Patient care

Primary care

H4 currently operates three walk-in clinics targeted towards homeless and other low-income populations, two in urban Honolulu and one in Kaneohe.  Please see LOCATIONS for the hours of operation and exact locations.

Each clinic is staffed by a physician or APRN supported by a medical assistant and/or care coordinator, with psychiatric care generally available one day per week.  The services normally provided by a primary care physician practice are offered, including:

  • Medication refills
  • Allergic reactions
  • Asthma attacks
  • Burns
  • Bronchitis
  • Cold and flu
  • Fevers
  • Minor procedures (such as stitches)
  • Lacerations
  • Muscle strains
  • Viral illnesses
  • TB test
  • MMR vaccination
  • Tetanus
  • All other common illnesses

In addition, treatment for mental illness and substance abuse are provided, either directly or through referral.

H4’s medical service capacity will be expanded when the space at 431 Kuwili Street opens up for our 24/7 urgent care center.  Much more space will be available at this location, including additional rooms for lab, X-ray, and counseling, five exam rooms, eight observation beds, plus enhanced space for reception, screening and waiting.  A floor plan for the urgent care center is displayed in FLOOR PLANS.

Social services

Onsite social services are provided at each of our clinic sites through partnering organizations or directly through H4’s support team and volunteers.  This includes case management, outreach, Medicaid application, and referrals for housing, employment, and other benefits.  H4  also assists in arranging care with specialty providers, including advanced wound care, outpatient surgery, and HIV testing and counseling.

Mail service for the unsheltered homeless is provided at H4’s Kaneohe clinic because this service would otherwise not be available in the Windward area.  Mail service is provided at the Punawai Rest Stop for homeless individuals in urban Honolulu.

Medical respite

H4’s medical respite service will provide up to 29 beds for homeless individuals who are too ill or frail to recover from a physical illness or injury on the streets but are not ill enough to require care in a hospital or nursing facility.  This service will be offered at the City’s Kuwili Street building once renovation of the space is completed in early 2020.  It will offer a clean and safe environment for residents while they recover from an acute episode of illness or surgery, or while they receive near-death hospice care.

At least two care coordinators or medical assistants will be on duty on the medical respite floor at all times.  In addition, H4’s medical team will make rounds on the floor once a day, and residents will have access to the medical care and social services available in the 24/7 urgent care center just one floor below.   Residents are expected to stay in a medical respite unit from several days to weeks, depending on their condition.

COVID-19 services

The State Department of Health has taken the lead in opening a quarantine center for the homeless at a vacant building owned by the City, which is configured with 26 small apartments (with double occupancy if necessary) and office space. The building is located at 524 Kaaahi Street, adjacent to the IHS Women’s Shelter in Iwilei.

The quarantine center will house individuals who are awaiting the results of a COVID-19 test or who test positive for the virus but do not have symptoms requiring hospitalization. H4 provides COVID-19 testing as needed but separate from our primary care clinic, which has been moved to this location from the police substation in Chinatown. H4 providers will staff the clinic from 10:00 a.m. to 6:00 p.m. seven days a week, and H4 will provide medical supervision 24/7 for patients housed in the quarantine center.

In addition to H4’s role in this initiative, the Department of Health has arranged for overall medical oversight of the quarantine center by a physician employed by the Hawaii Health & Harm Reduction Center.  In addition, members of the Local 5 hospitality union are furnishing food service, housekeeping, laundry, security, and maintenance for the facility, and the Institute for Human Services provides social work and case management services.

Funding organizations

H4 is grateful for the substantial capital funding provided by HMSA and Islands Hospice which helped launch our non-profit organization in late 2017.  Since then, additional funding has been provided by several other organizations.

In addition, a number of organizations have partnered with H4 to provide in-kind donations or services that complement and support H4’s operations.

Contributing and supporting organizations