The state would spend $1.4 million every year to operate two mobile medical clinics aimed at helping sick or injured homeless people under a Senate bill aimed at cutting emergency room costs to treat homeless people for non-life-threatening issues.
State Sen. Josh Green (D, Kona-Kau) moved SB 347 out of his Human Services Committee on Friday on a vote of 3-0.
Green, a Big Island emergency room physician, said he would volunteer for mobile clinic shifts himself and would recruit other doctors and nurses — and health care students — to join him.
Green envisions the two mobile clinics operating primarily on Oahu but periodically shipping one to the neighbor islands to treat the medical needs of the homeless there.
Ideally, Green said, each of the vans would include a driver, doctor, nurse and psychiatrist.
“This is an attempt to address the nexus between homelessness and the intense pressure that it’s putting on downtown and across the state so we can get people care in a much, much, much, much more affordable setting,” he said. “We could do it 20 times cheaper.”
An emergency room trip to treat staph infections and other minor injuries that turn nasty on the street easily could run up to $2,000 to treat in a hospital, Green said.
Oahu’s primary trauma center, the Queen’s Medical Center, annually faces $90 million in costs just to treat homeless people from the downtown area and is hardly reimbursed in full by the federal government, Green said.
“Our acute-care hospitals are spending tens of millions of dollars over and above what they’re being reimbursed for,” he said. “This is going to be a high priority.”
Green expects that it would cost $500,000 to buy and outfit each medical vehicle and then $1.4 million annually for operating costs.
Green’s bill comes as Waikiki Health’s two Care-A-Vans — a van and car — will sit idle now that Waikiki Health lost its state contract to provide homeless services.
Among the homeless, especially in the heart of Waikiki, Care-A-Van is a name brand. They had been using Care-A-Van for a wide array of services — from first aid to longer-term health care to receiving mail, a critical lifeline to staying connected.
The state has contracted with the Institute for Human Services to provide homeless services for the region that used to be covered by Waikiki Health and its Care-A-Vans. The IHS contract takes effect at the beginning of February.
But IHS has no mobile clinic similar to either of the two soon-to-be-dormant vehicles that make up Care-A-Van, said IHS spokesman Kimo Carvalho. Until Green’s bill receives final approval, there will be no mobile medical service for the homeless.
“We do medical outreach, such as wound care, but we currently only have one registered nurse to do both outreach and treat clients in our clinic,” Carvalho said. “We have a staff of just one RN.”
In an emailed statement, Waikiki Health CEO Sheila Beckham said its drop-in center in Kaimuki continues to offer medical and other homeless services.
But starting Wednesday, its two rolling medical clinics that treat the homeless on the street will shut down.
In the void, IHS maintains that Green’s idea “would be awesome,” Carvalho said. “We don’t have the nursing staff to keep up with demand. It’s a legitimate concern that should be addressed. Health care should be one of the many homeless solutions, in hand with housing and health and human services so we’re moving folks off of the street quickly and reducing their use of the Judiciary and hospitals, while preventing more people from falling into homelessness.”