Lunalilo Home was established through a will drafted by Hawaii’s sixth monarch and first elected king, William Charles Lunalilo.

Next week — more than 130 years after the home first opened its doors — Diane Paloma will begin serving as the first chief executive officer of The King William Charles Lunalilo Trust. Today is her last day heading the Native Hawaiian Health Program at The Queen’s Health Systems, a post she’s held since 2006.

King Lunalilo, who died from pulmonary tuberculosis after reigning just one year, had stipulated in the will that his estate be sold to pay for construction and perpetual operation of a home to care for infirmed, indigent Hawaiians with a preference for seniors.

Trustees appointed by the Hawaii Supreme Court unloaded landholdings on five islands, and Lunalilo Home opened in the Makiki area, makai of Roosevelt High School’s current site, in 1883 — six years after the king’s death. In 1927, to make way for Honolulu urban expansion and because the home had become costly to maintain, it moved to its current site on the slopes of Koko Crater in Hawaii Kai.

For Paloma, who grew up in East Honolulu’s Wailupe area, and still lives there, her new commute is about 10 minutes flat. Topping that enviable little perk, Paloma said, “I have the greatest privilege in combining my passion for Native Hawaiian culture with my abilities in the health care profession.” She added, “There is no other place in the world to do this kind of work.”

During school years and throughout her career, Paloma said: “The entire time, I’ve also been dancing hula, and it has grounded me culturally.” She continued, “Yes, I have done a number of Merrie Monarchs, but the most rewarding moment was through the ‘uniki ceremony (literally ‘binding’ achievement) where I ‘graduated’ as an ‘olapa (a skill ranking). Hula and the cultural practices within our halau connect all those links for me in how I approach and address health.”

Question: The stated purpose of the trust was to build a home for the “poor, destitute, and infirmed people of Hawaiian (aboriginal) blood or extraction, with preference given to older people.” Lunalilo was the first large-landholding alii to create a charitable trust. Others followed?

Answer: They essentially all provided a legacy of their wealth directly to their people. Pauahi, Queen Emma, Queen Liliuokalani, and Queen Kapiolani all had the vision and foresight to provide for their people. All of these have withstood the dramatic changes in Honolulu and are still present today.

King Lunalilo found a way to provide through modern means a time-honored value of honoring our kupuna. In a sense, he took the values of his ancestors and applied them in modern-day applications.

Q: How does the nonprofit Lunalilo Trust pick up costs for poor, disadvantaged kupuna?

A: The trust is able to subsidize Hawaiian residents who meet the criteria for admission and who do not have sufficient assets or funds to cover the cost of their care through its investment portfolio proceeds, generous philanthropic support, and fundraising events such as its annual luau and golf tournaments.

I hope to create opportunities and partnerships to enhance that ability to provide for more kupuna and potentially diversify some of our services.

Q: You will be tasked with extending the reach and impact of Lunalilo Home’s mission to support the well-being of kupuna. What are your top priorities?

A: As the first CEO, my role is to implement the newly revised Kauhale Kupuna Strategic Plan, which prepares the organization into the next 10 years. Key goals that were determined are to (1) optimize reach and impact, (2) enhance and sustain quality, (3) assure financial stability, and (4) strengthen organizational excellence. I hope to adapt as quickly as possible to the organizational culture and bring an increased presence of kuleana (responsibility, privilege) for our kupuna.

Q: The latest U.S. Census Bureau data finds that 17 percent of the state’s 1.4 million residents are age 65 or older — a bump up by almost 3 percent since 2010. Is the so-called “Silver Tsunami” prompting efforts to expand or change Lunalilo Home’s services?

A: Yes, and the Kauhale Kupuna Strategic Plan was the first step in making those opportunities possible. With the increased senior population and the impending rise in life expectancy, we will need to adapt to the growing need while making resourceful decisions so that our reach is not temporary, but in perpetuity.

Q: How many seniors live at Lunalilo Home? And what happens if they lose ambulatory ability?

A: Lunalilo Home has a capacity of 42 persons. … About two-thirds of the residents are Hawaiian. (A wheelchair is allowed in temporary situations only.) On an ongoing and regular basis, the staff of Lunalilo Home meets with each resident and their family/representatives to discuss best options available as anticipated and unanticipated mental or physical health circumstances change.

If a resident’s status changes in such a manner that their needs would be better served in another environment, the staff works with the resident and their family to assure that the next accommodations and services are a good match.

Q: How many seniors take part in various other services or programs?

A: Approximately 20 persons from the community are registered in the adult day care. And Lunalilo Home prepares over 900 meals per month that are delivered to homes by Lunalilo Home or through a collaboration with the Hawaii Meals on Wheels program. (There’s also a “Meals-to-Go” pick-up service.)

Q: A recent Centers for Disease Control and Prevention study found that Native Hawaiians are in unusually bad health — more likely to be contending with asthma, diabetes and obesity, for example — compared to other groups. That report echoes others, such as one released by the state Office of Hawaiian Affairs earlier this year. How do such studies inform your work?

A: Working in Native Hawaiian health for the past 20 years, it is part of my continual effort to eliminate those health disparities. These reports, while helpful in determining our deficits, do not necessarily provide frameworks for successful programs and services.

Working from a strengths-based perspective will lead us to the best possible programs and services and ensure a way to address the needs of our Native Hawaiian kupuna. It’s clear that kupuna need assistance, but not all of them need to be in a residential program; many choose to stay with family. I am going to find ways of supporting kupuna and their families in their own homes. We all want tutu nearby and thriving.

Q: Promoting good health was an aim in your work as director of the Native Hawaiian Health Program at Queen’s Health Systems. What changes did you see during your tenure in that post?

A: I started at Queen’s nearly 11 years ago and at the time, federal funding for health disparities had peaked — the focus for Native Hawaiian health was disease-specific, and the health care system was preparing for transformation with early attempts prior to the Affordable Care Act.

Today, we have seen the dramatic decline of federal funding; an increased awareness of social determinants of health; and a rapidly changing health care landscape that is volleyed back and forth in political agendas.

What is especially apparent to me today that was not so present in 2006 is the level of collaboration between Native Hawaiian health organizations. Agencies like OHA, the University of Hawaii’s John A. Burns School of Medicine, community health clinics and HMSA (Hawaii Medical Service Association) are all organizations I consider partners in this journey. We are definitely in a better place to collectively address the unique and specific health needs of Native Hawaiians.

Q: What do you enjoy most and least about working in the health care field?

A: I enjoy the impact I have on people’s everyday lives. When a medical crisis occurs, our work provides a return to normalcy and patients are able to thrive. I am able to work with teams of people, each excelling in their own field, to create the best possible health outcomes.

The hardest part about this work is the infrastructure that keeps us in silos rather than collaborative. However, that is changing.