He’s an ER doctor and a state senator. Last year, Senator Green introduced legislation that classified homelessness as a medical condition
and would allow doctors to prescribe housing, directing 2% of the state’s Medicaid budget to housing for people without homes. In fact, he introduced nearly three dozen bills that focus on issues related to homelessness. The Council’s Senior Director of Policy, Barbara DiPietro, recently spoke with him about his experience integrating service and advocacy. Below are highlights from the discussion.
Barbara DiPietro (BD): You have an extensive list of legislation you introduced or co-sponsored last legislative session that seeks constructive solutions to homelessness. What is driving your interest in this issue?
Josh Green (JG): My interest comes first as a physician and then as a legislator. I did my residency with the National Health Service Corps and saw how economic inequality and social determinants of health were damaging a lot of people and creating severe access to care issues.
BD: How have your fellow colleagues in the Hawaii Senate responded to your initiatives, particularly those across the aisle? What messaging or strategies have you found work well?
NPR and Rush Limbaugh
both liked the concept of prescribing housing. Rush was focused on cost and liked that it saved money. NPR liked it because it ended homelessness. So changing the model appeals to both sides.
BD: As someone who sees the problem directly in the health care system and as someone who holds public office, what do you think are the barriers to fixing the systemic problems that create homelessness?
JG: Political will is the #1 barrier. Less than 4% of Medicaid patients use 61% of the Medicaid budget in Hawaii. When a very small group uses a lot of resources, it’s a problem you have to fix. Changing our thinking as providers is the #2 barrier. We have to accept that we have to prove the cost savings are there. It’s not really what we do because we’re not normally bean counters, and this has been a barrier to making our case for changing the system.