City and state officials celebrated the opening of the city’s newest medical respite center in Iwilei on Monday after the completed facility sat unused for more than a year. The resource center is run by the city’s Crisis Outreach Response and Engagement Program, which has already begun identifying and treating patients.

“We’ve needed this. This has been the missing X factor,” Mayor Rick Blangiardi said.

The center is specifically designed to treat homeless people who are “medically fragile,” with the ultimate goal of getting 250 people per year into some sort of permanent housing such as a nursing home, foster care, a small-house village or an actual home, Honolulu Emergency Medical Services Director Dr. Jim Ireland said.

“The minute folks walk in, we’re going to start working on where they’re going to be for the rest of their life,” Ireland said.

The facility’s opening is also a big step for the city’s CORE staff who, since December 2021, were treating people too sick to go to a shelter but not sick enough for a hospital visit, which ultimately kept homeless people on the street. The center is at 806 Iwilei Road.

“It’s quite exciting because we’ve had a lot of trouble getting placements for our patients, and to know that we have our own residential facility where we can house people is really exciting for our staff,” said Raychelle Rin, the center’s operations manager.

There are 19 beds at the air-conditioned facility, and although Ireland expects the facility to fill up within a week, Rin said they hope to gradually take on five patients per week until they hit full capacity. She said her staff is a little anxious about starting operations as many of them have not worked in a residential facility.

“It’s a new ballgame for them,” Rin said. “We’re nervous, but I think the transition for the two patients that are already here went smoothly.”

CORE is made up of 30 community health workers and emergency medical technicians who patrol Chinatown, Waikiki and Moiliili and provide medical services to the city’s homeless population to prevent unnecessary hospital visits. The center will now serve as a referral base where staff will treat people with wounds, uncontrolled diabetes, uncontrolled hypertension, amputations, mild cognitive issues and mild mental health issues, Ireland said.

“They have to have a medical condition as we’re bringing them in,” EMS Deputy Director Ian Santee said.

Rin also said that patients have to be independent enough to use the showers, which are on the building’s second floor.

Ireland said the patrol staff will assess people’s eligibility to use the facility and send them to the city’s nearby Punawai Rest Stop at 431 Kuwili St. for a “fresh start” to take a shower and get a change of clothes before heading to the Iwilei center.

Once the patient arrives, they will undergo a social assessment, which involves identifying what social benefits they are entitled to and what they need to sign up for, and obtain state identification. A CORE physician and two nurses will then assess their medical treatment, Ireland said. While they stay at the center, patients will receive three meals and two snacks a day, Rin said.

“This specific project is filling a buffer for those people who are unable to participate in (Institute for Human Services), unable to apply for housing and do not have family to care for them,” said Rick Bruno, president of The Queen’s Medical Center.

The city’s medical respite center will serve hospitals around the island as a place to discharge homeless patients for temporary recovery. Ireland said patients without a place to be discharged can unnecessarily prolong hospital stays.

CORE expects it will take upward of 90 days for people to start filtering out of the center and find housing, Rin said. The challenge will be finding permanent housing quickly enough for CORE to keep referring homeless people to the center, Ireland said. Once the center gets to full capacity, Rin said, there will probably be a waitlist for future patients.

“If 19 people stay here for a year, it’s great for those 19, but then we haven’t helped anyone else,” Ireland told the Honolulu Star-Advertiser.

The center will also save up to $1 million in unnecessary hospital costs each year, Ireland said. At the center’s opening, Gov. Josh Green said that every bed used at the respite rather than in a hospital saves about $5,000 per day.

“Five thousand dollars in extra resources goes a long way if we want to buy food, medicine or other shelter for individuals,” Green said.

The project is a collaboration among the city, state and community organizations, including The Queen’s Medical Center, which donated hospital beds, nightstands and chairs used by the facility. Green said $4.5 million split between the state and city will fund the center in its initial operation.

“Honestly, we don’t care where the money is coming from, as long as it comes to help people in need,” Green said.

With the extra funding, Ireland said they hope to double the CORE staff who will assess more people in the streets.

Ireland said the medical respite center’s opening is just the first chapter for the entire facility. The center also has 27 studio apartments that have yet to be opened, and Ireland said the city is in discussions with the state Department of Health about possibly facilitating a mental health stabilization program. CORE also hopes to replicate this facility around Oahu, and Ireland said a West Oahu location is already in the works.

Blangiardi said this approach is a result of the city looking at best practices nationwide to determine the most efficient means of tackling homelessness locally.

“I’m very confident that we have an excellent strategy. It’s just going to be a matter of time with how quick we can get it done,” Blangiardi said.