 Welcome, and aloha. My name is Mark Shklav. I am the host of think tech Hawaii's law across the sea program. Today we're going across the state of Hawaii and the Pacific to find out the answers to these questions. What is the health and harm reduction center? What is its mission? What does it actually do? Where does it get its fund? My guest is David Abbott-Bowl, policy and contracts manager of the Hawaii Health and Harm Reduction Center. Welcome, David. How are you? I am doing well. Thank you very much for having me on today. Good, good. We're glad to have you. And before we get into the main topic, who is David Abbott-Bowl? Who are you? Where are you going? What's your background and history? And what are your general goals? Who am I? I mean, that's a really hard question to answer. But I mean, just generally, I was born and raised here in Hawaii. I grew up out in Waianae on Oahu. And I spent pretty much all my life here. I think one thing that's unique about me for somebody who grew up in Waianae and for somebody who spent most of their life in Hawaii is that I actually spent half of my time living in Israel because my dad is actually from Israel. So I'm somebody who is both native Hawaiian and Israeli. So I think that's something that a lot of people don't know about me. Well, that's a first for me too. Yeah. So that's kind of one thing that really, and the reason why I bring it up is because it is part of what defines me. So when you ask who I am, that's a big part of who I am. What I do, I am with the Hawaii Health and Harm Reduction Center. As a policy and contracts manager there, I also go to school in the evenings at the William S. Richardson School of Law. I'm a second year law student there. And just generally, my goals really is to serve Hawaii and serve our community and to make Hawaii a better place to live in. Okay. Yeah. Your cultural background is very, very interesting. And I can see how maybe you're pulling different ideas from different cultures into a combination that's rather unique. So that's interesting. Thanks for explaining that. Now, let's get into our focus. Okay. What is the Hawaii Harm and Reduction Center? The Hawaii Health and Harm Reduction Center. And Harm Reduction Center. There we go. So what is the Hawaii Health and Harm Reduction Center? We are a nonprofit organization that is based primarily here in Honolulu, but we do also serve the entire state as well as the Pacific. What we do is a number of services. We're actually fairly newly formed organization that originated from what used to be known as the Community Health Outreach Work Project or the CHOW Project and the Life Foundation. And two years ago, the two organizations decided to do a merger. And through that merger, we became the Hawaii Health and Harm Reduction Center. And just very generally and broadly, we provide healthcare services. We provide social services, mental health services, as well as other advocacy work that we do at the intersection between social determinants of health, substance use, mental health, and other just general health issues. Okay. So the Hawaii Health and Harm Reduction Center. That's a name I got to get used to. I never heard that name before until I met you. And I've heard about the Life Foundation and the CHOW Project sounds familiar. But I never heard of the Hawaii Health and Harm Reduction Center. And I'm kind of curious, first of all, why I never heard about it before. And then I like to find out more distinctly what its mission is. But it seems to me like it's flying under the radar a little bit. Am I right about that? Or is my perception wrong? Or is it just that the merger happened just a short while ago, and you're still getting up to speed on promoting yourself? So I mean, I think it's a little bit of everything. Yes, the merger did happen just fairly recently. What seems like yesterday for those of us who've been working at the organization. So there's a lot of that. There's a lot of people trying to get used to the new name, get used to the new branding. So it's taking a while for us to hit our stride and to kind of shift away from being just the Life Foundation or just the CHOW Project. So I think that's in part why we've kind of flown under some radars. But then at the same time, we've been on many other people's radars. So I guess it just depends on your radar. And that's really kind of generally why maybe you have not heard of us, but then there have been other places. And people, I guess, within your community know about you, especially since you've come from these two other organizations. Now, what were those organizations mainly doing, the CHOW Project and the Life Foundation? And how does it combine into your new company and its current mission? So I'll start with the CHOW Project. The CHOW Project was actually Hawaii's syringe exchange program. Syringe exchange? Yeah. So it started off as the syringe exchange program back in the early 1990s. We were actually the first statewide syringe exchange in the entire country. We weren't the first ever syringe exchange, but we were the first syringe exchange that did have statewide buy-in from the state of Hawaii. So we're really proud of that fact. So over the last 30 years, we've been providing syringe exchange services through the CHOW Project. And what does that mean, syringe exchange? I think I know, but I'd just like you to explain. Yeah. So syringe exchange services is basically public health intervention that we do in order to get people who inject drugs to have access to clean syringes to prevent the spread of infectious diseases like hepatitis C and HIV. And it actually came about as a sort of intervention to the HIV epidemic in the early 90s. Okay. And the Life Foundation? And the Life Foundation came about similarly, actually. It was also an intervention and a response to the HIV epidemic in the 80s. And what the Life Foundation did is that they were an aid service organization, and what they provided was HIV-specific case management. So case management for people living with HIV to help them sort of navigate medical care, to help them navigate the different social services and benefits program that was available to them, and to really give people a place where they can feel safe in response to a lot of the stigma that came about from HIV. Okay. So we have two social issues that are out there, and those two former entities were trying to assist people that had these issues. And now we have the Hawaii Health and Harm Reduction Center. Did I say it right? Yes, you did. Okay. And is it doing the same thing? Or is it doing more? Or what's its mission exactly? So our mission is very broadly is to promote health, to create wellness, and to reduce harm in Hawaii and the Pacific. What that means generally, it means that we're a place that really positions ourselves to respond to a lot of the social issues that occur with social determinants of health. Primarily, a lot of our services did arise out of a response to the HIV epidemic with the Child Project and the Life Foundation. But over time, what we found was that there were a lot of other issues besides just HIV that were affecting people. So we wanted to be able to address the whole person and take a holistic approach to our services. So we slowly expanded services to serving not only people living with HIV, but serving people who are also homeless, who have substance use issues and mental health issues, because a lot of them are kind of co-occurring. So we wanted to be able to respond not only to the people living with HIV, but also to the people who have these issues, but maybe aren't necessarily living with HIV. So it's kind of broader than those initial HIV foundational topics that you've gone out. Now you talked about homelessness and substance use and mental health. Well, let's focus. I want to ask you about, you used the word substance use. Now, guys like me, I've heard substance abuse. I've noticed in some of your material, it's substance use. Now, why do you use those terms? And educate me on that, because what I hear in other sources is they use the word abuse, but I know that you use the word use. Yeah, and that's intentional. So it's twofold why we use the term substance use. First, it's because that's actually the clinical term under the DSM-5 criteria or sort of mental health diagnosis is substance use disorder. So that's first why we refer to it as substance use rather than substance abuse. So it's staying consistent with the actual clinical terminology. But then the sort of underlying part of it too is there's a lot of stigma with the term abuse. And so we, as an organization, try to intentionally fight those stigmas or at least address those stigmas. And part of addressing the stigma of substance use is to maybe say it's substance use, but then let the people who are actually affected by it define for themselves, whether it's abuse or whether it's addiction or whether it's something else. But the term substance use is more generally descriptive rather than having a negative connotation to it like abuse. And so you're being non-judgmental in a way. Yes. Is that correct? Yes, it is. All right. And also you mentioned homelessness and mental health. And we're going to take a break right now. But after we take the break, I'd like you to talk a little bit about all those issues you mentioned and what you're doing, what you're actually doing for all of them. And I mean, what your company does or what your entity does. And then I want to ask you where you get your money for all of this. Okay, so we're going to take a break. We'll be back in a minute. Thank you very much, everybody. We will be right back. Aloha. I'm Mellie James, host of Let's Mana Up. Tuesdays, every other Tuesday from 11 to 1130. This show is meant to dive into stories of local product entrepreneurs and how they're growing their companies from right here in Hawaii. I'm so thrilled to have our show kicked off. And so please join us on Tuesdays at 11 o'clock as we talk to local entrepreneurs and hear their stories. Aloha, Stan Energyman here. You can see me every Tuesday at 3 p.m. here on ThinkTech Hawaii. We're not on Friday anymore, so don't be looking for me on Friday. I'm on Tuesday at 3 p.m. here on ThinkTech, coming to you live and direct from the beautiful studios in downtown Honolulu News Pioneer Plaza. So please join me and we'll talk everything about hydrogen and clean energy, not only for Hawaii, but for the whole wide world. Aloha. Welcome back, everybody. I'm Mark Shklav with Law Across the Sea, and I'm with David Abbottbull. David is with the Hawaii Health and Harm Reduction Center in Hawaii. And David, before we broke, we were talking about a lot of the services or the topics that you addressed, but we didn't really talk about what you do. So tell me a little bit about, again, you know, the various services, HIV, syringe, homelessness, mental health, drug use, or substance use, excuse me, okay? And explain what you folks do. Okay. So some of the programs that we have and some of the services that we actually provide, I think first and foremost, we're going to start with what we started off with, and that's our bread and butter, and that's going to be our syringe exchange service program. So we actually have, we do syringe exchange sort of statewide in Honolulu. We have a van that's parked on Kukui Street in downtown Honolulu, and we actually allow people to come up to the van and we'll do syringe exchange right there. So they give us a used needle and we'll give them a clean needle, no questions asked. And they already know about it, so they just know where to go. Yeah. Yeah. So they know where to go. And we also have a second van that goes around the island throughout the week and actually does scheduled appointments and meets people kind of where they're at, because it might not always be convenient for somebody to come to Honolulu to do a syringe exchange. So we try to really meet people where they're at through our syringe exchange program, and then statewide, we do the same where we have a van that kind of goes out and does scheduled appointments throughout each of the neighbor islands. Okay. And then we do HIV case management. So again, that's navigating the medical care and the social services available for people living with HIV here in Hawaii. So that's really a big part of what we do. But some of the other things that we've been doing lately is in our office, we actually just built out a new medical clinic. So we actually have a nurse practitioner that does actual medical care and we specialize in wound care and sort of acute care where people might have sort of an issue that comes up right now, but we won't necessarily be their long term primary care provider. So we are providing actual medical services out of our offices. Where is your office? We're located in the gold bond building. That's right in front of the medical school. And we're on the second floor of the gold bond building. Mental health, homelessness, substance use. And I'm starting to learn. Okay. You're teaching me a little bit because as I grew up and heard things, it was drug abuse. Now I'm hearing substance use, which is making me think differently. I can see that's part of your goal, right? Okay. Excuse me. Go ahead. Yeah. No, it definitely is. Tell me what you folks do with respect to these other issues. So with mental health and substance use, and I should clarify that a lot of these issues intersect. So by addressing somebody's HIV, we're also addressing their mental health. We're also addressing their homelessness. So there is a lot of intersection going on here by doing wound care. We can help somebody get access to other services as well. So some of the other services that we provide people is actual mental health services. We do have two other nurse practitioners who do have a mental health specialty. So some of the things that they do besides provide mental health counseling is they actually provide mental health treatment interventions. And that can kind of intersect with the substance use part of it because we do provide medication assisted therapy, which is providing medication for people to help them get off of an opioid dependence. Homelessness. I mean, that's a big issue. What do you folks do? So our biggest and primary intervention for homelessness is our law enforcement assisted diversion program. And we call it LEED. So our LEED program, while it wasn't intended primarily for homelessness or as a response to homelessness, it ended up being that a lot of the people that we serve are actually homeless. So if I can back up just for a second, the law enforcement assisted the law enforcement assisted diversion program, what it does is it actually is an intervention with law enforcement. And it gives law enforcement the opportunity to divert low level drug offenders away from incarceration and into case management. It just so happens that a lot of the people that our law enforcement officers encounter are also homeless. So by the fact of addressing sort of a criminal justice issue and a social justice issue, we're also addressing homelessness issues. So that's been our primary intervention for addressing homelessness. It's kind of a broad spectrum of all sort of interacting things that you folks deal with. Now, where does the Hawaii Health and Harm Reduction Center get its money? I mean, where does it get its funds to do all these things? That's a very, very good question. So we have a number of primarily grants that we get that consist of both federal city and actually state grants. Our primary funder from the state is the Department of Health. They actually have a harm reduction services branch that funds a lot of our activities. But then we also get funding for the lead program through the alcohol and drug abuse division of the Department of Health. We have some smaller city and county grants that we get to support some of our other ancillary activities that we're doing. But primarily it's been those two and as well as some federal grants from the health resources services administration or HRSA at the federal government. Look, why did your group do this? I mean, how did you folks get started? What was the idea behind all of this? What was the purpose? I mean, why is it you folks that are doing all this? So I think what happened was that it was just, again, we started off very narrowly. Both organizations did start off- Who were the people involved? I mean, what is driving them to do this? I mean, it's a social issue that's very hard to deal with, all of these issues. What's driving you folks to do this? So I think what drives a lot of us is our own personal experiences. A lot of our employees have lived experiences. So a lot of the people that we employ are formerly homeless, are formerly incarcerated. They are living with HIV. Some of us have family members or people that are really close to us that were affected by some of these issues that we address. And that's sort of what drives us to do the work that we do. So it's a personal foundation that has inspired a lot of these people to get involved. Is that what I'm hearing? Yeah, it's that personal foundation that really comes about after having that experience and having to know how important the organizations that serve these populations are. And I think that's really a big motivator. And again, it goes back to people from the community wanting to do something to better their own communities. And your organization is made up, sounds like, of a lot of people like this who are non-judgmental, it sounds like, I mean, I want to make sure I'm saying this right, that are trying to address these issues, not necessarily cure them, perhaps, if they can, yes. But they're trying to provide some way for these people that have these problems to exist or go on or maybe look for a cure. Is that a right way to put it there? I think so. I think that's a good way to put it. And really what we're trying to do is walk with these people, walk with the people that we serve and acknowledge their journey and their humanity through all of this. And I think you pointed out a really important piece of that is that non-judgmental piece because the people that work for us, that work with our organization, they, since they did come from these communities, they know what it's like to be judged, to be cast aside, to be marginalized by society. So for them it's really important to not only talk to talk, but to walk the walk and to make sure that people don't experience what they felt. And if they do, then they try to sort of reduce the impact of that harm, of that stigma, of a lot of the shame that comes with being marginalized. So our employees know what that's about and they really take it to heart and take it personally and they're extremely passionate about what they do in order to address these issues. And you know, I can identify because what we hear a lot of times is negative things not with the social context that you've put on it, but just that it's bad or it's negative. You know, the same way as substance use and drug abuse. Two different terms that may mean the same thing, but it's where you're standing and how you look at them that kind of defines it and how you try to solve it. Now, are you going to solve all these issues? Are you going to solve all of these social problems we have? Where are we going? Well, I mean, ideally we would all like to work ourselves out of a job in this field. But I think where we're going is that there's still is a lot of harm that's happening. There's still a lot of stigma that's out there. There's still a lot of fighting to be done. There's still a lot of advocacy to be done. So what we're going is, again, for us, we believe in incremental change and any positive change. And it's going to be a while till we see significant sort of community wide outcomes for a lot of the work that we're doing because our change is so incremental, but it has a big impact. And we're really hoping that going forward, we're just going to continue chipping away. And we're going to continue to try to reduce the harms of a lot of these issues while still acknowledging that there is harm there. So we're trying to mitigate some of that by the work that we're doing. And over the long run, we're hoping that it leads to a bigger impact and a bigger positive change. I've noticed that you folks also deal with the Hawaiian community, the Native Hawaiian community. Where are you at with that? What's the position of your organization with Hawaiian, Native Hawaiian community? I think for us, we recognize the need to be culturally competent in whatever we do. And we recognize that there is a need for us to respond to the Native Hawaiian community because they are so disproportionately affected by a lot of these issues. That's why we have Native Hawaiian case managers on our staff and that's their job title is Native Hawaiian case manager to specifically work with the Hawaiian community to specifically make sure that we are doing a culturally competent intervention with some of our services. And part of their job is to sort of blend what we do as a whole and some of the interventions that we do kind of throughout the state with some of the cultural practices that make it more relatable and that make it more understandable to the community. Sounds to me from what I've learned from talking with you today that kind of the philosophy is kindness in a way, dealing with these problems with some sort of empathy and kindness is how you deal. Now you've been with this organization Hawaii Health and Harm Reduction Center for about three years. Is that right? We have a minute left. What have you learned from your experience personally? So I've learned that a lot of the issues that we're facing isn't easily solvable. But I've learned that there's a right way to do things and there's a wrong way to do things. And the right way to do things is to recognize people for who they are and that's human being. And what we're dealing with a lot of times are human rights issues, but we can't address a human rights issue if we don't treat people like human beings first. I think first and foremost it's that compassion side of things and recognizing how important having heart in all of this is. David, I appreciate you coming on today and sharing the background of the Hawaii Health and Harm Reduction Center, which to me, although I must have come across it, it's something new for me and it's good to have it out there. So I appreciate David Abbott Bull coming on. Thank you, sir. Thank you. I look forward to talking to you again and good luck in law school. Thank you. Thank you. Thank you. That's all for today.