We Can't Reach Everybody

— 'The survival rate for people who are mentally ill and have alcohol or drug addictions is terrible," said Mike Milsop, who had been served with an eviction notice by the Shelter Plus Care facility on Streamview Drive in East San Diego. "We've had seven men die in less than four years that I've been here. It's not that they die on the premises. Sometimes they relapse and return to the bushes, where they get their heads bashed in."

Shelter Plus Care, a program of the U.S. Department of Housing and Urban Development, was funded in San Diego by the department with a $5 million grant in 2000. A welcome addition to the social services community, it is administered locally by the San Diego Housing Commission and Pathfinders, whose 54 years of residential treatment for alcoholism is the oldest in town. The program serves men who, at the time of entry, have been homeless for the equivalent of a full year, are mentally ill, and are alcoholic and/or drug addicted.

But when I talked to Mike Milsop last May, he alleged questionable management practices at the Streamview Drive facility. Milsop had filed complaints with Housing and Urban Development's Office of Inspector General, and in an April 7 letter, the office said that it would investigate the program.

"I started at the bottom," said Milsop, who thought his complaints had led to his June 30 eviction. "But Pathfinders, the Housing Commission, and the local Housing and Urban Development office ignored me. So I took it to regional HUD in Los Angeles. When they ignored me, I kept climbing the ladder all the way to Washington, D.C., where I got the Inspector General's attention."

Milsop's initial complaints to Pathfinders concerned wet spots and mold under dilapidated carpeting in his apartment and the denial to residents of garage spaces. He worried especially about the mold, since medication he takes for rheumatoid arthritis weakens his immune system. Several times in the past, bouts of pneumonia had required him to get urgent hospital care.

Facilities maintenance, however, seemed the least of Shelter Plus Care's problems. Milsop alleged that Pathfinders allowed several of its employees to live in apartments that should have gone to homeless men. And it relied on the residents it served to manage the Streamview Drive apartments. Milsop said he had not been paid for work he had done there.

Milsop, who is alcoholic and bipolar, was living on the streets in August 2001 when he sought help from Shelter Plus Care. By the following spring, he was performing the on-site managerial functions at Streamview. He took over the job suddenly, after the previous manager, Randall Dawson, suffered several strokes at the apartments one day. "The Pathfinders people claimed Randall had relapsed because of the funny way he was talking and staggering around," said Milsop. "They wanted to throw him out of the program."

By phone, Dawson told me that he remembered his pay for the managerial work being "about $120 per month." He said that several resident managers before him also got paid for working. "I liked doing the work a lot," Dawson said. "After I recovered from the strokes, I didn't know what to do with myself and went out and got drunk. It was my fault. But the program ended up treating Mike Milsop in a very shabby way."

Early this year, Milsop filed a complaint with California's labor commission alleging that Pathfinders owed him $400 a month in unpaid wages over a three-year period, for a total of $14,400. After a May 27 hearing, the commission ruled that it could do nothing about the problem and that Milsop would have to seek federal help since the work he had done was for a program funded by the U.S. government.

In a September 1, 2004, letter of recommendation, Richard Burtz, who is the director of the two local Shelter Plus Care facilities, itemized the tasks Milsop had been performing. "He monitors...daily routines and conformance to resident guidelines," wrote Burtz, "helps facilitate groups, tracks residents' appointments, shuttles residents to meetings and activities, helps newcomers in their orientation and access to social services, monitors building maintenance needs and services and reports pertinent information to staff."

Especially in the beginning, said Milsop, "I didn't know what I was doing. I had no training." Yet in his work capacity, Milsop eventually received from Shelter Plus Care intimate details about at least 25 of his fellow residents. Other resident employees and volunteers had received the same information. Milsop showed me a list of program participants living at both the Streamview facility and the second Shelter Plus Care residence facility, which is on Grimm Street in North Park. Next to each name were several items of personal information, including financial sources and social security numbers. Another list displayed the psychoactive medications that each resident was supposed to be taking.

Milsop managed the records of resident Bob Dietrich, and the two later became friends. Milsop said he noticed that Dietrich's rent was being covered by several different sources, eventually provoking him to include misappropriation of funds in his complaints to the Inspector General. Dietrich picked up the story, saying that the San Diego County Serial Inebriate Program ordered him to enter Shelter Plus Care in 2000 or else go to jail. He thought the Serial Inebriate Program paid all his rent but that Housing and Urban Development was kicking in too. For food, Dietrich said he relied on general relief checks of $150 a month. But Shelter Plus Care, he says, took $48 of that as well. "I had to go out," he said, "and scrounge around for food in Dumpsters and other places like I did when I was homeless."

Burtz, the program's director, said that Housing and Urban Development requires that 30 percent of any income Shelter Plus Care residents receive be used to pay for their housing.

Milsop also challenged a Shelter Plus Care promise that each of its residents would receive personal "case management." No one from Pathfinders even made a hospital visit to a resident who had to have cancer surgery, Milsop said. "What kind of case management is that?"

Does the program contract with psychiatric social workers to monitor residents? "No, I do it all myself," said Burtz, going on to indicate that he was responsible for monitoring sometimes more than 30 residents.

"But not all the time," said Milsop. "Burtz has hung up on me when I've called him on weekends. Then I ended up taking the guys who get suicidal to the crisis center by myself."

Burtz works out of an office at the Grimm Street facility. He is a California-certified alcohol and drug-abuse counselor. Burtz admitted that "suicidal ideation is not uncommon among alcoholic and drug-addicted men, especially when they are also mentally ill. They might go off their medication, or its effects start to wear off, making the dosage wrong."

But the case management that Shelter Plus Care provides is substantial "to the degree that residents accept it," according to Burtz. He cited referrals he makes for residents to vocational training programs at San Diego City College and the Regional Occupational Program. He said he makes sure they get appropriate medical attention and mental health assistance through such facilities as UCSD's Gifford Clinic. And he collaborates with the Solutions Consortium and St. Vincent de Paul's How to Live program.

In early June, two months after the Inspector General's office opened its investigation, Milsop finally received answers to complaints he had first made in December 2002. The letter denied the legitimacy of the complaints about Pathfinders' staff living in quarters earmarked for program participants and about withholding case management services from tenants. The letter did not respond to Milsop's allegations of fund misappropriation.

Although Burtz said he could not comment on the case histories of individual residents, he clearly was frustrated with Milsop, Dietrich, and others who had complained loudly in the past. "You have to understand," he told me, "where these people are in life. We can't reach everybody. It's too bad."

"The Pathfinders people ask us," said Milsop, " 'Where's your gratitude?' And they say our complaints stem only from alcoholic resentments." The Big Book of Alcoholics Anonymous, which inspires regular early-morning meetings at Streamview, maintains that resentments are the greatest incitements for recovering alcoholics to drink again.

The last point addressed in the June 3 letter Milsop received from Housing and Urban Development concerned a claim that his eviction was unfair. The letter cited Milsop's relapse into drinking as the real reason for his eviction, not retaliation over his complaints, as he contended. Milsop admitted that he had relapsed but claimed he recovered quickly and had remained sober since then.

Bob Dietrich, contacted last week, said that Milsop challenged his eviction in superior court and lost. Dietrich believed that after Milsop was evicted, he left San Diego to live with family members in Lake Tahoe. Dietrich has not heard from his friend since.

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