Public, private and non-profit organizations and agencies formed the Behavioral Health and Homelessness Statewide Unified Response Group (BHHSURG) with the support of the University of Hawaiʻi at Mānoa, to break down silos and to ensure the community’s most vulnerable receive the care they need, especially during the COVID-19 pandemic.

The Hawaiʻi Department of Health has operated the TQIC with a number of community partners, including the Institute for Human Services; the Hawaiʻi Homeless Healthcare Hui; Local 5, the union that represents hospitality, healthcare and food service workers; and others. Collectively, the groups provided the necessary human resources support, including healthcare professionals, case managers and round-the-clock security for the center to open its doors in late March.

As a result, the center has been able to free up hospital space to improve care capacity, save on medical costs, and keep the community protected from potentially infected individuals.

According to a recent report prepared by the Department of Health and the UH Mānoa Office of Public Health Studies, data collected from clients at the center has also proven that such a facility has been effective in tackling a deeper, more pervasive challenge: the need for a behavioral health crisis stabilization center to take care of the health and social needs of homeless individuals, including those with substance use disorder.

“The population we serve is often marginalized but the services we provide are vitally important to the overall health and wellbeing of our entire community, and is a necessary component to safely reopening our state,” said Edward Mersereau, the Department of Health’s deputy director of behavioral health.

Mersereau said unsheltered individuals generally have other chronic, pre-existing health conditions such as undiagnosed or unmanaged diabetes and heart disease and have a disproportionately high rate of behavioral health conditions, including substance use disorders. This makes their care more complex, requiring an interdisciplinary approach.

“Through our work at UH on analytics, evaluation and the CARES Line, we are grateful for the opportunity for UH to partner with DOH on this proof of concept of a behavioral health crisis stabilization center which has the potential to save the state the large medical and economic costs of behavioral health crises,” said Victoria Fan, a UH Mānoa associate professor in the Myron B. Thompson School of Social Work.

For more see the Hawaiʻi Department of Health website.

To help protect essential workers who provide mental and behavioral health services and their clients including those experiencing homelessness, the Hawaiʻi Department of Health and the Behavioral Health and Homelessness Statewide Unified Response Group (BHHSURG) with support from the University of Hawaiʻi at Mānoa are coordinating the donation and the distribution of donated personal protective equipment (PPE) across the state. So far, more than 13,000 surgical masks, among other items, have been donated to “resilience hubs,” on Oʻahu.

Three nonprofits on Oʻahu are operating the resilience hubs: KROC Center in Kapolei, KEY Project in Kahaluʻu and the YMCA in Kalihi.

“UH Mānoa has played a role in developing infrastructure for the Resilience Hubs to distribute PPEacross the island,” said Victoria Fan, UH Mānoa associate professor of health policy at the Myron B. Thompson School of Social Work. “In partnership with DOH, UH developed an inventory management app along with the standard operating procedures for warehousing. Given limited PPE stock, we also developed and implemented an algorithm to prioritize PPE to providers with the highest infection risk.”

As of May 25, Oʻahu’s resilience hubs have received: 13,153 surgical and cloth masks, 7,069 N95 masks, 9,035 disposable gloves, 2,023 goggles, 823 homemade masks, 590 medical gowns and 212 face masks.

“A partnership of DOH, Hawaiʻi Community Foundation, the Hubs, UH and several organizational partners, we are appreciative of everyone’s support who make our collective achievements possible,” said Rebecca Choi of the Hawaiʻi Department of Health Behavioral Health Administration.

Of these donations, UH facilitated a PPE donation from Tzu Chi USA to the Resilience Hubs. “With UH‘s help, we appreciated the opportunity to donate 10,000 surgical and N95 masks, 2,000 cloth masks with filters, 2,000 goggles and 480 medical gowns to this public-private partnership between the Department of Health and the Resilience Hubs to effectively reach providers,” said Jackson Chen, CEO for Buddhist Tzu Chi Foundation, USA based in San Dimas, California.

To date, distributions ordered for 80 provider organizations will help keep many essential workers and their patients safe during the COVID-19 pandemic. More PPE are needed for behavioral health and homelessness service providers working across the state.

“This PPE will go to providers across the state who are working with individuals and families and communities who are struggling with homelessness and behavioral health issues,” said Eddie Mersereau, deputy director of the Behavioral Health Administration. “The public sector, the private sector, and the community, when they get together for a common cause, can accomplish great things. When we unite in a common cause, there is no limit to what we can achieve.”

PPE donations needed

Donations of homemade and unopened store-bought PPE such as masks, goggles, gloves and face shields are needed. In addition, the resilience hubs are now accepting sanitation supplies including bleach, disinfecting wipes, paper towels and toilet paper.

To donate, items can be dropped off at the following times and locations:

KROC Center in Kapolei

Drop-off hours: 9 a.m.–noon, or by appointment
Phone: (808) 682-5505

KEY Project

Drop-off hours: 9 a.m.–noon, or by appointment
Phone: (808) 239-5777

Kalihi YMCA

Drop-off hours: 9–11 a.m., or by appointment
Phone: (808) 848-2494

Challenges arising from the COVID-19 pandemic have resulted in ever-changing information and guidance being given to behavioral health and homeless services providers, slowing down their ability to help vulnerable populations in Hawaiʻiduring the crisis.

In an urgent effort, three state agencies mobilized and launched the Behavioral Health and Homelessness Services Unified Response Group (BHHSURG) with support from the University of Hawaiʻi at Mānoa. This groundbreaking initiative makes Hawaiʻi the only state to integrate behavioral health and homelessness in one place with a website that centralizes and unifies information. It coordinates resources given to providers, helping reduce confusion, which allows providers to assist their clients safely.

BHHSURG is an innovative partnership. The State Department of Health Behavioral Health Administration, the Governor’s Coordinator on Homelessness and the State Department of Human Services Office of Homeless Programs with support from UH Mānoa Myron B. Thompson School of Social Work and other partners have pooled resources and efforts to address long-standing gaps in the system of care for vulnerable populations.

“The platform is groundbreaking in the way it has been organized,” said Victoria Fan, UH Mānoa associate professor of public health. “It hasn’t been done before. We believe it will help many who are in need of these services. UH Mānoa has played a key role in organizing and disseminating critical information and resources to providers so that vulnerable populations can continue to receive services during this unprecedented time.”

UH Mānoa experts have helped to develop the program on many levels including coordination and integration of resources through data and analytics, as well as other operational, logistical and communications support.

Undergraduate students have been helping by staying abreast of federal policies such as Centers for Disease Control and Prevention guidance for testing and telehealth. Graduate students have been translating the information they find into operational and clinical tools that providers can use to help their clients.