss and Hope at YoloCares: 530-758-5566.