City plan shuffles but
doesn’t solve problemThe issue: The city is enforcing
a curfew at Fort Street Mall to try
to chase away the homeless.HIDING a problem doesn't make it go away, but that's the tack the city has chosen in routing homeless people at Fort Street Mall. Instead of trying to help the destitute while sprucing up the downtown area, the city's unbalanced approach merely pushes them out of sight.
Businesses and Hawaii Pacific University had complained about the homeless people. Store owners say they have had to clean up after the homeless and that customers felt uncomfortable. "We need to make this location clean and safe for our downtown residents and workers," said Carol Costa, spokeswoman for Mayor Harris.
To do so, the city has removed public benches from the mall and will eventually replace them with ones that have armrests in the middle, making it difficult for people -- namely the homeless -- to lie down or sleep. The city also has begun enforcing a law that bans people from the area between 10 p.m. and 6 a.m. The ban prevents the homeless from loitering on the mall, but also affects anyone -- from casual evening strollers to diners walking from downtown restaurants to parking areas. Fines run from $45 to $75.
No one would argue that a beautified mall with the flower-filled planters the city is installing there enhances the area. However, the city's effort only displaces the impoverished, many of whom suffer from mental illnesses, and forces them elsewhere. As it happens, some of the indigent who used to populate Fort Street Mall have moved to an area at River Street near Nimitz Highway.
"Instead of Fort Street, they just go to other places. If we go tell them to move again, they just find another place and we tell them to move again and they move and we tell them move again -- it just goes on and on," said one police officer at the Chinatown substation. "Maybe they're out of sight for little while, but they're still there."
As the economy worsens and the number of homeless people grows, shelters are being overrun. Statewide, about 950 housing units are available, but nearly 13,000 people are in need.
Although the city is obligated to present a wholesome atmosphere downtown, it also should assume some responsibility to help the less fortunate. That people who are homeless make others uncomfortable is understandable. No one should feel comfortable when fellow human beings are left to cull through trash cans for a bite to eat. No one should be comfortable when others have no choice but to sleep in doorways and alleys. No one, least of all city officials, should feel comfortable about turning a blind eye and a deaf ear to those in need.
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Prepare for boomers
needing elderly careThe issue: The nation's
nursing homes need more nurses
and aides to provide proper care.STAFFING levels at nursing homes already are at a critically low level and could reach a crisis point in the near future with the aging of baby boomers. Major increases in federal and state assistance will be needed to assure proper care for the elderly. The urgency will be felt especially in Hawaii, where the elderly population is growing at 2.5 times the national average.
A report ordered by Congress and prepared by the Department of Health and Human Services found that more than 91 percent of the nation's nursing homes had staffing levels below that "minimally necessary to provide needed care." More than 40 percent would need to increase their nurse staffing by half to reach that minimal level. Otherwise, it said, patients were more likely to experience bedsores, malnutrition, weight loss, dehydration, pneumonia and serious blood-borne infections.
According to the report, a patient needs 4.1 hours of care each day -- 2.8 hours from nurse's aides, who help patients with eating, dressing and going to the bathroom, provide exercise and reposition those who are immobile, and 1.3 hours from registered or licensed practical nurses. Nursing homes commonly have only one aide for every eight to 14 residents.
Medicaid and Medicare pay for three-fourths of nursing home residents, so hiring more staff would mean increasing taxes. However, the Bush administration is hoping market forces and more efficient use of nurses and aides will solve the problem.
The report concluded that achieving the minimum ratio of nursing staff to patients is "not currently feasible," largely because of the cost -- an additional $7.6 billion a year, an 8 percent increase over current spending. The amount needed to reach an acceptable level will increase as the population aged 85 and older -- those in most need of the care -- doubles to 8.9 million by 2030.
Hawaii also has a shortage of nursing-home facilities -- 27.4 beds per 1,000 population, second-lowest in the nation and compared with the national average of 53 per 1,000 -- attributed by the state Executive Office of Aging to the high cost of land and building. Still, the office figures the state's total long-term care bill will grow to more than $2 billion by the year 2020, and its share of Medicaid expenditures alone to $544 million.
Advances in technology -- allowing more electronic monitoring of patients -- and efforts to increase voluntarism could help lessen these demands over the next quarter century. But large increases in expenditures will be necessary to provide proper care to the nation's elderly.
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Published by Oahu Publications Inc., a subsidiary of Black Press.Don Kendall, Publisher
Frank Bridgewater, managing editor 529-4791; fbridgewater@starbulletin.com
Michael Rovner, assistant managing editor 529-4768; mrovner@starbulletin.com
Lucy Young-Oda, assistant managing editor 529-4762; lyoungoda@starbulletin.comJohn Flanagan, contributing editor 294-3533; jflanagan@starbulletin.com
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