Hawaii has the highest homelessness rate of any American state — and it was the first to declare the problem an official state of emergency, in 2015. Rough 19,000 people in the state are considered to be chronically homeless — that is, on the streets for an extended period of time, and with a disabling condition. Lack of affordable housing in the islands remains the single biggest reason so many people find themselves on the streets.
Hawaii receives $2 billion a year in Medicaid, but that money is often spent as inefficiently as possible. 3.6 percent of recipients, many of whom are homeless, use 61 percent of the state’s Medicaid budget on emergency care. “They get sick or scared…the ambulance costs a thousand dollars, the ER visit costs one, or two, or three thousand dollars, and then, they’re back on the street again,” Hawaii senator and practicing ER doctor Josh Green told VICE News about the vicious cycle.
Green wants to redefine chronic homelessness as a medical disease and allow doctors to prescribe housing using Medicaid funds. Caroline Modarressy-Tehrani went to Hawaii to talk to Hawaii senator and practicing ER doctor Josh Green about his proposal, as well as the homeless Hawaiians who would benefit.