Code Blue helps NJ homeless when temps drop, but some still get left out in the cold

Matthew Keenan huddled under the ramada of a Hackensack train station one recent night as snow flurries blanketed Bergen County. The moisture on his clothing crystallized into tiny icicles in the mid-30s chill.

Glen Stewart, 33, passed Keenan on his way to the pharmacy and was concerned about his safety, so he spent hours on the phone trying to get Keenan sheltered through the state’s assistance hotline, NJ 211. Keenan had helped Stewart in the past when Stewart was sleeping on the streets himself, and he wanted to return the favor.

When that didn’t work, he hoped the police would perform a welfare check and take Keenan to the hospital for refuge. New Jersey offers a three-decades-old screening law similar to New York City Mayor Eric Adams’ recent mental health and homelessness directive that allows authorities to involuntarily hospitalize the mentally ill if they are a danger to themselves or others.

According to a rough count by the state medical examiner, about 30 people in New Jersey experiencing homelessness died due to hypothermia in the last five years, so staying outside in the cold seemed to qualify as behavior that was a “danger to self.” Stewart hoped a hospital stay would give Keenan a reprieve from the frigid air.

All these efforts failed, and Keenan was left out in the cold.

That recent frustrating experience highlighted the serious limitations of the public systems — including 211 and Code Blue — that are currently set up to help get New Jersey's homeless people out of the cold.

‘Code Blue is useless’

As Keenan sat leaning against a light post a few nights later, people who passed by called out to him with a smile or wave. A man shook his hand, folded a bill into Keenan’s palm and said, "What's good, my man."

Keenan, 44, has become a fixture in Hackensack, where he’s been sleeping on the streets the past five years. He said he and his girlfriend broke up amicably so he moved out, and he was kicked out of the next apartment he moved into after one day.

“It’s scary how easy it is to become homeless,” Keenan said.

He said he’s working with Bergen County, Transition Professionals and the Women's Rights Information Center to find housing, but each time there appeared to be a lead, it fell through. He used to stay in Bergen County’s sole shelter, but said he was kicked out and doesn’t want to go back.

Keenan appreciated Stewart’s efforts on the phone. Keenan’s cell was recently stolen, along with other belongings, including his sketchbook. He’s a cartoonist, and his murals can be seen in bars, houses and strip clubs throughout the county. But there’s “no business anymore,” he said.

By the time Stewart got through to a live person at 211 that snowy night, the operator told him they could not help Keenan. Bergen County had not issued a Code Blue — an order that opens additional warming shelters and relaxes shelter rules so more people can seek refuge when the temperature drops below freezing or a certain wind chill level is reached.

Instead of providing Keenan with a motel stay, the agent told Stewart the hotline could provide Keenan with “resources” for the following day.

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Bergen County’s Office of Emergency Management decides at the beginning of each week what days they will activate Code Blue. After being contacted by NorthJersey.com about Keenan's experience, the county said it would change its policy “to continually check and update Code Blue alerts," said Michael Pagan, Bergen County public information officer.

On the same night Keenan could not find shelter in Bergen County, nearby Passaic, Union, Morris and Sussex counties had activated Code Blue. So had Burlington, Hunterdon, Mercer, Ocean and Somerset counties.

“We need to visit the fact [that] although Code Blue wasn’t activated, a homeless person could not receive services,” Pagan said. “There needs to be a system of checks and balances irregardless of the Code Blue law.”

In response to questions about what happened to Keenan, NJ 211 communications manager Dana Catapano sent a statement.

“Placement instructions, Code Blue activations, warming center listings, and motel information are based on what NJ 211 receives from each individual county,” Catapano said. “If there is an issue with the placement, the consumer needs to reach out to NJ 211, so we can take the necessary steps to investigate and adjust the placement, if needed.”

The night after Stewart was unable to get Keenan shelter, Bergen County did activate Code Blue, so Stewart tried again.

About three hours after he first called 211, he said, he secured a room for Keenan at a Travelodge 2½ miles away. He found a Hackensack police officer who agreed to drive Keenan part of the way there, so his walk to the motel would be cut to about a mile.

Stewart knew which resources to call because he had experienced homelessness himself several times, in some cases sleeping in the shelter before he was kicked out, and other times crouched over a fire in a snowy cemetery. During his latest stretch, Keenan helped Stewart by showing him the abandoned house where he was sleeping at the time, information he doesn’t normally share because it could risk his safety and draw unwanted attention.

But on the night Bergen County declared a Code Blue, Stewart’s persistence still wasn’t enough to secure Keenan shelter.

Keenan said that when he got to the motel, the person at the front desk said they had given his room away, and refused him when he asked to use the motel phone to call 211, saying it was broken.

When reached by phone, a Travelodge employee told NorthJersey.com she saw Keenan’s name in the log book for Monday night, not Tuesday night, but is not sure what happened.

Keenan walked an hour back to the area where he normally sleeps and feels safe.

“I felt frustrated and annoyed,” Keenan said. “Code Blue is useless.”

Catapano said 211's records indicate Stewart waited on hold for 4 minutes on Monday, and after leaving a callback number, 211 responded 40 minutes later. She said 211 does not have record of a call on Tuesday.

"Long wait times are the exception and not the rule," Catapano said. "Last year, NJ 211 answered 78% of Code Blue calls in less than 3 minutes."

Danger to oneself

When 211 didn’t help Keenan that first night because Bergen County had not declared a Code Blue, Stewart hoped the police might step in. Hackensack law enforcement received a call that night asking for a wellness check, Capt. Michael Antista confirmed.

Stewart watched from a distance as officers and an ambulance pulled up, stayed for a few minutes, and then drove away. Keenan said nobody from the ambulance spoke to him.

Stewart wanted authorities to take Keenan to the hospital, where he could safely spend the night. Keenan said he wouldn’t refuse a way to get out of the cold, but that he was unsure whether he should be in a hospital because he said he’s as “healthy as a horse.”

“No, you’re not,” Stewart said.

Antista said that if officers see a person who is too intoxicated to take care of themselves, they will take that person to a hospital or treatment center.

“Officers do have to make judgment calls, and if they believe that this person is not intoxicated, or is in the right frame of mind, they can't force someone to go to a hospital,” Antista said.

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The department did not immediately respond to a public records request for the computer-aided dispatch note on the officers’ wellness check of Keenan.

New York City drew recent headlines for Adams’ polarizing directive to address the city’s homelessness and mental health crises with involuntary hospitalization. The policy directed mobile crisis teams and police officers to take into custody a person experiencing a mental health episode and take them to a hospital for evaluation against their will if they are a danger to themselves or others and unable to meet their basic needs.

New Jersey, like a majority of states, has a similar policy in place.

After a decade of debate fueled by the decision to empty state psychiatric institutions, Gov. Thomas Kean signed a law in 1987 that legalized involuntary commitment of certain mentally ill people for 72 hours without a court order if they pose a danger to themselves or others. Four years later, lawmakers passed a patient “bill of rights” for those patients, protecting them from “unnecessary physical restraint and seclusion,” and acknowledging that such patients can refuse medication.

“If someone's saying, ‘I don't want help,’ but clearly they're not well enough to make that decision for themselves, that is what the law is intending to do, to kind of supersede them in that moment because they're not able to make clear, logical, safe decisions,” said Lisa Montuore, director of the psychiatric emergency screening program at CarePlus in Bergen County. “The goal is to get them into care and have that care be sustainable. It's just very complicated, and there's a lot of steps in between.”

If police observe someone who is dangerous to others, to property or to themselves due to a mental illness — which means they not only appear to be suicidal, but also behave "in such a manner as to indicate that the person is unable to satisfy his need of nourishment, essential medical care or shelter,” they can transport the person to Bergen New Bridge Medical Center in Paramus for observation.

In Bergen County, anyone can call 262 HELP to reach a CarePlus representative, who will dispatch a mental health screener — ideally within 20 minutes, but it can take longer — fill out two screening documents, and decide what makes sense: Does the person agree to be hospitalized, or should they be taken involuntarily for inpatient or outpatient care?

After a person receives a medical and psychiatric evaluation at the hospital, sometimes the hospital admission criteria aren’t the same as the screening laws for commitment, Montuore said, so the hospital may offer the person a shower or something to eat, and discharge them to a shelter or another housing option.

“We wish it was as easy as taking them off the street, getting them into care — even if it's short-term — but it's not a quick fix and it’s much more complicated than that,” Montuore said. “Our mental health system is fragmented and costly, and over time our hospital emergency rooms have become the catch-all safety net.”

In the meantime, Keenan continues to accept a hot meal from a friend, a short stay with someone in the community, a friend’s help spending hours on hold with the county, a folded bill to pay for what he needs.

“In general, though not always, people are decent,” Keenan said.

'Fantastic, marvelous'

Stewart's third attempt worked.

On Friday night, Stewart said he spent another one to two hours waiting and speaking with 211 until he was able to secure a motel stay for the weekend. Stewart accompanied Keenan on a bus to the motel to make sure he was able to check in.

Keenan set his red backpack on the dresser and smiled, surveying the room's neatly made queen bed, the mirror and the peeling wooden door. He sat down on a blue leather chair, giggling.

"It feels fantastic, marvelous," Keenan said to Stewart, who asked him how he felt walking into his room. "It's freezing cold outside. I haven't been able to shower for ... months. Now I can just sit down and relax and be normal for a little bit."

This article originally appeared on NorthJersey.com: Code Blue limitations leave some NJ homeless people out in the cold