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State's first medical kauhale village takes shape in Honolulu

Sabrina Bodon
Hawaiʻi Public Radio
A medical respite kauhale at the state Department of Health parking lot in Honolulu.

More than 200 people without housing are discharged from Oʻahu hospitals each month onto the streets, James Koshiba, the governor's homelessness coordinator, said Tuesday afternoon.

Oftentimes, without a safe, hygienic place to fully recover, recovering from a stay in the hospital can be long and difficult.

To help those experiencing homelessness, the state will open a medical respite kauhale village in downtown Honolulu. Five units arrived at the state Department of Health parking lot on Tuesday. Eventually, the village will have 10 units.

“We are building a medical respite kauhale in our own backyard because in many ways it is an epicenter of people suffering from a lack of care and hygiene support – and because we want to lead by example,” Gov. Josh Green said in a release.

Office of Gov. Josh Green
James Koshiba is Gov. Josh Greenʻs homelessness coordinator. He discusses the medical needs of homeless residents who might use the kauhale on May 9, 2023.

“We need to say 'yes in my backyard.' We can and will welcome partnerships to provide the services they need to put them on a path toward healing; we can and will show aloha to our neighbors," Green said.

The kauhale structures were built by the nonprofit HomeAid Hawaiʻi, and a hygiene trailer from Project Vision Hawaiʻi will be available for those in the village, and other unhoused community members. Project Vision will also provide registered nurses to make daily rounds.

“The design process accounted for the privacy of both kauhale residents and state employees who park in the adjacent lot, as well as people who walk through the area to get to their offices,” Chief Housing Officer Nani Medeiros said in a release.

“The exterior design is inspired by the ‘ōhiʻa lehua blossom, which is often the first to bloom after a lava flow and which embodies resiliency and thriving amid destruction," Medeiros said.

At the Annual Milken Institute Global Conference, Green discussed the concept of medical kauhale to expand on the idea that housing is a form of health care.

According to a release from earlier this month, the average spending on emergency room care for a homeless person is $82,000 per person per year. By establishing medical respite shelters, it could reduce the cost by up to 73%, depending on the patient.

"These follow-up services will dramatically reduce ER visits and bring the average cost down to $21,000 a year," Green's release said. "The savings can be reinvested in our communities."

Koshiba said hospitals will refer patients for placement.

"There's a range of kind of medical respite needs, it might be someone that's had surgery, it might be someone that just needs help making sure that their medications are stored and available," Koshiba said. " Folks that come to this space will generally be able to perform activities of daily living on their own with some assistance."

 Kauhale can be seen in the state Department of Health parking lot in Honolulu on May 9, 2023.
Office of Gov. Josh Green
Kauhale can be seen in the state Department of Health parking lot in Honolulu on May 9, 2023.

He added that residents may be able to shower or use the bathroom on their own, but there will be staff to help.

The medical respite kauhale should open before the end of this month.

"Number one, people feel welcomed here," Koshiba said. "They feel like they're part of a community."

Sabrina Bodon is Hawaiʻi Public Radio's government reporter. Contact her at sbodon@hawaiipublicradio.org or 808-792-8252.
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