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Introduction

H4 is a comprehensive homeless service facility serving Oahu’s chronically homeless population.  The organization was founded by two dedicated physicians with extensive experience in responding to the healthcare needs of the homeless:

  • Dr. Josh Green, who has served as an emergency room physician for many years on the Big Island.
  • Dr. Scott MIscovich, who operates urgent and palliative care services in the Kaneohe area.
    H4 will be housed through the renovation and re-purposing of an existing building in the Iwilei area of Honolulu.  It will include four dedicated floors to meet specific needs and is projected to open in fall 2018 with a hygiene center.  Additional healthcare and housing services will be added in winter 2018.

Beginning April 9th, 2018, H4 will offer medical services at two temporary locations:

  • Institute for Human Services’ men’s shelter in Iwilei, 350 Sumner Street
  • Chinatown Joint Outreach Center, 61a North Hotel Street (adjacent to police substation).

Services will be available on a walk-in basis on Monday, Wednesday, and Friday each week, from 8:00 a.m. to 12:00 p.m. at the IHS site and from 1:00 p.m. to 8:00 p.m. at the Joint Outreach Center.  These medical clinics will close when H4’s primary site is fully operational.

The temporary locations will offer the following non-emergency medical services:

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

H4 is committed to addressing the dramatic surge in healthcare services used by the homeless, including ambulance services provided by Honolulu’s Emergency Medical Services (EMS) and both the emergency department and inpatient services of local hospitals.  Between 2010 and 2016, the cost to serve the homeless has more than doubled to over $100 M per year.  Police engagement with the homeless has also increased.

H4 will serve 1,200-1,400 chronically homeless individuals, saving Hawai’i taxpayers $30-$40M per year by curbing the tide of healthcare demand.  Without action, growing demand will compromise patient safety, constrain access, jeopardize the quality of care, and increase healthcare costs.

Hawai’i has the highest rate of homelessness per capita in the nation.  The lack of safe, adequate housing for families in poverty – Hawai’i’s most vulnerable residents – impacts health, safety, and opportunities.  H4 will provide a safe place for homeless patients while they receive healthcare services and assistance in locating permanent housing.

H4’s patients will have four levels of service available to them, organized by floor.

Patient’s Journey

1

Hygeine

A hygiene center located on H4’s first floor will provide an initial point of entry for the homeless along with a shower facility and laundry services. 

2

Healthcare

H4’s second floor will be a full-service urgent care center dedicated to the needs of homeless and underserved populations.  It will operate 24/7 and will provide an array of healthcare services, including mental health and drug treatment, both onsite and through referral.

3

Medical Respite

When extensive follow-up care is required, the third floor will provide a medical respite service. Patients will stay from a day or two to a few weeks, with medical care and monitoring
available in the nearby urgent care center.

 4

Transitional Housing

For patients learning to manage chronic conditions or requiring longer-term follow-up care, the 4th floor offers transitional housing for several months. During this period, social service agencies will attempt to arrange permanent housing.

Hawaii Homeless Healthcare Hui
Iwilei