HomeMy WebLinkAboutCOM 0447.001 2016-2018 Dru M.Kanuha, Council Membe -'iv oc ill Karen Eoff, Council Member
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Council District 7—Central Kona Council District 8-North Kona
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HAWAI`I COUNTY COUNCIL
County of Hawai i
West Hawai`i Civic Center, Bldg.A
74-5044 Ane Keohokalole Hwy.
Kailua-Kona, Hawai'i 96740
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DATE: September 18, 2017 too
TO: Valerie T. Poindexter, Chair
And Members of the Hawai`i County Council w '
FROM: Dru M. Kanuha, Council Member for Council District 7—Central Kona
Karen Eoff, Council Member for Council District 8 —North Kona
SUBJECT: Additional Information for Communication 447; Update by Lance Niimi
Regarding the Homeless situation in West Hawai`i.
Please find attached additional information for reference during the discussion pertaining to
Resolution 447; an update by Lance Niimi regarding the homeless situation in West Hawai`i.
Information was sent by Lance Niimi on September 18, 2017.
Mahalo.
DK/lw
KE/wpb
Att.
Comm. No. y-Z
Ref. To: Fl H SSSG
Ref, Date.SEP 1 9 UV
Serving the Interests of the People of Our Island
Hawaii County Is an Equal Opportunity Provider And Employer
Arranging Leveraged Options for Harm Abatement(ALOHA)Initiative
An Evidence-Based Multidisciplinary Plan to Address Behavioral Health(BH) Challenges in Hawaii's
Homeless Population
Michael J. McGrath, MD:Acting Medical Director, Kalani Ola BH Unit, Kona Community Hospital
Condensed/Edited by Alysa Lavoie: West Hawaii Community Health, BH Care Coordinator
Addressing the homelessness crisis in Hawaii can only be accomplished by the transcending of
boundaries between the homeless and the services provided for them, also those separating the providers
that interact with the homeless.Meeting the health needs of homeless will require an understanding many
face due to untreated behavioral health(includes both mental health and substance use)problems.
Transitioning from homelessness to health and abating the physical/emotional harm of being homeless are
the goals of the ALOHA Initiative.
• At least 20%of the homeless have serious mental illnesses(thought disorders such as
schizophrenia or bipolar disorder)
• 40-60% have substance use disorders
• Tragically, many have a combination of both.
Medical research informs us these health problems involve neurologic changes that impair the
person's ability have a true understanding their illness(insight),control impulsive behavior, and use their
memory or judgment effectively to accomplish their goals. These conditions impair the brain,the choice
organ,therein disabling the afflicted person's ability to act in their own best interest when offered BH
care.Even if a person wants the treatment they don't have the ability to access it.
The ALOHA Initiative approach uses evidence-based strategies in health care delivery.
Leveraged options for treatment utilize a source of motivation for treatment that originates outside the
patient(extrinsic motivation), like legal encumbrances or entitlements. Also,the ALOHA Initiative
utilizes a working partnership of stakeholders involved with the homeless to organize a compassionate
and effective response to the homelessness crisis in Hawaii.
The basic elements of the ALOHA Initiative include:
1) A multidisciplinary behavioral health team involving Kona Community Hospital BH staff
(psychiatrist, unit and case managers),DOH [Adult Mental Health Division and Alcohol and
Drug Abuse Division],West Hawaii Community Health Center staff and providers and non-profit
providers such as HOPE services. This team would meet regularly to identify high-utilizing
and/or high-risk homeless persons and design treatment approaches
2) Coordination with entitlement providers(SSA and DHS)to formalize appropriate, clinically-
guided assistance for the homeless with management of their funds.
3) Education and engagement with the judiciary to utilize forensically- leveraged treatment
approaches such as those provided through Assisted Community Treatment orders and 704 orders
4) Education,support and coordination with law enforcement personnel to charge BH
challenged homeless persons with legal infractions-forensic monitoring and support
5) Engagement with health plans to utilize existing benefits to fund treatment
6) Residential substance use disorder treatment providers/sober living
7) Legislators
Assisted Community Treatment(ACT): HRS §334-121 (2016)
This statue has the potential to order a person with a mental health or substance use disorder to
community-based treatment to address symptoms and recovery. The ACT law requires the individual
meet certain criteria to demonstrate the individual is at severe risk for harm. Since this law will be
difficult to enact by a single agency the group is problem-solving strategies to work together.
Next meeting: Tuesday, September 26th, Ipm: Kalani Ola conference room, Kona Community
Hospital. Please contact Alysa, amlavoie@westhawaiichc.org for any additional info