When Waikīkī Health celebrates its 50th anniversary on April 22, 2017, the organization will likely feel proud and accomplished given its history of progress in the field of community health.

The organization was recently recognized by Hawai‘i Gov. David Ige for its efforts in combating homelessness through medical care, shelter, and arrangement of social services; Waikīkī Health received a “Certificate of Appreciation” for its work.

Based on the developments of recent years alone, in which the organization opened and expanded more clinics, there is also great anticipation for the next chapter of Waikīkī Health.

According to Waikīkī Health’s development manager, Liz Makarra, Waikīkī Health has had its current CEO, Sheila Beckham, since 2008. Makarra says that under Beckham’s leadership, “the organization has grown exponentially.” 

Waikīkī Health is a non-profit, federally funded community health center that operates a number of clinics throughout Honolulu. Many provide both medical care and social services. They operate the Next Step Shelter in Kakaʻako providing temporary shelter for those experiencing homelessness; Youth Outreach in Waikīkī, which provides social services, education, and even medical care to homeless youth; and the Path Clinic in Kaimukī, which provides medical and perinatal care to at-risk women.

Waikīkī Health’s Care-A-Van Drop-in clinic on Wai‘alae Avenue in Kaimukī is unique in the sense that its stated mission is to provide medical care and social services to Honolulu’s homeless population.

According to the Associated Press, Honolulu has the highest rate of homelessness per capita of any city in the United States. The Honolulu Star-Advertiser reported in November that the population has also grown 4 percent since 2015.

The Caldwell administration is also doubling down on homelessness by providing more permanent housing. The city is involved in an effort called Housing First, modeled after successful examples by cities on the mainland such as Denver and Los Angeles. In this “flipped” approach, homeless applicants receive housing in lieu of such requirements – being sober, completing a psychiatric evaluation, and observing rules – that typically would preclude them from accessible housing in the past.

But, because the population of individuals experiencing homelessness at any point in time is a largely transient one – and without a permanent address to call home – the difficulty of establishing a place of residency for all practical purposes is a challenge.

According to Waikīkī Health’s Care-A-Van manager, Michelle Ip, it is difficult to apply for many social services without an address or state-issued ID card. Beneficiaries of food stamps, disability insurance, and other welfare services typically require the state-issued ID, which in turn requires an address. Waikīkī Health’s Care-A-Van therefore offers their own address, on Wai‘alae Avenue in Kaimukī, as a mailing address so individuals can access these services.

Waikīkī Health’s Care-A-Van is truly a “one-stop shop where they [clients] can receive more than one service at a time,” said Ip.

Before becoming the manager at Waikīkī Health’s Care-A-Van, Ip worked specifically with the social services team at the clinic and stated that “the work is close to my heart.”

At Waikīkī Health’s Care-A-Van, clients can interact with voluntary organizations that stop by weekly to provide their assistance and services. Legal Aid comes twice a week and Helping Hands Hawai‘i comes weekly to help with food stamp applications. Referrals for homeless shelters are also processed at Waikīkī Health’s Care-A-Van. Again, as is typical for many of these services, the mailing address is crucial, of which Makarra stated, “[it is one] major component in offering the service needed for them to get back on their feet.”

Moving from the streets to a homeless shelter and eventually permanent housing is a priority for the social services team at Waikīkī Health’s Care-A-Van.

As Ip stated about such efforts, “we have to move at their pace,” especially as individuals begin the transition from living on the streets to finding an occupation and more permanent housing. Sometimes the pace of progress is slow and old habits are hard to break. Ip recalled a scenario where one individual had moved to a shelter only to sleep on the floor next to the bed for six months.

Since many clients – homeless or otherwise – come to Waikīkī Health’s Care-A-Van for medical care, the clinic remains highly accessible and affordable. Same-day appointments are often scheduled and there is always a physician’s assistant (PA) or medical doctor (MD) on-site to see patients. There is a sliding scale of payment for those under-insured or without insurance.

Taking into account all the patients seen at the medical clinics offered by Waikīkī Health, about one in five are homeless and about one in four are uninsured.

Those with insurance and a permanent residency, which comprise the majority of patients, choose Waikīkī Health for a variety of reasons. They can both receive excellent medical care and feel empowered knowing that they are supporting the humanitarian mission of the non-profit organization, according to Makarra.

Waikīkī Health’s Care-A-Van has existed since 1987. Before then, medical and social services outreach to the homeless population was achieved through a mobile (medical vans) presence operating out of Waikīkī Health’s Ohua Avenue clinic in Waikiki.

The Mobile Medical Unit (MMU), as it has been formally known since 2008, can reach homeless patients across the island. The large vehicle offers a patient room on-board, staffed by medical professionals. There are also medical vans operated by Waikīkī Health’s Care-A-Van that make rounds five days a week. Both medical care and social services are offered by the mobile medical vans.

Because it is a small island and Waikīkī Health’s Care-A-Van offers a range of services, the clinic will continue to make an impact on the lives of those experiencing homelessness. Looking forward, Waikīkī Health’s Care-A-Van plans to become more involved in the process of arranging for more permanent housing through the Housing First Program, which is advocated by the Caldwell administration.