To help the hardest to house, they start with a simple question: How are you feeling today?

Hundreds of homeless people lost a lifeline last year when Hilo’s only street medicine program ended due to a caregiver shortage and funding cuts.
Published: Oct. 10, 2023 at 6:21 PM HST|Updated: Oct. 12, 2023 at 4:34 PM HST
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HONOLULU (HawaiiNewsNow) - Hundreds of homeless people lost a lifeline last year when Hilo’s only street medicine program ended due to a caregiver shortage and funding cuts.

Now, Hawaii Island’s largest homeless service provider is working to reestablish the critical resource in an attempt to take some of the burden off hospitals.

The reboot comes at a critical point: Hawaii Island’s homeless population now stands at more than 1,000 people — up nearly 50% in the past five years, according to the latest point in time count.

Many of those without a home are unsheltered, living in parks and in the brush. The situation is putting a strain on the island’s limited resources, especially its healthcare system.

But Hope Services Hawaii is trying to tackle the challenges head-on.

This is Part II of a new HNN Investigates series, “Hope for Hawaii Island.” Get more of our special coverage of Hawaii’s homeless crisis by clicking here.

When the street medicine program ended last year, it severed a lifeline for scores of people living on the street. The agency turned to the county and members of the community for donations so it could establish a new project.

The newly-funded team is made up of about a half dozen members. They hit the street in April.

Kevin Emmons, a nurse practitioner and wound specialist, is volunteers to serve.

Every Wednesday, from 4 p.m. to 8 p.m., the street medicine team travels from neighborhood to neighborhood, providing free medical care to people living on the streets.

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The health care professionals can treat up to 20 people in a single shift.

“The severity ranges from minor abrasions and cuts — like you would see from falling, blisters, shoes that don’t fit, not wearing socks,” Emmons said. “All the way to very large wounds that have a lot a dead tissue. That could have maggots and infection.”

He says providing this type of primary care can cut costs for the community down the road.

According to the National Library of Medicinee, the average person experiencing homelessness visits the emergency room five times a year — at a cost of more than $18,000 a year.

Emmons says street medicine can significantly reduce the burden on the health care system by decreasing the number of ER admissions. Helping people with their immediate health needs not only keeps them out of the hospital, it also allows outreach workers to start a conversation with them.

And that can eventually lead to getting people housed.

From January to September, Hope Services teams helped 10 people move off the street into shelter. Four more people were placed into permanent housing.

On a recent day in downtown Hilo, outreach workers worked with a homeless man named Robert. He said he ended up on the streets in 2016, after losing his arm in a work accident.

Now he’s having trouble with a gash on his leg that just won’t heal.

“I do want to go to shelter,” he said. “It’s hard living out here.”

Emmons said in addition to medical care and housing support, the team also tries to connect people with job interviews and work. Often the biggest challenge is keeping regular contact with patients.

“It’s trying to have that continuity to make sure things heal and progress,” he said.

For Hope Services to continue its mission, the team needs to secure additional funding. Last year, the county provided about $50,000 to get the program off the ground.

Advocates are pushing to have street medicine added to the county’s budget again next year. They’re also collecting donations for medical supplies. If you would like to donate to the Hope Services Street Medicine Program, click here or call 808-935-3050.


Street medicine isn’t the only project Hope Services has set up to reduce strain on the island’s health care system. The homeless service provider also launched a medical respite facility, a place that provides in-patient medical services for homeless people who need care but aren’t sick enough to stay at Hilo Medical Center, allowing the hospital to free up beds for people who need them.

Catch that story Wednesday in part III of HNN’s four-part series: “Hope for Hawaii Island.”