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City flexes law to force homeless into care

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City officials are looking for a "test case" to invoke a never-used state law to force mentally disturbed homeless people into outpatient medical services — and in some cases subject them to involuntary medication.

Homeless people who pose a danger to themselves or to others can be ordered by a Family Court judge to undergo outpatient medical services, Mayor Mufi Hannemann said yesterday in outlining new approaches to Oahu’s homeless problem.

"It’s an existing law that just hasn’t been tapped into," Hannemann said.

Many details need to be worked out, such as how medication would be administered against someone’s will, and how people would receive adequate mental health services and housing, said Debbie Kim Morikawa, director of the city Department of Community Services.

"We will need to clarify every step of the way what needs to be done, then establish a test case to run through the system," Morikawa said.

The plan to force severely mentally disturbed homeless people into outpatient medical care has been under discussion for months and included input from the American Civil Liberties Union of Hawaii, which continues to have concerns.

"The problem with any sort of program that involves involuntary medication is that you infringe on personal autonomy and rights," said Lois Perrin, legal director for the ACLU of Hawaii. "We all have the right to choose our medical treatment. To force medication on them is troubling on a number of fronts. We would certainly monitor the situation and be very concerned about it."

Hundreds of Honolulu’s estimated 4,000 homeless people could fall into the legal definition of people who require mental health services, including those who are substance abusers, Morikawa said.

Marya Grambs, executive director of Mental Health America of Hawaii, said city officials want to focus on homeless people who are "gravely disabled as a result of a severe mental disorder or substance."

"These are the people who are severely psychotic and because of their psychosis they do not know they’re ill and they do not seek treatment and take medication," Grambs said. "We believe that getting people into treatment and requiring they get treatment is a better solution than having them live in unsafe, unsanitary and degraded conditions."

The Honolulu Police Department’s three psychologists respond to about 150 mental health cases per month, many of which lead to hospitalization and medical care, said Michael Christopher, one of the HPD psychologists.

Hannemann yesterday also said he:

» Has directed city transportation officials to come up with "creative ideas" to get homeless people to shelters or jobs.

» Will ask the City Council to approve bills that would establish procedures for removing and disposing of personal property stored illegally in public spaces and prohibit unlawful camping on all public property, including sidewalks and medial strips.

» Supports the concept of a "safe zone" where homeless people can camp long-term, on the condition that such an area have rules (such as no drugs or alcohol), staffing and security to enforce the rules, sanitation and allow pets.

He also said a safe zone likely would have to charge fees to help pay for operating costs and that it should be run by a private operator.


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