For 20 years, the Houseless Outreach and Medical Education (H.O.M.E.) Project has been on the frontlines of the houselessness crisis in Hawaiʻi, delivering free, comprehensive care to those in need, all while training the next generation of physicians.
Founded in 2005 by Dr. Jill Omori, JABSOM's Director of the Office of Medical Education, H.O.M.E. Project began as a single makeshift clinic behind the Next Step shelter.
"When I was a student, I wanted experiences like this, and there was nothing," Omori said. "When I became faculty, I felt it was important for students to work with underserved populations so they'd be more likely to give back once they became practicing physicians. When we started, we were in a tent with shower curtains for walls."
Today, H.O.M.E. has expanded its operation to include multiple mobile clinics as well as one brick-and-mortar clinic in Iwilei, which serves hundreds of people each year.
" Houselessness rates in Hawaiʻi are some of the highest in the nation because of the increased cost of living and inadequate social resources available for these communities," said Philip Lee, a third-year JABSOM student. "The mission of H.O.M.E. is to provide the basic human right of healthcare to these communities. In exchange, we as medical students have the ability to learn how to take a patient history, perform a physical exam, come up with a running diagnosis and treatment plan, as well as build that patient rapport and learn how to connect with them on a one-on-one basis”.
At H.O.M.E. clinics, JABSOM students not only provide wound care, checkups, and specialty services in ophthalmology, psychiatry, and neurology, but they also help connect patients to social support.
"We also have a dedicated social worker, Lindsay, who helps facilitate a lot of the behind-the-scenes work," Lee says. "Things such as getting them SNAP benefits, stable housing, adequate food and fluid intake, and even taking those next steps to getting an income. We really try to deliver a comprehensive care approach model, caring for them as a person more than just a patient."
Lee, a former H.O.M.E. manager, says the program has taught him lessons that go beyond textbooks. "Disease is the bacteria in a wound," he said. "Health is whether someone can still walk to get food, shower to keep themselves clean, and interact with others. We're not just treating the disease, we're treating them as a person."
For many students, H.O.M.E. offers their first direct patient encounters, and it happens during their first year at JABSOM.
" I think having the ability to make these connections provides an indescribable sense of fulfillment and satisfaction, that I don't think I could get from any other job. This is why I love medicine," Lee said.
These experiences sharpen clinical skills and deepen empathy. On the morning we visited, we observed Lee talking with Anthony, who walked in because he was dealing with pain in his hand. Lee says hearing patients' life stories helps him see the human side of medicine.
"Anthony was born and raised here," Lee said. "He was a local kid who went to McKinley and worked construction for 40 years. He was in the union just like my dad. Getting those bits and pieces of the humanitarian aspects is just as important as understanding his health issues. This is a human with similar upbringings as the rest of us who’s in an unfortunate situation. The real issue we need to address is how do we, as medical professionals, best care for him?"
Over the last 20 years, the benefits H.O.M.E. provides extend beyond the houseless patients. By bringing care directly to the streets and shelters, H.O.M.E. helps reduce the strain on Hawaiʻi's healthcare system and local taxpayers.
"Earlier, the city used to track how many ambulance calls they would get in certain areas," Omori said. "They had noticed that on the days that we had clinics in certain areas, there were fewer EMS calls at that time. It's really hard to track actual numbers because of the nature of our patient population, but we certainly reduced the number of emergency department visits. One thing we have started to track is whether we felt that a patient would have gone to the ER instead of seeing us that day, and we have noticed a significant benefit there."
JABSOM teaches students to care for the patient as a "whole," and the H.O.M.E. Project is a perfect example, as the program routinely runs drives to address quality-of-life needs.
Each year during the back-to-school season, students distribute fully stocked backpacks to children in shelters, ensuring they start the school year prepared. This summer, they handed out 340 bags — the most in the program's history. At Christmas, students and volunteers pack lunches and essentials for the houseless community. In May, gifts are collected for an annual Mother's Day drive.
"It's about giving them a sense of normalcy," Omori said. "Health isn't just about medicine. It's about wellbeing."
As the project celebrates its 20th year, Omori hopes for a future where such services are no longer needed. Until then, she says H.O.M.E. will keep going wherever patients are.
“For a long time we were the only ones that were providing truly free care,” she said. “I think the community health centers do a wonderful job in servicing our underserved population, but there's always going to be patients that kind of fall through the cracks and that don't receive the care that they need, so I think that our program does, fill a very big need in our community.”
Lee sees himself following in the footsteps of volunteer physicians who serve as mentors, hoping to one day give back as they have.
"At the end of the day, we all pursue medicine because we love people," he said. "H.O.M.E. reminds you of that every day."