Two facts are at odds. Hospitals, which cannot turn away the sick who arrive in the emergency room, simply cannot sustain the demand, and the inadequately reimbursed costs, of treating homeless people. Neither can the emergency medical services teams who respond to their frequent 911 calls.

The other, equally inescapable reality: These frequent users of the system are not going to stop calling or walking in.

The way the state must confront this problem is head-on: Government must find a less expensive, and more readily accessible, form of health care for those living unsheltered, often under conditions that rapidly cause health to deteriorate further.

At the same time, it makes no sense for lawmakers to approve a separate initiative aimed at treating the homeless more effectively for mental illness and substance abuse — because it duplicates a program already in the works.

But first, the good news.

The Senate Ways and Means Committee on Friday passed Senate Bill 2374, a measure that needs to advance to enable the revival of a temporary “paramedicine” service for the homeless.

SB 2374 would allot $1.5 million to fund a three-year pilot program that focuses on serving those frequent 911 callers, largely emerging from the homeless population. Experts have underscored why this makes better use of taxpayer funds.

Dr. Jim Ireland, former head of Honolulu Emergency Medical Services, put the annual cost estimate for unnecessary ambulance visits at $2.4 million.

More than 1,500 frequent callers to the Queen’s Medical Center made emergency room visits for non-emergency problems, he said, costing more than $12 million. Many of these cases involve chronic diseases, better handled in a clinical setting, but often the patient lives in rural communities, far from those services.

Most of these patients are on Medicaid, so the taxpayers ultimately pick up the bill. So it’s rational to invest now, including a proposed $250,000 paramedicine training program, to manage costs.

All of this underscores the rationality of a program that provides care in an unconventional setting — bringing it closer to where the care is needed. Those paramedics who have worked on a city pilot project launched in 2012, or another headed by Hawaii County Fire Department paramedics, confirmed the urgency of the need among the poor and homeless.

The call to address the health problems of the homeless also was invoked by House Bill 2147, aimed at creating another pilot project to divert homeless criminals from prosecution to appropriate treatment.

It’s a good instinct — except that the state Department of Health has already followed the same instinct and has a similar program underway.

The bill proposes referring homeless people suspected of a nonviolent, nonfelony crime on state property for an evaluation by DOH if they have mental health or substance abuse problems, instead of arresting them. But, as asserted in DOH testimony, the pilot was established already and was funded in the last legislative session; Year 2 of the program should be funded.

There’s no disputing the rationale for the program: Almost a quarter of Hawaii’s homeless (23 percent) have mental illnesses, according to last year’s Point in Time Count census, and 19 percent have substance-abuse issues.

But the impetus should be on carrying out the Law Enforcement Assisted Diversion (LEAD) project already on the books. HB 2147 should be shelved, to this end. And, as recommended by the department, “the Legislature is encouraged to first review the LEAD pilot evaluation report scheduled to be completed in December 2019 before determining how best to expand and support ongoing efforts.”

The homelessness crisis requires smart use of resources — including passing only the measures that are truly needed.