By: Brandee Menino

Street Medicine and Psychiatric Street Medicine

HOPE’s Street Medicine Team delivers care directly to those living unsheltered—meeting immediate needs, from wound treatment to connecting individuals with primary care, insurance, and housing. With a wraparound approach, the team ensures support at every step toward stability.

Across Hawaiʻi Island, more people experiencing homelessness are struggling with untreated medical and psychiatric conditions. To address this urgent need, our multidisciplinary team, which includes a registered nurse, a housing navigator, a case manager, a licensed therapist, and a psychiatrist, provides critical care where it’s needed most.

Leading this effort is Dr. Chad Koyanagi, who offers psychiatric evaluations, medication management, and long-acting injectable treatments. By meeting people outside clinic walls, we’re improving access, preventing crises, and helping those with the most complex challenges move toward permanent housing.

Assisted Community Treatment (ACT)

Through the ACT program, HOPE is utilizing a structured, legally supported approach to provide life-saving treatment to individuals who—due to their illness—are unable to seek care voluntarily. ACT allows us to intervene before it’s too late. We currently have two active ACT petitions in progress, with the long-term goal of helping our neighbors stabilize and move toward whole, healthy lives in permanent housing.

These innovative behavioral health programs are part of a broader systems-level response to homelessness that recognizes housing is health care, and that proactive, street-based care saves lives and reduces strain on emergency and inpatient services.

At shelters, our Shelter Medicine program helps guests avoid unnecessary emergency room visits by addressing health issues early. For those recovering from illness or injury, Medical Respite offers a safe and supportive environment for healing. These vital services are possible thanks to strong healthcare partnerships that connect hospitals, insurers, and community providers to bridge critical gaps in care.

We know that proper stability begins with a home. Over the past 15 years, we’ve demonstrated that housing combined with supportive services equals success. That’s why we’re investing in affordable housing across Hawaiʻi Island:

• Hilo: Youth apartments tailored for young adults priced out of the rental market
• Kona: Kani Leʻa Apartments—affordable homes for families and individuals
• Honokaʻa: Renovating the historic convent at Our Lady of Lourdes to house kūpuna with dignity
• Pāhoa: Sacred Heart Community Phase 3—expanding family housing options
• Mountain View: Planning a future village that integrates housing, services, and economic opportunity
• Islandwide: Master leasing 155 units to expand housing access immediately

From healing to housing, these programs reflect our commitment to lasting change—one person, one home, one community at a time.

Join Us This September

We invite you to celebrate our milestone year at two special events:

• September 9: 15th Anniversary Gala at the Hilo Hawaiian Hotel, honoring our founder, Carol Ignacio
• September 9–12: International Street Medicine Symposium at the Grand Naniloa Hotel, bringing together healthcare professionals, community leaders, and advocates dedicated to providing care for those experiencing homelessness

Sponsorship and partnership opportunities are available for both events. 

We warmly invite you to join us in this journey of hope, healing, and community. As a community leader, your voice, resources, and networks can drive change—whether through collaboration, advocacy, volunteering, or direct support. Together, we can build a stronger, more compassionate Hawai‘i where everyone has a place to call home.

Let’s talk story! Contact Brandee Menino at bmenino@hopeserviceshawaii.org or Emily Schoen at eschoen@hopeservices.org.