h4 Iwilei site of H4’s medical respite and clinic services H4 Blessing for Punawai Medical Respite H4 Blessing speakers H4 Executive Director Andy Mounthongdy, Lt. Governor Josh Green,
Mayor Rick Blangiardi, and Queens Health System CEO Jill Hoggard-Green
H4 Opening of Kaneohe JOC H4 U.S. Surgeon General Visits H4 H4 Groundbreaking for the Kuwili Street Hygiene Center
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H4's Mission

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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.

Mission

To care for the people of Hawaii who are struggling the most among us.

Vision

A private/public partnership supported by all healthcare & social service professionals, regional health systems, and philanthropists in Hawaii to create a new model to address chronic homelessness.

Comprehensive health care and housing services for the homeless

Hygiene

A hygiene center located on the first floor provides an initial point of entry for homeless individuals, with general case management, toilets, shower facility, mail, internet, and laundry services, with accommodation for pets. Mental Health Kokua operates this first-floor center known as the Punawai Rest Stop.

H4 Medical Clinic

The second floor is a full-service medical clinic, known as the Punawai Clinic, dedicated to the needs of homeless and other underserved populations. It operates eight hours a day seven days a week, and provides an array of services including mental health and drug treatment, both onsite and through referral, in addition to case management.

H4 Medical Respite

When extensive follow-up care is required following an acute episode of illness or injury, the third floor provides a medical respite service. Patients stay from a day or two to a few weeks, with case management, housing counseling, medical care, and monitoring available from the medical clinic on the floor below.

Permanent Supportive Housing

For patients learning to manage chronic conditions, the fourth floor offers 20 units of permanent supportive housing. Social service agencies will help residents in transitioning into the permanent home that best meets their long-term needs. Steadfast Housing operates this fourth-floor center known as Hale Punawai.
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Current Services

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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.

Please see ABOUT for more information on the services H4 offers at these sites and  see LOCATIONS for their hours of service.

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.