Center tackles homelessness at root levels
STAR-ADVERTISER / 2024 'A 'ala Respite, which opened Sept. 16, provides shelter and medical respite care to Oahu's homeless population. Hospital beds are shown set up in the shelter.
1 /4 STAR-ADVERTISER / 2024 'A 'ala Respite, which opened Sept. 16, provides shelter and medical respite care to Oahu's homeless population. Hospital beds are shown set up in the shelter.
GEORGE F. LEE / GLEE @STARADVERTISER.COM T.J. Utai, above, is making progress with the help of Iwilei health center, shown behind him. The facility marked its first anniversary March 3.
2 /4 GEORGE F. LEE / GLEE @STARADVERTISER.COM T.J. Utai, above, is making progress with the help of Iwilei health center, shown behind him. The facility marked its first anniversary March 3.
GEORGE F. LEE / GLEE @STARADVERTISER.COM Josten Gu tierres, is a client at the Behavioral Health Crisis Center, which on March 8 marked one year of providing services to those who might not have other resources available.
3 /4 GEORGE F. LEE / GLEE @STARADVERTISER.COM Josten Gu tierres, is a client at the Behavioral Health Crisis Center, which on March 8 marked one year of providing services to those who might not have other resources available.
GEORGE F. LEE / GLEE @STARADVERTISER.COM Iwilei Health Center staff shown Monday in front of the facility include Dr. Chad Koyonagi, left ; Angie Dickson, director, clinical psychology ; Sue Gie Kim, program manager ; and Mitchell West, program manager.
4 /4 GEORGE F. LEE / GLEE @STARADVERTISER.COM Iwilei Health Center staff shown Monday in front of the facility include Dr. Chad Koyonagi, left ; Angie Dickson, director, clinical psychology ; Sue Gie Kim, program manager ; and Mitchell West, program manager.
STAR-ADVERTISER / 2024 'A 'ala Respite, which opened Sept. 16, provides shelter and medical respite care to Oahu's homeless population. Hospital beds are shown set up in the shelter.
GEORGE F. LEE / GLEE @STARADVERTISER.COM T.J. Utai, above, is making progress with the help of Iwilei health center, shown behind him. The facility marked its first anniversary March 3.
GEORGE F. LEE / GLEE @STARADVERTISER.COM Josten Gu tierres, is a client at the Behavioral Health Crisis Center, which on March 8 marked one year of providing services to those who might not have other resources available.
GEORGE F. LEE / GLEE @STARADVERTISER.COM Iwilei Health Center staff shown Monday in front of the facility include Dr. Chad Koyonagi, left ; Angie Dickson, director, clinical psychology ; Sue Gie Kim, program manager ; and Mitchell West, program manager.
The Behavioral Health Crisis Center opened in 2024 across the street from the Institute for Human Services' men's shelter in Iwilei and has seen 1, 182 people ever since to address issues including substance abuse and mental health, which are considered critical underlying reasons why people end up and remain homeless.
The center opened on Iwilei Road and saw its first patients on March 8, 2024, and continues to take in people like T.J. Utai, 27, who grew up in Kalihi, failed to graduate from Farrington High School and more recently had been living in and out of IHS.
Last week represented Utai's third visit to the Behavioral Health Crisis Center in two weeks.
He was starting to believe that better things were possible once he kicks his addiction to meth and addresses and stabilizes his mental health issues, which include anxiety.
Now, Utai can see himself possibly getting a job one day and, perhaps, reuniting with his estranged family.
'I fell into a rat hole, ' he told the Honolulu Star-Advertiser.
Don 't miss out on what 's happening !
Stay in touch with breaking news, as it happens, conveniently in your email inbox. It 's FREE !
Email 28141 Sign Up By clicking to sign up, you agree to Star-Advertiser 's and Google 's and. This form is protected by reCAPTCHA.
On the street, Utai said, 'they told me this was the place. … Now I'm getting the help I need.'
The state-run center operates out of a city building and was the first of three new joint city and state facilities to open within blocks of one another over the past year to help people—many of them homeless—with their medical, behavioral and mental health issues.
They individually represent new models to address the root causes of homelessness in Hawaii and get more people off the street and on to better lives.
Iwilei—home to IHS, which started Hawaii's original homeless outreach efforts—continues to represent the center of new approaches to addressing homelessness.
Most of the people who have been seen at the Behavioral Health Crisis Center over the past year—78 %—were homeless.
But anyone can walk in and get evaluated and observed over just a few hours.
Or they might involuntarily be brought in by Hono lulu Police Department officers and remain upstairs on the mezzanine level for 10 to 14 days before leaving with longer-term case management plans including treatment beds to get additional, stable help.
The center also gives HPD officers a time-efficient alternative to get the people they encounter evaluated, compared with the sometimes hours officers can spend in emergency rooms like The Queen's Medical Center, said Dr. Chad Koyanagi, the state Health Department's medical director for crisis continuum, who oversees patient care at the Behavioral Health Crisis Center.
In 2024 the Legislature approved the latest version of Senate Bill 3139, which allows law enforcement to take a person considered dangerous to themselves or others against their will to alternative facilities like the Behavioral Health Crisis Center.
Gov. Josh Green signed the bill into law as Act 86.
Last week two HPD officers brought a man in handcuffs to the behavioral health center whom they encountered in Aiea, got him admitted and were back on their way within minutes to patrol their Aiea district.
The officers were not authorized to speak to the media and said they could not comment to the Star-Advertiser.
In the past, Koyanagi said, HPD officers from across Oahu would have to transport patients as far away as Castle Medical Center in Kailua to get them evaluated.
The number of people seen at the Behavioral Health Crisis Center has steadily grown over the past year, from 62 in March 2024 to a peak of 225 in December to 215 in February.
Most of them—40 %—had mental health issues, including schizophrenia, bi polar disorder and major depression.
They were followed by 24 % who suffered from substance abuse and 10 % who were having a 'housing crisis, ' according to Health Department data.
Most—73 %—were men, and a plurality of all patients—32 %—were ages 35 to 44.
The open-air, ground-floor observation room of the Behavioral Health Crisis Center sees clients up to 24 hours—or no more than '23 :59 ' as Dr. Angie Dickson, the center's director and clinical psychologist, called the time limit.
Some only need to rest in one of 16 oversize chairs, sit in quiet watching television or take a few hours away from life on the street to get reoriented, she said.
'They just need a minute to get away from whatever situation they're in, ' Dickson said.
There are no reasons someone won't be seen, such as lack of health insurance, she said.
'We take everyone.'
The design of the space—and the focus on a calming approach by health care workers—was based on what Koyanagi saw while visiting similar behavioral health centers in Arizona's Maricopa County.
Koyanagi thought the same approach would work on Oahu after spending years providing psychiatric care for homeless people through IHS and in the Ha lawa Correctional Facility, while also teaching at the University of Hawaii's John A. Burns School of Medicine.
Upstairs in the nine-bed mezzanine level, patients can stay 10 to 14 days while they receive case management designed to improve their situations through substance abuse treatment, mental health medications and longer-term housing and employment goals.
The top three floors of the four-story building will soon open as long-term housing for homeless people—or people at risk of becoming homeless—who also struggle with mental health or substance issues.
Each of the upper floors, accessible from the Sumner Street side of the center, will have nine studio apartments. One will be reserved for a resident manager.
The residents will have to pay rent of 30 % of their monthly income, typically through government financial assistance.
The units have been built out, a contract has been executed with Care Hawaii and the first residents will move in after the units are furnished, along with other finishing touches such as the installation of security cameras.
Josten Gutierres, 43, was staying at the Behavioral Health Crisis Center last week after he lost his job on Hawaii island, ended up homeless and came to Oahu hoping for a fresh start, only to end up homeless in Kaneohe, sleeping in Kaneohe District Park at night.
Someone on the street encouraged Gutierres to call 988, which referred him to the Behavioral Health Crisis Center, where he began receiving medications, including mood stabilizers.
He also was working to stay off of meth and alcohol, or what Utai called 'relapse prevention.'
'They helping me get clean, ' he said. 'It is tough.'
But in less than a week of getting help at the center, Gutierres said, 'I feel way better.'
By the numbers 1, 182 People seen at the Behavioral Health Crisis Center between March 8, 2024, and March 14 78 %
Patients who were homeless 40 %
Patients with mental health issues, including schizophrenia, bipolar and major depression 24 %
Patients with substance abuse issues Source : State Department of Health HERE TO SUPPORT Behavioral Health Crisis Center—Opened : March 8, 2024—Located : 806 Iwilei Road—Facility : Open-air, ground-level observation room for short-term stays of up to 24 hours ; Longer-term care and treatment up to 14 days in a nine-bed facility on the mezzanine level.—Focus : Observation, assessment, treatment and case management for people who are brought in by police or voluntarily walk in for care.
'A 'ala Respite—Opened : Sept. 16—Located : In the former First Hawaiian Bank branch at 445 N. King St.—Facility : 62 beds, including 30 indoor hospital-style beds and 30 outdoor, tiny-home kauhale for patients transitioning into more permanent housing.—Focus : Long-term medical care for homeless people, including kupuna with dementia and Alzheimer's ; people in need of substance abuse and mental illness treatment, dialysis and diabetes care ; and homeless stroke and heart attack victims.
Iwilei Center Compassionate Housing Kauhale / Kumu Ola Hou Transitional Center—Opened : March 3—Located : Kuwili Street—Facility : 13 temporary, portable, single -room structures erected inside an air-conditioned building until workforce housing can be developed to coincide with the opening of the planned Iwilei rail station—Focus : Treatment for 24 homeless patients at a time with mental health, memory and brain injury issues ; on-site health care with a focus on neuroscience Source : City and County of Honolulu, State of Hawaii 7 Comments By participating in online discussions you acknowledge that you have agreed to the. An insightful discussion of ideas and viewpoints is encouraged, but comments must be civil and in good taste, with no personal attacks. If your comments are inappropriate, you may be banned from posting. Report comments if you believe they do not follow our.
Having trouble with comments ? .
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Hamilton Spectator
20 hours ago
- Hamilton Spectator
‘There is something wrong': Patients say they are paying out of pocket for cataract surgeries at private clinics
It all started at the optometrist. Stephen Purdey was at a regular checkup to update his prescription last summer when his optometrist flagged something in his eye. The optometrist thought it was cataracts, but recommended Purdey visit an ophthalmologist to confirm. So Purdey visited a private clinic in Toronto in March for a consultation after months on the wait-list to see a specialist, and that is where he said he started to feel 'vulnerable and susceptible.' 'Because of the combination of wanting to do the best thing for yourself,' said Purdey, who is in his 70s. 'Plus not necessarily understanding everything that the doctors are telling you, you really are as a patient vulnerable to suggestions.' 'And that's what happened to me.' The ophthalmologist he was referred to, according to Purdey, acknowledged that the patient could get his procedure done for free under OHIP. Cataract surgery is considered a 'medically necessary surgery' by the province, so even if a person opts to go to a private clinic they shouldn't be billed for the basic OHIP-covered procedure. Patients who spoke to the Star said they went in for cataract surgery at private clinics and felt they had to pay between a couple of hundred and thousands of dollars out of pocket, whether to bypass reportedly long wait times or receive better treatment, including upgraded lenses. Their stories come at a time when the provincial government continues to expand the number of privately run surgical and diagnostic centres performing cataract procedures, a move first announced two years ago. They also raise questions about whether there are sufficient guardrails in place to make sure patients don't feel pressured to pay out of pocket for upgrades they may not need. In Purdey's case, he said his ophthalmologist offered him other options, such as laser-based eye measurements, instead of a free ultrasound measurement, and 'better quality' corrective lenses — treatments that would cost money but, to Purdey, sounded appealing. 'Right away you have the impression that lasers are better than ultrasound,' he said of the measurement procedure. 'And they said, 'Yeah, that's true.'' Laser-based measurements have been found to be more accurate than an ultrasound, although the American Academy of Ophthalmology notes that there does not appear to be a difference between using a laser or ultrasound during the cataract surgery itself. Purdey was convinced, however, so he agreed to spend $650 on the laser measurements and an astigmatism test and said he'd consider paying another $200 to $1,600 for the so-called better lenses, then went home. The four patients who spoke to the Star for this story are older adults who were worried that they might forever damage their vision if they didn't get surgery for their cataracts. Some of these same patients also said they didn't think they were given all the information they needed to make a decision about whether to pay for so-called better measurements and lenses. 'It is really out of control,' said Natalie Mehra, executive director of the Ontario Health Coalition (OHC), an advocacy group focused on protecting public health care. 'Essentially it's like there isn't public medicare when it comes to eye surgery in Ontario,' says Natalie Mehra, executive director of the Ontario Health Coalition, an advocacy group focused on protecting public health care. 'It's gone.' Things have gotten so bad from the perspective of the OHC that the group is filing formal complaints with the provincial and federal governments next week, Mehra said. She said some private clinics around the province bill OHIP for medically necessary cataract surgeries, as they are allowed to, but also charge patients 'mandatory' user fees for things like eye measurements or the surgery itself in a practice known as extra-billing — which is illegal under Ontario law and a breach of the Canada Health Act. Extra-billing also includes charging patients for speedier care. Mehra noted that the onus to report extra-billing to the province is on patients, many of whom do not realize that such 'mandatory' user fees aren't allowed. After investigating, if the province finds that extra-billing took place, it is required to report this annually to the federal government. Ottawa, in turn, will then claw back a certain amount of funding for the province's medicare program under the Canada Health Act. And, on top of the extra-billing, private clinics are charging patients add-ons under the guise that they are medically necessary for cataracts, Mehra said. Last year, Mehra said the coalition received more than 200 complaints over alleged extra-billing for cataract surgeries, one of the top two concerns the group heard from Ontarians. The other was about patients being kicked out of hospital before they are ready to be discharged. And Mehra said she believes there are probably thousands more who just don't know that they're being charged for what should be a free procedure. For its part, the provincial Ministry of Health said that 32,000 people had publicly funded cataract surgery at community surgical and diagnostic centres in 2024. 'We will continue to deliver more connected, convenient care in every corner of the province, always ensuring that people are accessing the care they need with their OHIP card, never their credit card,' ministry spokesperson Ema Popovic said in an emailed statement. Still, Mehra said the complaints heard by the OHC run counter to the intentions of the province's medicare system — something patients also echoed in interviews with the Star. 'Essentially it's like there isn't public medicare when it comes to eye surgery in Ontario,' Mehra said. 'It's gone.' Up until her death in April from complications following cardiac surgery, something about a procedure Judith Deutsch had on her cataract back in 2022 didn't sit right with her, said husband Jim Deutsch. Judith Deutsch, pictured here in March, didn't 'feel good' about her experience seeking care for her cataracts three years ago up until her death in April, husband Jim said. Three years earlier, the Toronto couple had decided to go to a private clinic after they were told the wait time for cataract surgery covered by OHIP 'was going to be too long' by a doctor at a separate clinic. They considered the situation to be an 'emergency' — she incurred a concussion and a gash on her face because she couldn't see well — so the couple was willing to pay out of pocket to get care faster. 'It was going to cost a lot of money,' Jim told the Star. 'But she kept falling and just wanted to get it done as quickly as possible.' Jim said he doesn't believe that he and his wife were scammed — they were aware of the private option and had the means to afford it. But he said the couple still didn't 'feel good' about paying to 'jump the queue' for Judith's surgery. The OHC's Mehra said that long wait times are commonly mentioned by doctors at private clinics to encourage patients to pay out of pocket for their surgeries. 'They say the wait times in the public hospital are two years, which they are not,' Mehra said. 'Most people are getting it in 90 days, so they lie to patients and convince them to pay.' According to the province's surgery wait-time website at the time of publication, the average wait time between a referral and the first clinician appointment for the lowest priority patients is 100 days. Meanwhile, the average wait time between a clinical decision for a surgery and the operation itself is 103 days. It's not just wait times; doctors also upsell patients with 'medically unnecessary stuff,' Mehra said. She said the OHC has heard from past cataract patients that they were encouraged to buy corrective lenses that address non-cataract issues like astigmatism. Judith was one of these patients, with Jim saying his wife ended up paying more than $5,000 for her surgery, including specialty lenses that she thought were connected to her cataracts and would lead to better outcomes for her vision, but later learned were for other eye conditions. Although the couple willingly paid more to get faster care, they say they weren't aware the specialty lenses weren't necessary. Mehra said she has also heard of patients being charged for post-operative medicine — something Paula from Barrie told the Star separately. Paula told the Star she had to pay $230 for eye drops after her 2023 surgery at a private clinic, on top of the $5,000 she paid for special lenses and to get faster care. (She said her ophthalmologist told her the wait would be over a year if she did not pay $2,500.) 'That's not right,' Paula said of the eye drop charges. 'They should be covered.' The Star agreed to use only Paula's first name since she has glaucoma and worries that speaking publicly could interfere with her ability to receive care. While Paula knew going into her surgery that she wanted to get upgraded lenses and extra measurements, she said the ophthalmologist didn't ask her if she wanted the upgraded measurements. 'They should have asked me,' she said. 'If there were two options, they should have given me the option of 1 or 2.' Jim Deutsch thinks that his wife's experience seeking care for her cataracts stems from a failure of Canada's medicare program. The office of Ontario's Patient Ombudsman received some 4,429 complaints in the 2023-24 fiscal year — the most since it opened in 2016. The office of Ontario's Patient Ombudsman received some 4,429 complaints in the 2023-24 fiscal year — the most since it opened in 2016. 'Medicare ended up being something that was quite different from what (Tommy Douglas) originally imagined,' said Deutsch, a psychiatrist who moved to Canada from the U.S. decades ago to work in the country's public system. 'Along the way we've ended up with this situation of scarcity and profit and allowing there to be private clinics that will offer something more speedily.' Paula, too, believes the current system isn't fair — even if she said she would pay out of pocket again to get her surgery done faster. 'There is something wrong with the whole system,' she said, describing it as 'two-tier medicine.' The OHC pins the blame on the Ford government, specifically the passage of Bill 60: Your Health Act in 2023. The legislation allows more private clinics to provide certain publicly funded procedures , including cataract surgery. The provincial government said the Act was intended to reduce long wait times, while critics, including the OHC, said it would draw resources away from public hospitals. 'No one is able to regulate and control the private market for health care,' Mehra said. 'The most sensible thing we can do is bring (cataract surgeries) back into public hospitals.' The Ministry of Health's Popovic stood by Bill 60 in her statement to the Star. 'To be very clear, Ontario has provisions through legislation that prohibit a patient from being charged for an OHIP-covered service, legislation that was strengthened by our government through Bill 60,' she said. Popovic added that anyone who believes they have been charged for an OHIP-covered service can contact the Commitment to the Future of Medicare Act program to ask for a review, and that those who have been found to have been billed will be reimbursed. After coming home from the private eye clinic, Purdey changed his mind; he wasn't going to pay for the laser measurements or other add-ons. 'I was told that the laser measurement stuff was better,' he said, 'but they didn't really tell me how much better it was.' He called up the clinic to ask for the OHIP-funded procedures and in late May he had the first round of publicly funded surgery on one of his eyes. 'I'm quite satisfied,' Purdey said the day after his surgery. 'I feel like I narrowly missed getting trapped into spending a whole lot of money.'
Yahoo
2 days ago
- Yahoo
Opal Lee returns to Fort Worth after Ohio hospitalization
The Brief Opal Lee, the 98-year-old "grandmother of Juneteenth," has returned to Fort Worth after being hospitalized in Ohio. She's currently resting and not doing interviews, though she did take a call from former Vice President Kamala Harris. Lee will still participate in her Juneteenth Walk for Freedom on June 19, but will use a golf cart to conserve energy. FORT WORTH, Texas - Opal Lee, the grandmother of Juneteenth, is back in Fort Worth after being admitted to the hospital in Ohio. The 98-year-old returned home from her out-of-state hospital stay on Monday evening. Dionne Sims, Lee's granddaughter, says the 98-year-old has been resting, reading and staying in bed. For now, she is not doing any interviews to give her time to rest. What they're saying "I think one of the things she is most encouraging young people to do is to take Juneteenth, take the baton and go forward. you'll hear that, she's always said it. I think we just need to pay attention to what she said. She always said It's not a me thing. It's a we thing," said Sims. There is one call that Lee did take. Former vice president Kamala Harris called after she heard about her hospital stay. What they're saying "She had a big smile on her face, right. To think that the former vice president, would call to check in on her, really, it made us feel special. We all know that she is, but I don't think she realizes she is," Sims said. Lee's health is leading to some changes for her Juneteenth festivities, including her Walk for Freedom on June 19. She will still take part in the walk, but will be in a golf cart. What they're saying "It was always the plan to have my grandmother in a golf cart, one so we can finish in a timely manner, but it's just time," Sims said. "It is named for her but we definitely don't want to wear her out, so I think that is the name of the game, to keep her here as long as possible." The Source Information in this article comes from an interview with family members of Opal Lee.
Business Wire
2 days ago
- Business Wire
Astria Therapeutics to Present at Upcoming European Academy of Allergy and Clinical Immunology Annual Congress
BOSTON--(BUSINESS WIRE)-- Astria Therapeutics, Inc. (Nasdaq:ATXS), a biopharmaceutical company focused on developing life-changing therapies for allergic and immunologic diseases, today announced that it will present four posters at the European Academy of Allergy and Clinical Immunology (EAACI) Annual Congress, taking place June 13-16, 2025 in Glasgow, United Kingdom. Dr. William Yang, M.D., FRCPC, FAAAAI, Managing Director and Chair, Ottawa Allergy Research Corporation, will present combined initial safety and efficacy data from the Phase 1b/2 and long-term open label trials of navenibart in a late-breaking poster presentation of poster number D1.390 titled, 'Long-term Safety and Efficacy of Navenibart in Participants with Hereditary Angioedema (HAE): Initial Combined Results from ALPHA-STAR and ALPHA-SOLAR.' The presentation will take place on Friday, June 13 in a poster session beginning at 12:00pm BST. Nikolaos Biris, Ph.D., Senior Director of Structural and Functional Biology at Astria Therapeutics, will present information on the differentiation of STAR-0310 in a presentation of poster number D1.343 titled, 'Unveiling the Underlying Mechanism of Differentiation for STAR-0310, an Anti-OX40 Antibody for Atopic Dermatitis.' The presentation will take place on Friday, June 13 in a poster session beginning at 12:00pm BST. Dr. William Lumry, M.D., Clinical Professor of Internal Medicine at the University of Texas Health Science Center at Dallas, will present data from the Phase 1b/2 trial of navenibart in a presentation of poster number D3.391 titled, 'Results from the ALPHA-STAR Trial, a Phase 1b/2 Single and Multiple Dose Study to Assess the Safety, Tolerability, Clinical Activity, Pharmacokinetics, Pharmacodynamics, and Immunogenicity of Navenibart in Participants with Hereditary Angioedema (HAE).' The presentation will take place on Sunday, June 15 in a poster session beginning at 12:45pm BST. Dr. Emel Aygören-Pürsün, M.D., Goethe University, Frankfurt, Germany, will present information on the global Phase 3 trial of navenibart in a presentation of poster number D3.390 titled, 'ALPHA-ORBIT: a Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate the Efficacy and Safety of Navenibart in Participants with Hereditary Angioedema (HAE).' The presentation will take place on Sunday, June 15 in a poster session beginning at 12:45pm BST. About Astria Therapeutics: Astria Therapeutics is a biopharmaceutical company, and our mission is to bring life-changing therapies to patients and families affected by allergic and immunologic diseases. Our lead program, navenibart (STAR-0215), is a monoclonal antibody inhibitor of plasma kallikrein in clinical development for the treatment of hereditary angioedema. Our second program, STAR-0310, is an investigational monoclonal antibody OX40 antagonist in clinical development for the treatment of atopic dermatitis. Learn more about our company on our website, or follow us on Instagram @AstriaTx and on Facebook and LinkedIn.
