After more than six months of housing and treating homeless patients discharged from Oahu hospitals, Hawaii’s first “medical respite” kauhale will begin shutting down today and take the lessons learned to two new projects designed to expand to mental health issues affecting the homeless.
HomeAid Hawaii organized its hui of builders and trades workers to create Pulama Ola in only seven weeks atop a state Health Department parking lot between the governor’s mansion and The Queen’s Medical Center to house and treat homeless people, who disproportionately make costly emergency medical room visits.
It opened in June as a pilot project to help patients who are well enough to be discharged but too fragile for life on the streets, while providing them with a wide range of social service help.
Pulama Ola was driven by Gov. Josh Green — America’s only sitting governor who is also a medical doctor — and his former housing director, Nani Medeiros, who helped Green create the first tiny-home, or kauhale, homeless community in Kalaeloa when he was lieutenant governor.
“Pulama Ola has been a tremendously successful pilot project and we have collected data that will help to inform our future efforts to help our houseless neighbors,” Green said in a statement. “We have seen the community model for kauhale with wrap-around services work effectively time and time again.”
The dozen tiny homes that comprise Pulama Ola will now be relocated next week to create another kauhale on Middle Street in Mapunapuna.
Pulama Ola’s residents have since moved into — or plan to move into — the city’s H4 homeless housing project in Iwilei, run by the Kalihi-Palama Health Center, and Hawaii’s original brick-and-mortar medical respite, Tutu Bert’s House, which is run by the Institute for Human Services.
The lessons learned at Pulama Ola will then be applied to a nine-unit kauhale in Iwilei to help other homeless clients recently discharged from hospitals and to treat homeless people with mental health issues, along with a bigger 33-unit kauhale with the same concept in Kaneohe near the State Hospital.
The Iwilei and Kaneohe kauhale will be the first to focus on homeless mental health issues, “because there is an obvious need in the population,” said Darrah Kauhane, executive director of Project Vision Hawaii, which runs Pulama Ola and will oversee the new kauhale opening in Iwilei and Kane ohe in January and are expected to be fully operational in February.
While operating Pulama Ola, Project Vision met weekly with hospital officials from Queen’s, Straub and Kuakini medical centers and Kapiolani Medical Center for Women &Children to discuss how the kauhale was — or was not — meeting the needs of the 21 residents and the more than 200 other homeless people in the downtown area who took showers at Pulama Ola and received psychiatric and social service help. Two of the residents were referred by Maui hospitals following the devastating Aug. 8 wildfires.
“The idea was always to have this pilot project to understand where the pukas are, to understand what the level of need is and the level of care that’s needed,” Kauhane said.
Two things became clear: Homeless patients have a wide range of needs and require “a diverse range of options” — and kauhale residents want and need a sense of community and enjoy helping their community by gardening, serving in a neighborhood watch, distributing food to kupuna residents and packing hygiene kits for homeless people around the kauhale, Kauhane said.
More than 200 homeless people living downtown also were welcomed at Pulama Ola to get medical treatment, eat, use the bathroom, take a shower, pick out donated clothes, get fresh hygiene supplies, charge their cellphones and get help accessing their government benefits and other social service help.
Thirteen more kauhale are planned across the state: two on Hawaii island, including one focused on homeless substance abuse issues; two on Maui; one on Molokai; and six more on Oahu.
HomeAid Hawaii, the state’s kauhale developer, is reviewing hundreds of potential kauhale sites across Hawaii, said the organization’s executive director, Kimo Carvalho, who previously was spokesperson for IHS, which operates Hawaii’s largest homeless shelters, interacts with homeless people on the street to get them help and provides medical treatment.
For Pulama Ola, HomeAid Hawaii was able to bring the building costs of each unit down to $16, 000 from $22, 000.
“We’ve been learning how to make kauhale more efficient,” Carvalho said.
There were 10 units dedicated for residents, another for on-site nurses and one more for administration, operations and security.
HomeAid Hawaii has since been talking to medical centers and health care providers across the islands to best serve their homeless patients and “expand the concept of medical respite,” Carvalho said. “It’s a proven concept, but there are multiple subpopulations: physical therapy, cancer treatment. Every medical respite discharge requires a treatment plan that needs to be thought through to deal with all those special care needs.”
Overall, though, “In terms of a demonstration project, Pulama Ola really did bring people together and served its purpose,” Carvalho said.
