John Roberts Jr. was sprawled on the sidewalk, unable to move, next to his wheelchair on the corner of Hotel and River Streets in Chinatown. A team of first responders rushed to the scene after getting a call for help from community health workers.

The first responders hoisted the 74-year-old Navy veteran onto a stretcher and into the ambulance, then drove him to the Institute for Human Services, where he was cleaned up and given new clothes.

This has long been the reality of police and other first responders who often find themselves called on to help homeless people in Honolulu, potentially diverting the crews from more serious emergencies.

The city’s new Crisis, Outreach, Response and Engagement program aims to change that by removing the Honolulu Police Department and Emergency Medical Services from the process of responding to nonviolent, homeless-related emergency calls and deploying social workers, EMTs and community health workers instead.

‘Balancing Act’

CORE, which began operations on Oct. 15, was funded with approximately $3.5 million from the American Rescue Plan Act for the first year, according to city officials. The program has hired 15 people so far, including a program manager, EMTs and community health workers.

On Monday, CORE launched a hotline that will allow people to call them directly if it’s a non-emergency. The number is (808) 768-2673, and the operating hours are from 7:45 a.m. to 4:30 p.m., down from the 24/7 availability that was originally intended.

Honolulu Emergency Services Department Director Jim Ireland, who oversees CORE, said the plan is to hire 15 more people, including nurse practitioners, paramedics, physicians and a psychiatrist, early next year.

The program is housed under the Honolulu Emergency Services Department and currently uses two old ambulances that otherwise would have been retired. The ambulance that picked up Roberts Jr. had 200,000 miles on it.

“It’s a balancing act and it can be difficult.” — EMT Alyssa Bustamante

The program is focused on urban Honolulu stretching from Chinatown to Waikiki, but Ireland hopes to get four more ambulances by next year and to eventually expand across Oahu.

“Everybody can agree that there’s homelessness everywhere – everywhere in the country,” Ireland said. “But looking at Oahu, it’s the westside, Windward side, Central Oahu and certainly downtown and Waikiki.”

Long-Term Assistance

The shape of the program has changed, but Ireland said the ultimate goal is to help homeless people find transitional or permanent housing as opposed to just providing one-time assistance.

Ireland said it’s important to break the traditional EMS cycle, which he described as picking up people living on the streets, transporting them to the hospital, then finding them back on the streets. 

The CORE team trying to help Roberts Jr. had to navigate a series of obstacles that took much of the afternoon on Thursday. A Civil Beat reporter was riding along with the team, escorted by Ireland.

IHS did not admit the Navy veteran for long-term services, according to Alyssa Bustamante, one of the EMTs, so the ambulance took him back to Chinatown, dropping him off on a different block at his request. But nearby business owners asked the team not to leave him there so he was returned to his original location.

“It’s a balancing act and it can be difficult,” said Bustamante, who was one of CORE’s first hires.

About 10 minutes later, the outreach workers from CORE’s main office called and said they had arranged for Roberts Jr. to be accepted at the Veterans Affairs clinic near the Tripler Army Medical Center, so the ambulance returned and transported him there. 

It was the second time CORE has responded to a call about Roberts. In November, CORE transported him to Tripler, but he still ended up back on the streets.

“We’ve transported him before,” Ireland said. “We got him some additional benefits that qualify for long-term foster care, but it’s just a matter of time and we’re struggling to get him placed.”

As of Tuesday, Ireland said that he hasn’t seen Roberts back on Hotel and River Streets.

Community Concerns

CORE keeps a database that tracks each patient, Ireland said. Outreach workers do walk-throughs in the neighborhoods to build those connections, retrieve personal information and relay it back to the office so they can follow up with people experiencing homelessness. 

Though it sounds similar to existing programs, the key difference is the transportation and outreach. CORE’s concept was developed on ideas borrowed from some mainland programs, Ireland said. 

“We will work more as connectors with the mayor’s Office of Housing, nonprofits and state agencies that are already doing this,” he said.

However, there’s still some skepticism about the program.

Wookie Kim, legal director of ACLU of Hawaii, expressed concern that 911 calls about homeless people are still being routed to the police. 

“The devil is always in the details,” Kim said. “There’s some aspects of it that sound promising, but the question is what it actually looks like on the day-to-day.”

Kevin Lye, former chair of the Downtown-Chinatown Neighborhood Board, was optimistic when the idea of CORE was presented in January. Though Lye acknowledged that the program is still in the early stages, he said he hasn’t seen any decrease in homelessness in Chinatown.

“We have yet to see any quantitative results from the CORE program,” Lye said. “We hope that there will be some tangible improvements, and we hope that the city will continue to relay information to our neighborhood board.”

Improving Outreach

Aura Reyes was formerly homeless and currently provides outreach through Hui Aloha, a nonprofit volunteer network. She is taking a “wait-and-see” approach to CORE. 

“I think CORE would be a good program if they focus more on the transportation part and provide extra medical attention or care services,” Reyes said. “Getting people to their doctor appointment or getting them their prescriptions so they don’t act out would help.”

Rayechelle Rin was recently hired as the CORE program manager. She echoed some of the similar challenges other outreach services face when trying to assist homeless individuals.

Though the program is still new, Rin said it can be difficult to find homeless individuals if they don’t have a phone or they migrate to another neighborhood.

“I think the biggest thing for me is that I would like to align with the other community partners so that we can better help our population,” Rin said. “That’s a gap too. Everyone has their own mission and purpose, so we want to get together and coordinate as best as we can.”

So far, CORE has received three to four referrals a day from 911 calls with complaints ranging from pain, inability to move, diarrhea, access to care, psychiatric issues and injuries, Ireland said. Though the CORE hotline was set up on Monday, there may still be 911 calls for CORE, but Ireland said the team is working on getting the hotline out to the public. 

Ireland said the 911 dispatchers use a series of questions to determine if the calls are critical, serious or minor, then decide whether to route the calls to CORE or EMS. 

“Right now, we don’t specifically ask or track 911 callers based on homelessness,” Ireland said. “However, dispatchers estimate that on an average day, EMS gets approximately 20 to 30 calls to 911 from homeless callers.”

“As CORE expands, we hope to have as many minor 911 calls as possible offloaded from EMS and police to CORE,” Ireland added.

Developing Relationships

Jennifer Kawata, part of CORE’s outreach team, was homeless and living on the streets of Hawaii Kai and Manoa with her 11-year-old son for about seven months.

Now housed, she was drawn to work for the program because of the “ability to start something from the ground and build up.”

“It’s a huge vision and being able to be a part of something that can start from the ground is very exciting,” Kawata said, adding that there’s still a lot of work to do in building connections with homeless individuals and other organizations.

“CORE could focus on trying to help get them connected with  the right services, so they’re not alone,” she said.

The CORE team also transported an ailing homeless man from his tent in Ala Moana Beach Park to the hospital, and even took the extra step of promising to care for his dog Smiley until he could return.

However, the team had a hard time finding the man after he left the hospital.

After a week of searching, Ireland said CORE returned Smiley to his owner Wednesday and was able to build some kind of a relationship with the man. Though he’s still homeless, Ireland said he hopes that CORE will help him access the appropriate services.

“There’s a lot of work to do, but we’ll take care of these people one person at a time,” Ireland said.