As a city program that helps homeless people approaches its one-year mark, it has faced obstacles including a lack of shelter space and psychiatrists. But the Crisis Outreach Response and Engagement program has taken 30 people off the streets and that’s a successful start, its director says.

The CORE program was launched last year in an effort to divert nonviolent, homeless-related emergency calls from the Honolulu Police Department and Emergency Medical Services. The idea is to respond with teams of social workers, community health workers and EMTs instead.

“We recognize that there are homeless everywhere on Oahu, and it’s our goal to address each and every one of them,” said Jim Ireland, director of the Honolulu Emergency Services Department that oversees CORE. “But it’s just a matter of doing what we can with the resources we have.”

So far, more than 30 people have been taken off the streets since the program launched on Oct. 15, 2021, according to Ireland, adding that they’ve been placed in foster care, transitional housing, shelters and small house villages.

Although it may not sound like a lot, Ireland said most of them had been chronically homeless, meaning it’s usually hardest to find homes for them because they have underlying conditions such as mental illness, substance abuse or disabilities.

“Every person taken off the street is a success, but there’s still a lot of work to do,” Ireland said.

Overcoming Challenges

The dearth of shelters and specific services for people with mental health problems has hampered the program’s efforts, along with many other service providers.

Shelters have decreased capacity and limited staffing amid the coronavirus pandemic, leaving fewer beds for people experiencing homelessness.

Ireland said more shelter space would help CORE get people off the streets, suggesting building more tiny house villages like Hui Mahiai Aina in Waimanalo and repurposing the Hawaii State Hospital in Kaneohe.

“Even if I could get 100 people off the streets next week with CORE, I don’t think we have 100 places to put them between the existing shelters because they’re just at or near capacity,” Ireland said.

Ireland suggested that Oahu needs 10 small house villages with 25 to 50 structures at each site, adding that could house 500 people. Ireland said that could be a solution for people in Waianae who want to stay in the community.

“But at the same time, people who have mental health or addiction issues, those wraparound services need to be available to those folks as well,” Ireland said. “We can’t just put somebody in a small house with decompensated mental illness and expect them to do well.”

Last Wednesday, Hawaii reported having 39 vacancies in emergency shelters, while transitional shelters on Oahu had 63, according to city officials.

But Ireland said some shelters will not accept people who are unvaccinated, have pets, are sex offenders or have been banned from shelters in the past for bad behavior.

Oahu has 17 shelter providers, according to Partners In Care.

“While this isn’t enough to accommodate our entire homeless population at once, we do have space for people when they decide to engage,” Department of Community Services spokesman Adam LeFebvre said in an email. “We hope to encourage and convince more people to use shelter space, and we hope to correspondingly create more shelter space as demand increases.”

According to Ireland, conversations are happening with the city to expand shelter beds up to 200.

Oahu has only two inpatient psychiatric facilities on Oahu, including The Queen’s Medical Center and Adventist Health Castle. Ireland said there’s only so much space in these facilities, and often homeless people cannot transfer to a shelter or other facilities.

“It would be nice to have a place that is a bridge between the hospital and getting into some kind of structured living environment,” Ireland said. “What I like about the Kaneohe State Hospital is, people with mental health emergencies and decompensated mental illness need to be in a safe environment. They can’t be in a room where they can potentially hurt themselves.”

The city also plans to open a free wound-care clinic in Chinatown, across the street from CORE’s headquarters early next month. The program dubbed Homeless Outreach and Medical Education is a collaboration between the city and medical students from the University of Hawaii’s John A. Burns School of Medicine.

Continuing To Grow

CORE was funded with approximately $3.5 million in federal Covid-19 relief funds under the American Rescue Plan Act. Ireland said Congress also allocated $9.5 million to CORE this year.

So far, CORE has a staff of approximately 32 EMTs, community health workers, community specialists, field supervisors and an operations manager. It also recently hired a full-time family practice physician and two psychiatric nurses, and a psychiatrist is scheduled to begin work on Nov. 1. Ireland said it took longer to find a psychiatrist to hire due to the lack of psychiatrists in the state.

The program, housed under the Honolulu Emergency Services Department, currently uses four retrofitted ambulances with about 250,000 miles each. Ireland said the additional funding would help finance three new ambulances.

CORE’s operating hours are from 7 a.m. to 5 p.m. Ireland said the plan is to extend those hours to midnight.

CORE initially focused on Honolulu’s urban core, stretching from Chinatown to Waikiki, but has since expanded and responded to calls in Waianae, Wahiawa, Waipahu and Kailua, Ireland said. The teams deal with a variety of needs including social services such as helping homeless people get IDs, bus passes, SNAP benefits and apply for health insurance.

The calls usually come from neighbors either expressing concern about somebody or complaining about a problem with a homeless person, Ireland said, adding that CORE receives calls from its hotline or 911. CORE generally does outreach by driving around neighborhoods.

According to Partner In Care’s Point In Time Count, homelessness on Oahu is down nearly 11% overall but up slightly among those living on the streets as opposed to those in shelters.  Most individuals surveyed in the count were chronically homeless.

CORE recently helped one woman in her 70s get off the streets. Ireland said she couldn’t afford her home after her husband died, but the team eventually found her a place to stay at Hui Mahiai Aina in Waimanalo.

“She’s doing quite well, and we’re super happy about that,” he said.

Another person CORE helped was a man with moderate dementia who had been homeless for years. Ireland said the man wasn’t aware he was receiving a monthly check, adding that CORE got him into foster care to tend to his medical needs.

CORE is currently keeping track of between 150 and 200 people. According to Ireland, the program gives cellphones to homeless individuals to contact their families and as well as the organization.

Recently the CORE program reunited a woman experiencing homelessness with her family in American Samoa. CORE kept in contact with her through their cellphones.

“We made sure she got to the airport, and she got back to American Samoa, to her family who were welcoming and ready to care for her,” Ireland said. “But she was homeless in Honolulu for quite some time.”