Mayor Rick Blangiardi, and Queens Health System CEO Jill Hoggard-Green
It is well known that Hawaii has one of the highest rates of homelessness per capita in the nation. But besides lacking stable housing, homeless individuals have woefully inadequate access to health care. Often their only source of treatment is a hospital emergency room, But episodic ER care does not provide continuity or access to preventive services while wasting resources that are needed for true emergencies. H4 seeks to expand access and improve the quality of care for the chronic homeless, while reducing the cost of their care by eliminating unnecessary use of expensive hospital services.
The City and County of Honolulu envisioned a model of comprehensive services for the homeless in a single location. The City’s Department of Community Services (DCS) has made available a previously unoccupied four-story building at 431 Kuwili Street, known as the Punawai Building, for this purpose. This location at the outskirts of Chinatown is known to be a cross road for many homeless individuals, both sheltered and unsheltered, in the urban core of Honolulu.
The City’s model has four levels as described below, and H4 will provide the second and third levels of care in this continuum.
Comprehensive health care and housing services for the homeless
H4 Medical Clinic
H4 Medical Respite
Permanent Supportive Housing
H4’s Punawai Medical Respite Center opened in February 2021 with 18 patient rooms. Two additional rooms are available for treatment and counseling for respite patients, with the clinical staff including a physician or advance practice nurse (APRN) during the hours of 10:00 AM to 6:00 PM daily. In the near future, H4 will open this primary care clinic to the public during the same eight-hour period, targeting the homeless and other low-income individuals.
H4 is currently building out the second floor (beneath Medical Respite) to house the Punawai Clinic, which will substantially expand the space available for medical care and counseling as well as ancillary services and office space for the clinical staff. The Punawai Clinic is expected to open in the fall of 2021.
H4 also operates a satellite clinic to serve homeless individuals in Windward Oahu, covering the area from Hauula to Waimanalo. It operates M-W-F from 10:00 AM to 2:00 PM.
Homeless in Hawaii
The lack of safe, adequate housing for families in poverty—Hawaii’s most vulnerable citizens—impacts health, safety, and opportunities. H4 and its partner organizations providing services within the continuum of care at Punawai provide a safe place for homeless patients while they receive hygiene, healthcare, and social services, plus assistance in locating permanent housing.