Issue:  Vol. 48 / No. 11 / 15 March 2018

City panel to review homeless deaths


A man sleeps on Noe Street while a sidewalk art sale goes on in the background. Photo: Rick Gerharter
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San Francisco officials are working to establish a homeless death review committee. The project comes as a transgender person died recently in front of a Castro neighborhood coffee shop.

Bevan Dufty, who serves as director of Housing Opportunity, Partnerships and Engagement for Mayor Ed Lee, said, "for the past several months, I've been on a mission" to restart the committee, which had existed several years ago in the city.

One of the aims of the panel would be to examine the deaths of people like Anastasia, who was found dead December 31 in front of Peet's Coffee, 2257 Market Street, to see what contacts they'd had with service providers, and what may have been done to prevent the loss.

"I believe her tragic death can be a rallying point to make sure we don't leave people behind," Dufty said.

Anastasia, who was well known in the neighborhood, had refused numerous offers of shelter and other services, according to people who knew her, even though many people said she'd appeared to be in declining health before she died.

The city was experiencing a severe cold snap at the time Anastasia was found. The medical examiner's office isn't likely to publicly release the cause and manner of her death for several months. Officials have not indicated there were any signs of foul play.

Sam Dodge, who in November joined the HOPE office as deputy director, said his goal is to make the committee "relevant for successfully preventing death and moving people into more stable places, out of homelessness and into care" or housing.

Dodge said either he or Dufty would represent the HOPE office on the committee, which would also likely include the medical examiner's office and other city agencies.

One aim would be for medical examiner's staff to provide information to homeless outreach workers so they can "immediately" respond to the location where the person died and see if people who knew the subject need help, he said.

In cases where the person died of a drug overdose, for example, if the people around them were also using drugs, "maybe they're ready to reconsider their use," Dodge said. "... It creates an opening that could be well used by the outreach team to talk with people about their options and provide support."

The next step, he said, would be quarterly reviews of medical examiner's data involving homeless deaths and looking for trends, or areas that may need improvement.

For example, Dodge said, if there had been three homeless deaths in the review period, and those people had bracelets from the emergency room indicating they had recently been discharged from the hospital, "we could convene a case study on these three."

Emergency room workers and others could be brought together to ask "how did this happen?" and "see if maybe there's something we can improve on that point," he said.

In the case of a single death like Anastasia's, a review could include looking at "what happened? How many times was she reached by outreach workers? What were the offers that were being made?" Dodge said.

He said the third part of the committee's work would involve a report on homeless deaths that the health department is working on. Information collected from the medical examiner's office could be added to the health department's data, which may include information on people who died in the hospital.

"I'm looking to start the first two processes this month," Dodge said. "So far the medical examiner's been very encouraging," as has the homeless outreach team medical director. Dr. Barry Zevin, the medical director, referred an interview request to health department spokeswoman Rachel Kagan, who declined to comment since the panel is still "Being evaluated."

Dodge has sat on a homeless death review committee in New York, and he said he's also seen such panels work in Philadelphia.

"I have every reason to believe we can make it work here," Dodge said.

Dufty acknowledged that some of the reasons Anastasia may have declined help, and that people who have received assistance in the city have sometimes had bad experiences.

"Certainly there are ways in which services to homeless and mentally ill people don't always meet their needs," he said. Dufty said he didn't know what services Anastasia had refused, but "putting her in a traditional shelter was probably not going to work."

Many who knew Anastasia indicated she might have been mentally ill, saying that she often talked to herself unintelligibly.

Dufty said San Francisco previously had a committee several years ago, but the "medical examiner's office has had some peaks and valleys over the years, and this protocol was discarded." Dufty's comment was an apparent reference to leadership problems at the agency.

A call to the medical examiner's office about the committee being formed wasn't returned.


'She was freezing'

Barry Lawlor, 51, one of the last people to see Anastasia alive, said he put a blanket that he'd brought over her at about 8:30 p.m. December 30 as she lay on the bench in front of Peet's.

"She was freezing," said Lawlor, who had frequently seen her around the neighborhood. "She was totally cold, and a little out of it."

However, he said, when he asked her if she was warm enough, she said, "Yes." He added, "She seemed like she could mange. ... She didn't seem like she was on death's doorstep."

Lawlor, who's director of community health and clinics at St. Mary's Medical Center in the Haight district, which sees many people who are uninsured, said the homeless death review committee "would be really helpful."

"We want to be a part of the solution," he said, and "to make sure no one, homeless or not, is ever disconnected from care."

Many who knew Anastasia use feminine pronouns when referring to her and have indicated she was likely transgender, although it's not clear if that's how she self-identified.

A staffer at the medical examiner's office, who referred to Anastasia as "she," said that the name his agency has for her is Theodore Walton. He said she was 50 years old and had "no fixed residence."


City seeking volunteers for homeless count

In another homeless initiative, the city is seeking volunteers to help with this year's count of homeless people, which requires people to walk or drive for one or two assigned routes in pairs or groups of three. The federal Department of Housing and Urban Development requires the census for providing funding. The Point-in-Time Homeless Street Count takes place January 29 from 8 p.m. to midnight. Volunteers are most needed in the Sunset and downtown locations. Anyone over 18 is welcome. To register, go to

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