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Hawaii Dem Argues Doctors Should be Able to Prescribe Housing to Cure Homelessness

Doctors agree that being homeless can make a person sick. Lack of hygiene, quality meals, and everything else that goes with not having a permanent address can result in a number of medical conditions.

And health problems, doctors say, can cause homelessness.

So Hawaii Sen. Josh Green (D) has introduced legislation to classify “homelessness” as a medical condition under state law.

Green, who works as an emergency room doctor when he isn’t in the state legislature, contends that if it is true that homelessness is a medical condition or a disease, it naturally follows that physicians should be able to prescribe a cure.

And that cure, according to Dr. Green, is obvious: Housing.

“This is the solution of the future,” Green said on WBUR’s “Here and Now” program. “We are all in this together because everyone has a neighbor that’s just one or two paychecks away from being in deep trouble.”

Homelessness in Hawaii is so bad that Gov. David Ige (D), as PJM reported, declared a state of emergency in 2015.

The National Alliance to End Homelessness issued a report in 2016 that showed Hawaii had the highest homeless rate of any of the 50 states, although it was about half the rate of Washington, D.C.

Hawaii News Now reported Queen’s Medical Center in Honolulu has seen a dramatic increase in the number of homeless people seeking treatment. Fewer than 7,000 people who were homeless sought treatment in 2013. But that number jumped to just under 11,000 in 2016.

Medicaid doesn’t cover all of their bills, so Queen’s had to eat about $40 million in medical care for the homeless over the past four years.

"Right now, it's just a crazy system," Green said, "to have a hospital being occupied by individuals for $4,000 and $5,000 visits when they need $30 worth of care and a roof over their head.”

In addition to Green’s bill that would classify homelessness as a disease, Hawaii’s legislature is looking at a variety of plans to clear homeless people from city streets.

One of those proposals involves spending $1 million to build small campgrounds in several neighborhoods. Along with having a place to call home, store their gear and get mail, they would also be able to shower and use clean toilets.

Another idea came from state Sen. Suzanne Chun Oakland (D). As PJM reported, she proposed a year ago that Hawaii should build neighborhoods of grass huts for the homeless.

State Rep. Gene Ward (R) said he was open to the idea of letting people rent out their driveways as places where the homeless could spend the night in a car.

“The point is: we have to get people off the streets,” Ward said.

That kind of thinking scares state Homelessness Coordinator Scott Morishige.

He told KITV the idea of legal homeless camps has been tried before and didn’t work well. The campgrounds turned into cesspools of health and sanitation issues.

But Green said health and sanitation problems are already prevalent where the homeless congregate on public streets.

“We have unlicensed camps that are not accepted by local authorities and mayhem ensues, as we've seen over and over again. This would be an improvement on that," said Green.

The human instinct is to survive. One of the unlicensed camps was called “Obamaville.” It was an encampment of tents and shelters made out of cardboard boxes. At one time, it covered 50 acres.

But Green sees ideas like public campgrounds for the homeless as tactics, not a strategy.

Green’s proposal, Senate Bill 2, calls on the Hawaii state auditor to study the impact of using Medicaid money to pay for treatment for homelessness.

Green spelled out treatment in his proposed legislation that included behavioral health services such as mental health and substance abuse services, case management, personal care and personal assistance services, home and community-based services and housing services.

Connie Mitchell, executive director for the Institute of Human Services, the largest provider of housing services in Hawaii, agreed: “Housing is healthcare because it does afford a person a much greater chance of sustaining their health.”

But Mitchell also told the Associated Press that it could be tough to decide who among Hawaii’s homeless population is sick enough to qualify for free housing.

"You need to really look at when that's appropriate because there's a lot of people that become homeless," Mitchell said. "Just because they become homeless doesn't mean it entitles them to write a prescription for a unit.”