Improving access to urgent care for Honolulu’s homeless and decreasing their over-utilization of ambulance services and visits to hospital emergency departments—often for non-urgent needs—have been top priorities of the Hawaii Homeless Healthcare Hui, also known as the H-4 Project.

Some estimate that the care provided to a homeless individual averages $80,000 per year—money that must be absorbed by providers or paid by taxpayers.

Lt. Gov. Josh Green, an emergency room physician, and Dr. Scott Miscovich, who specializes in urgent and palliative care in Kaneohe, saw the need to meet the health and social needs of Honolulu homeless. They formed H-4, a private-public partnership as a nonprofit organization, and has received extensive support from HMSA, the City and County of Honolulu, and The Queen’s Medical Center.

The City and County purchased a building in Iwilei to provide housing and healthcare services for $6 million and budgeted an additional $10 million for construction. HMSA contributed $8 million, and The Queen’s Medical Center is providing physicians and staff to run the healthcare program.

The partnership continues to expand. The Hawai‘i Health Information Exchange (HHIE) is now a part of this public-private partnership, providing valuable real-time patient information for the H-4 team to deliver quality preventive care and management.

“We’re glad to be doing our part to address Hawaii’s challenging homeless issue. HHIE will allow the H-4 healthcare team to access patient information to better monitor what has been a transient population,” said Francis Chan, HHIE’s CEO. “Ultimately, this will mean better care management for Honolulu’s homeless and curb utilization of costly medical services and ER visits. We will also work with H-4 team to make the health records of these patients at H-4 available to HHIE users so that this information can be readily available in the future should these patients receive care at participating hospitals and clinics.”

“HHIE’s involvement takes this project to a new level of sophistication that we need to effectively deliver the care to this vulnerable population,” said Lt. Gov. Josh Green. “HHIE is  welcome addition to improve the quality of care that H-4 provides.”

"H-4 was born out of a need to provide better care for Hawaii's homeless and reduce healthcare costs," said Andy Mounthondgy, H-4's Executive Director. "Improving public health has always been a priority for HHIE. We appreciate the HHIE team for stepping forward as our newest partner and for being willing to freely share their valuable asset for the common good."

H-4’s transitional and permanent housing in Iwilei provides a safe place for homeless patients to stay while receiving ongoing care to prevent hospital readmissions or an inappropriate level of care. The facility also provides wraparound health and wellness services that include a shower facility, laundry services, drug treatment, mental health services, respite care, and on-site case workers who assist patients with obtaining permanent housing.