The Institute for Human Services opened its fourth “specialty shelter” — the Kalihi Uka Recovery House — in December, and calculates it already has saved The Queen’s Medical Center $2.46 million that otherwise would be spent treating homeless addicts in expensive hospital beds.
Instead, the hospital spends “close to $750,000 per year” to help fund Kalihi Uka and two other IHS specialty shelters aimed at “medically fragile” homeless patients who are ready to be discharged but aren’t healthy enough for life on the street and even more vulnerable to attacks and thefts, said Kathy Morimoto, vice president of patient care for The Queen’s Medical Center and The Queen’s Health Systems.
From the hospital’s perspective, Morimoto said, IHS’ specialty shelters represent “a real blessing.”
“It’s allowed us to safely discharge these patients into the community and give them enough resources to hopefully get back on their feet,” Morimoto said. “We want them to thrive in the community.”
IHS opened its first specialty shelter — VET House — out of a rented seven-bed, four-bath home in Kalihi in July 2013. IHS joined with the U.S. Department of Veterans Affairs to help like-minded homeless veterans with the goal of finding permanent housing.
Out of 38 homeless veterans who checked into VET House in fiscal year 2017, 25 found housing and seven were still in VET House when the fiscal year ended. The other six left VET house on their own.
In March 2016, IHS worked with Queen’s to open Tutu Bert’s House in a rented six-bedroom, three-bath home in Kalihi. Since then 109 homeless patients have checked in. Thirty have found permanent housing, and another 30 moved into homeless shelters. Fourteen went back to a hospital.
IHS estimates that Tutu Bert’s House in Kalihi has saved Queen’s at least another $7.68 million.
Then, in July 2016, IHS opened another Tutu Bert’s House, in Makiki, in partnership with Queen’s and Castle Medical Center. Castle did not respond to email and telephone requests for comment, but IHS estimates that Tutu Bert’s House, Makiki, has already saved Queen’s and Castle a combined $3.7 million.
In all, IHS said it has saved Queen’s and Castle $13.87 million in just over a year.
“We needed options,” Morimoto said. “These patients no longer meet medical necessity. But discharging patients to the street without adequate support oftentimes can be a difficult option.”
IHS’ specialty shelters, Morimoto said, “really provide a safe landing for these patients who need more than health care. They need the basics of integrating back into the community.”
Stacia Aukai, 39, who was raised in Papakolea, said Tutu Bert’s House, Makiki, saved her life after she suffered kidney failure on the streets of Pearl City two months ago and woke up bloated in a Queen’s hospital bed weighing 245 pounds from fluid buildup.
“I had no place to go,” Aukai said. “I think I would have died.”
Aukai, who now weighs 160 pounds, suffers from a wide range of ailments, including kidney disease that requires dialysis, Type 1 diabetes, anemia, a fractured bone in her right foot that punctured her skin, an ulcer in her right foot that requires hyperbaric treatment, heart disease and a blood clot on the brain.
Homeless in Pearl City, “I just wanted life to end,” Aukai said. “I just gave up.”
Now she’s back on her medications, eating healthier and receiving outpatient treatment at Queen’s while she recovers at Tutu Bert’s House, Makiki.
“This place gave me a second chance,” Aukai said. “If I was to win the lottery, I would open more houses like this. It gives people a reason to live.”
Connie Mitchell, IHS executive director, said many other homeless people with specific problems also could benefit from specialty shelters. There are no specific plans, but Mitchell is thinking about how to create additional specialty shelters to treat homeless senior citizens, homeless people with mental health issues, and homeless youth, who cannot legally enter shelters on their own because of complex issues including guardianship and parental rights.
All three groups represent “a huge need” currently not being met, Mitchell said.
The specialty shelters, Mitchell said, serve “people who just have nowhere to go,” adding, “We needed to do something. Queen’s had many homeless people who were kind of stuck at Queen’s because they needed to complete treatment that could ordinarily be done at home. We needed to give them a place where they can get re-nourished while they receive treatment. … We know we saved the system a lot of money.”
Justin Ka‘alekahi, 34, originally from Ewa Beach, said he was in and out of Queen’s 47 times last year for Type 1 diabetes, meth addiction, depression, schizoaffective disorder and post-traumatic stress disorder for childhood trauma that he declined to describe.
Living near the old Kmart on Nimitz Highway, Ka‘alekahi was unable to refrigerate his insulin, which often got stolen anyway. He had also checked into seven drug rehab programs that had little effect on keeping him sober or off the streets.
Just between January and May, Ka‘alekahi estimates he went to Queen’s nine or 10 times for treatment, mostly for diabetes-related problems.
Then on May 7 a Queen’s case manager referred Ka‘alekahi to Kalihi Uka Recovery House, and “I haven’t been to the hospital since,” he said.
He’s also been sober for three months — the first time in 17 or 18 years, Ka‘alekahi said.
“KURH,” as the residents call it, “gave me the opportunity to better myself,” Ka‘alekahi said.
If it wasn’t for the specialty shelter, Ka‘alekahi said, “I would be out there smoking (meth) for sure. I’d be getting high, and I would have been in the hospital four or five times by now.”
Now he feels “more confident than I’ve ever been before.”
And he’s starting to envision a future where he remains sober and has a permanent place to live.
Now that he’s been around others devoted to helping Oahu’s homeless addicts, Ka‘alekahi can even see himself one day doing the same thing.
“I want to help people like me,” he said.
Queen’s Morimoto said working with IHS to help homeless patients get healthy — and, hopefully, on their way to permanent housing — fits with King Kamehameha IV’s ideals when he helped lay the cornerstone for the hospital in July 1860 and declared that “the destitute and the sick are our brothers and sisters.”
“That really drives all of us at Queen’s,” Morimoto said. “The need is just so great.”