In an effort to limit the spread of hepatitis A among homeless people, four temporary toilet and handwashing facilities will be installed at some of the larger encampments in unincorporated Los Angeles County.

The Board of Supervisors unanimously approved the effort Tuesday after learning there were 222 homeless encampments identified across the County. In addition, officials with public health and the Los Angeles Homeless Services Authority conducted almost 880 surveys. After determining that encampments with 30 people or more needed toilets and handwashing facilities, sites in Palmdale, West Athens, Lennox, and West Carson were chosen.

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“We found that with no exceptions, that there was a need for either more handwashing facilities and toilets or more access to the handwashing facilities and toilets that were there,” said Dr. Barbara Ferrer, Los Angeles County public health director.

Ferrer said the toilets and handwashing facilities needed to be open for 24 hours, seven days a week, and would likely be available for six months, which is the time she and other health officials estimate the current hepatitis A outbreak will have concluded.

There have have been calls from the skid row community for years for more working toilets, sinks and showers in their community. A report this summer called “No Place to Go,” found that from 9 p.m. to 6 a.m. on skid row, there are nine public toilets available for 1,777 unsheltered homeless people.

“Even counting these nine public toilets, skid row is short of the United Nations sanitation standard by 80 toilets,” according to the report released by the Los Angeles Central Providers Collaborative.

“We found it’s not simply a question of the number of toilets but accessible toilets,” said Greg Spiegel, director of strategic initiatives at the law center during Tuesday’s Board meeting. “Functional means it has to flush. It has to be safe and it has to be private.”

RELATED STORY: LA County declares its own hepatitis A outbreak; 10 infected include homeless

The issue of access to toilets and handwashing facilities came into sharper focus in September as a result of the hepatitis A outbreak that that has sickened 544 people and killed 20 in homeless encampments within San Diego County. In Santa Cruz County, 76 people, also within homeless encampments, have been sickened with the liver disease. Hepatitis A can be spread person-to-person through close contact or through contact with environments contaminated with feces.

An outbreak was declared in Los Angeles County in September. As of Monday, there were 32 cases reported and no deaths. Of those, 15 cases appeared to be among homeless people and 17 among gay men who are not homeless.

Tuesday’s vote on a motion authored by supervisors Hilda Solis and Mark Ridley-Thomas also directs several county departments to look into adding mobile shower units, as well as partnering with cities to increase the number of hygiene centers.

“The good news is, through our efforts, we’ve been able to keep our infection rate low,” Solis said of the public health department’s efforts to provide free hepatitis A vaccine. “Lets’ try to stay this course in order to keep these numbers low. We need to stay on track. We need to continue our efforts on all fronts ”

Ridley-Thomas said expanding hygiene facilities help people gain dignity.

“Fundamentally, we’re speaking the language of dignity and support for those who are homeless,” he said. “We are duty bound to attend to this with the kind of care it warrants.”

This story has been amended to reflect the proper name of the Los Angeles Central Providers Collaborative.