Living on the streets can be dangerous to one’s health, even for the unsheltered who don’t start out with a physical or mental health problem. Lacking access to routine care, the homeless often end up in the hospital, only to be returned to the streets after treatment. There they frequently relapse and head back to the hospital. A painful and costly cycle begins.

That’s why the long-awaited opening of the city’s new medical respite center could herald the start of a better strategy for guiding Honolulu’s homeless toward appropriate and cost-effective medical interventions that also leads to long-term housing placements.

That’s the hope for the Iwilei Resource Center, which opened this week at 806 Iwilei Road, after more than a year’s delay.

The goal for the center is to treat 250 people each year and direct them toward a range of permanent housing options, including nursing homes, foster care, a modular “tiny” home or more conventional accommodations. It would help these clients get the support they need by interrupting the cycling of the homeless between the streets and the hospitals. In medical respite, patients are in a fixed location, where social service and medical workers have a window of opportunity to stabilize their health and provide a direction forward.

Planning for the resource center, including the conversion of a four-story former sportswear factory, got underway in 2016, when the movement to provide medical respite care for the homeless began to take off nationally. The city spent $6.3 million to buy the property.

The delay in opening the center was caused by problems navigating various restrictions on how the funding for the $17 million project was to be used. There was also the heavy lift of getting the health-care providers in place to provide the services the clients need.

Those are knots the city will need to untangle if plans to replicate this project elsewhere are to be realized in a reasonable length of time.

Currently there are 19 beds for patients, overseen by staffers of the city’s Crisis Outreach Response and Engagement (CORE) Program. The focus of the center is to divert the homeless from hospital emergency rooms, where they represent about 30% of the census on a given day. After an assessment that determines their need for respite care, the patients are admitted and receive meals and snacks during their stay.

The center will function in tandem with the nearby Punawai Rest Stop, part of a continuum of services from mail pickup and showers to 20 studio apartments.

The center represents clear progress in the city’s efforts to address homelessness because it provides a humane outreach that fills a major gap in care for people living on the margins. But it also signifies some needed collaboration between the city and the state on this shared challenge. Similar help is being provided at the state’s new medical “kauhale,” a collection of small private units with nursing care, located across from The Queen’s Medical Center, where many homeless are discharged after treatment.

Diverting the homeless first to respite care instead of a hospital is expected to save $5,000 in daily hospital costs per patient.

Queen’s is participating through a donation of hospital beds to Iwilei. More private partners, across the health-care and nonprofit sectors, will be crucial. Already the city is discussing a second respite facility for West Oahu, which is sorely needed.

Now the city and the state must scale up training for the staff — the skilled professionals who provide the human touch that is so essential to success.