1-stop facility might stem the overuse of ambulances

Question: There is a homeless man who stays in the small park across from my apartment building. It’s very sad, but also frustrating because an ambulance is called to assist him so often. … Once the ambulance arrives, he usually tries to wave it off or accepts only minor treatment. Occasionally he gets in and goes to the hospital and is back a few hours later. The cycle repeats. There’s got to be a better way. Is anyone looking into this? … Please do not consider me callous for asking. I am concerned about him but calling 911 isn’t the answer.

Answer: Yes. Overuse of emergency medical services by homeless people on Oahu has long been recognized as a problem and is part of what’s driving a concerted effort to consolidate housing, medical and behavioral health services at a one-stop facility in urban Honolulu.

“The city’s Emergency Medical Services reports the homeless have overwhelmed its ambulance services. One EMS worker estimated that paramedics sometimes transport 12 homeless people to the hospital in a 12-hour shift, often for minor ailments and other non-emergencies that do not warrant use of ambulance services,” states a recent audit of city programs serving Oahu’s homeless. The 74-page report, which you can read at 808ne.ws/homelessaudit, was issued in September by the Office of the City Auditor.

The audit said The Queen’s Medical Center, for example, had cared for homeless patients 10,126 times in 2015, resulting in gross charges of $89.3 million. “Medicare and Medicaid picked up some of the cost, but Queen’s calculates it absorbs about $5 million in unpaid homeless expenses each year,” it said.

Queen’s is among the government and private-sector groups spearheading a plan to transform a four-story city building in Iwilei into a one-stop facility for homeless services, to include 24-hour urgent care, rapid detox, wound care and room for some patients to stay up to 30 days for treatment, according to a story by Honolulu Star-­Advertiser reporter Kristen Consillio published Aug. 28 (808ne.ws/iwileihub).

The group hopes to open the hub next year but must raise several million dollars to do so.

Q: I was listening to a discussion where the panelists kept referring to “unsheltered homeless.” … Aren’t homeless people by definition unsheltered?

A: No, that’s not how government and private agencies frame the problem. They define “unsheltered homeless” as people who are living where people are not meant to live, such as in cars, parks, abandoned buildings, under bridges and on sidewalks. “Sheltered homeless” are those living in emergency or transitional shelters or other nonpermanent housing.

“Chronically homeless” is another common term. As defined by the U.S. Department of Housing and Urban Development, which allocates federal grant money throughout the country, this priority category describes people who have a diagnosed disability — such as drug or alcohol abuse, mental illness or some other medical condition — and have been homeless (sheltered or unsheltered) continuously for a year or intermittently at least four times in the past three years.

A January census found 7,220 homeless people in Hawaii, 4,959 of whom live on Oahu.

Mahalo

With the closing of the Waterfront Park and the blight of the Old Stadium Park, it is easy to overlook the great job the Parks staff do in maintaining so many of our other parks. We have a view of Ala Wai Community Park, and Dang Tran and the crew daily do a superb job for a task that must be daunting. On weekends, civilians show up and clean the park on their own time. A big mahalo to all. — David Wagner

Write to “Kokua Line” at Honolulu Star-Advertiser, 7 Waterfront Plaza, Suite 210, 500 Ala Moana Blvd., Honolulu 96813; call 529-4773; fax 529-4750; or email kokualine@staradvertiser.com.