Honolulu’s new homeless crisis outreach response and engagement program is expected to begin in 2 weeks


The city’s long-awaited Crisis Outreach Response and Engagement program, which uses a separate team of first responders to handle non-violent calls for the homeless, is expected to begin in the next two weeks.

The program has evolved over time. Originally, the program was intended to derive nonviolent, homeless emergency calls from the Honolulu Police and dispatch social workers to replace them.

However, the CORE teams will now consist of emergency physicians and community health workers.

CORE will be housed in the emergency services department. Two trucks will start, manned by three to four rescue workers and at least one community health worker.

Because of the medical and psychological components in many nonviolent emergencies related to the homeless, the city has decided that CORE should be housed in EMS.

“Right now … if a homeless person calls 911, he’ll get the police, he’ll get EMS, and often they need that when it’s a real emergency,” said EMS Director Jim Ireland.

“But if the call is … a minor complaint, it really ties up a lot of emergency resources.”

Emergency dispatchers ask callers a series of questions to determine if the situation is critical, serious, or minor. If the dispatcher judges this to be critical or severe, they will dispatch traditional emergency medical services, including the Honolulu Fire Department, Honolulu Police, and Ambulance Service.

However, if the dispatcher decides it was a small call, they would normally send an ambulance, but without sirens or lights. Once CORE begins, if the minor call is related to homelessness, the dispatcher would send the CORE ambulance instead.

“By minor calls, I mean things like a foot wound, a cough with normal vital signs. People who call like this say, ‘I’m hungry.’ These are all legitimate complaints, but they don’t need an ambulance, ”Ireland said.

“We want to care for, but we want to care for appropriately.”

CORE will operate in downtown Honolulu in Downtown, Chinatown and Waikiki approximately 12 hours a day.

This was also a change from the original concept in which it was to operate island-wide and around the clock.

Ireland said this was just the beginning of the CORE program and that EMS had found from previous experience that most post-midnight emergency calls related to homelessness require traditional services.

“You need a regular ambulance,” he said.

“It’s assaults, overdoses, things that need to be taken to the emergency room.”

CORE will differ from the regular ambulance service in that it will accompany patients after they have been discharged from the medical service and bring them to a type of accommodation such as an emergency shelter or temporary shelter.

“When the (traditional) ambulance service takes the patient to the hospital, the relationship is over,” said Ireland.

“We want to interrupt this cycle of the street, ambulance, emergency room, street.”

CORE also plans to hire psychiatrists and other mental health or substance abuse service providers to help with many of the mental health calls.

CORE is not fully staffed with social workers as was the original idea, Ireland said.

First, the CORE trucks are being renamed ambulances that would otherwise have been retired. Ambulances must be operated by at least two EMT employees.

Second, social workers are harder to find and hire.

However, Ireland is hoping to add some social workers to the CORE team in the future.

“Social workers, if we can hire them, they will be on the team, possibly more supervisors or help with case management,” he said.

“But like nurses and doctors, there aren’t many of them.”

The city has chosen to use the older ambulances instead of the regular transport vehicle because it is safer to carry people on their backs, interior cleaning is easier when patients have hygiene problems, and the public is more likely to recognize an ambulance on the road than you Homeless.

The CORE ambulances, like any other ambulance, will have basic life support equipment so that in the event of an emergency, a life-threatening emergency nearby can be responded to, even if it is not homelessness.

CORE employees do not wear the traditional EMT uniform, but a recognizable red CORE polo shirt and jeans.

Although CORE will be housed in the EMS, Anton Krucky, director of the city’s Department for Housing and Homelessness, led the effort.

He originally received $ 1.5 million in funds from the US federal bailout bill for the program, but said that has since been increased to $ 5 million.

A document released by the city reports that $ 4.9 million of ARPA funding will be used to hire 10 EMT employees for CORE for four years.

Krucky also said he expected to receive congressional funding for the program as well.

CORE was originally scheduled to start last summer and then in September, but has been postponed until this month due to delays in releasing ARPA funding.

CORE will start with two ambulances, but Ireland estimates that in six months the program will have enough staff to accommodate four.

To measure the success of the program, the city will study metrics such as the number of engagements required to persuade individuals to use services, the number of calls CORE replies to, and whether patients are after the interaction stay in the programs with CORE.

“If we evaluate the program and its course and expand it, then we push it into the regular budget,” said Krucky.

“When I first got into this position it was just, ‘There’s shelter or you can’t do anything.’ We are trying to expand these decision-making scenarios. “

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