State-run health care center opens in Iwilei

Mar. 8—The use of rainwater, ti leaves and the untying of a long, green maile lei were part of a Thursday morning blessing ceremony that tentatively opens the state Department of Health's new Behavioral Health Crisis Center in Iwilei.

The use of rainwater, ti leaves and the untying of a long, green maile lei were part of a Thursday morning blessing ceremony that tentatively opens the state Department of Health's new Behavioral Health Crisis Center in Iwilei.

Located in an industrial area of downtown Honolulu where homeless people live in tents or shacklike structures erected on city sidewalks, the stand-alone BHCC at 806 Iwilei Road will provide short-term "compassionate mental health care " in a supportive environment to people suffering from the effects of long-term homelessness as well as a range of medical issues including drug use and mental illness, DOH says.

For now the two-story center will provide initial triage and the opportunity for patients—or clients—to receive extended care and treatment, the state says.

Deemed a drop-off center, too, the BHCC—which can accommodate 16 people "in initial crisis " for up to 24 hours as well as offer nine beds for a longer duration for more stabilized patients—is also meant to curb overcrowding in hospital emergency rooms or prevent some people from being wrongly funneled into the criminal justice system.

Instead, BHCC patients are expected to receive longer-term treatment and integrated health care serv ­ices, the DOH says.

The center's clients will include people identified by law enforcement as suicidal. Over time, though, the state says that will expand to referrals through the Hawaii Cares Line, a service to provide mental health support via phone.

Performed by Kameha ­meha Schools Chaplain Kordell Kekoa, the morning blessing at the new center drew Gov. Josh Green and first lady Jaime Kanani Green, Honolulu Mayor Rick Blangiardi, Hawaii State Supreme Court Chief Justice Mark Recktenwald and DOH Director Dr. Kenneth Fink.

In addition, DOH Crisis Continuum and Medicaid Services Medical Director Dr. Chad Koyanagi and CARE Hawaii Inc. President Brian Morton, whose private company contracted to operate and manage the state-run facility on a 24 /7 basis, also attended.

"This was a team effort and a wonderful collaboration of many parties, especially at the state and county, " Fink told those gathered, prior to the ceremony. "It was the culmination of a lot of work, and we all share a common, ambitious goal : to provide high-quality, integrated mental health care to those most in need in a safe and nurturing environment."

He added that "the center will have a focus on serving the homeless and those at risk of becoming homeless as well as other vulnerable people in crisis."

"But it will be open to anyone who's in crisis and needs these services, " said Fink, noting this crisis serv ­ice is part of a continuum of care. "So while we're looking at this one particular serv ­ice, which was a puka and needed to be developed, the facility is intended to help stabilize people for less than 24 hours—that they would be in one of the stabilization beds.

"And at that point they're either stabilized to receive care on an outpatient basis, they may need to be transferred to a stabilization bed, that could be 10 or 15 days, or they may need to go another facility for other care, " Fink said.

The city-owned building in which the BHCC now resides—costing about $17 million to construct in 2021—sat vacant for years before being repurposed toward the state's health care use, an action that only occurred earlier this year.

For his part, the governor believed the city building's reuse with state services was a golden opportunity. He also believed the center's opening was an opportunity to share one more acronym.

"The acronym is KAAH ... which means a kick-ass approach to health care, " Green quipped. "Not traditionally used by the federal government, perhaps, or even state or county governments, but that is what it has become. As we all have seen over these many years, we have a great challenge to those who struggle terribly."

Green added that the average life span for an unsheltered, homeless person on the streets is 53 years.

"For every individual that we provide caring support and health care resources, that's that much more life they will have. Instead of living 53 years ... their life span returns to normal, back to 83 years, " Green said.

Following discussions with the governor to curb chronic homelessness, Blan ­giardi related that reuse of a building that stood vacant for years was a bit of relief for his administration.

In part, past contract disputes for a service provider led to delays for the building's full opening.

"We said, 'Look, we can't let this $17 million facility sit. This is too good a place and too important and in a strategic location for us to let that happen. We've got to be able to figure this out, '" Blangiardi said.

Under the guidance of DOH's Adult Mental Health Division, CARE Hawaii, as the contracted operator, will staff BHCC's first-floor observation unit with a licensed psychiatrist, or advanced practice registered nurse, a registered nurse, a qualified mental health professional, a case manager, a behavioral health technician, a certified peer specialist, housekeeping staff and security, DOH says.

Similarly, its second-floor stabilization section will be staffed with a case manager, a registered nurse and related staff similar to those working the observation unit, DOH says.

The facility will cost about $6.7 million a year to operate, the state adds.

After the ceremony, Scott Humber, the mayor's communications director, told the Honolulu Star-Advertiser that "the state has possession of the property through a 'rental agreement' not a lease."

"There is no rent associated with the lease, however, the state is responsible for all costs to operate and maintain the facility, " Humber said, noting the agreement was executed Feb. 22. "The form of contract is a memorandum of agreement."

"As a bond requirement, the city must retain control of the property and there's case law indicating that a long-term lease effectively transfers control, " Humber said, adding that the MOA allows for a 12-month term, from Feb. 22, 2024, to Feb. 21, 2025. "It provides the state options to extend and there is no cap set on the number of extensions."

Meanwhile, DOH Director Koyanagi, who will oversee the BHCC, says the center is not fully open yet.

"Because we're still working through some licensing issues and construction issues, which licensing issues are contingent upon, we're going to have a soft opening (today ), " Koyanagi said.

He added that other issues affecting the center's operations—including handling certain patients—involve actions yet to be taken by the state Legislature.

"A lot of this depends on the statutory changes through the Legislature, " Koyanagi said. "It's so that police can drop off the nonsuicidal ones at our facility. ... It takes a language change in the current statutes."