One of the chief complaints from civil-liberties advocates about initiatives cracking down on those living on the streets is that they tend to criminalize homelessness rather than address it. Finding housing for the unsheltered is preferable to the punitive approach, they would say.
Now it appears that a third way may be more effective than either, for a large proportion of them who may not be ready for permanent housing. These are the chronically homeless: people who, due to mental illness, substance abuse or multiple causes, may cycle through emergency rooms and the criminal justice system, at a cost disproportionately large for their relatively small numbers.
The Law Enforcement Assisted Diversion (LEAD) program, growing in popularity nationwide, is seeing some success in its first Honolulu application in Chinatown, steering more of this population to agencies where they can be helped and guided to greater self-sufficiency.
This is encouraging news: LEAD should over time help to address one of the most persistent aspects of Hawaii’s homelessness crisis, and deserves further support to expand across Oahu and as officials move to replicate it across other counties.
The Oahu rendition pairs the Honolulu Police Department with outreach workers from the Hawai‘i Health &Harm Reduction Center to connect the homeless with services rather than to issue citations or arrests.
The University of Hawaii Department of Psychology has issued a report evaluating the program one year after its launch. Participants who otherwise might have been cited or arrested as a result of their encampment were invited to enroll in LEAD; 37 did sign up.
That’s a small study sample, to be sure, but it’s hard to ignore the results. According to the report: There was a 55% reduction in law enforcement encounters, and a 40% reduction in emergency medical services used. On average, the number of days sleeping unsheltered was cut to 13 days a month, instead of the 21 that was the average before enrolling in LEAD.
It works by recording a brief initial form for contacting the enrollee; on a second encounter, a questionnaire is filled out to gauge what services the person needs.
This is intensive work, a fairly long-term commitment to intervention. But that kind of attention pays off. Sometimes the participant is reunited with family; in one case, a man homeless for 10 years managed finally to get his birth certificate from American Samoa, a document he needed to secure housing.
And he’s housed.
This kind of sustained outreach is an investment that ultimately yields lasting improvement in the lives of the chronically homeless, and saves public resources as well.
According to statistics gathered by Lt. Gov. Josh Green, who has taken on homelessness as his focus, roughly 10% of the estimated 15,000 homeless individuals in the state can be classed as chronically homeless, those with poor health or who have lived on the streets for more than six months. They comprise most of the highest Medicaid users, with an average per-person cost to the health system of $4,650 each day.
Paired with another HPD-originated initiative — a pop-up system of short-term shelters linked to social services, now being piloted at Hawaii’s Plantation Village — on-the-spot intervention by trained teams is the right course.
So many other strategies can and should be pursued, not the least of which is securing more short- and long-term housing. But meeting people where they are and connecting them to the help they need is crucial for those most firmly rooted to an unsustainably rough life on the streets.