Friday, January 10, 2014
Hawaii–the State of Denial
by Larry Geller
de·ni·al
noun \di-ˈnī(-ə)l, dē-\
1. : a statement saying that something is not true or real : a statement in which someone denies something
2. psychology : a condition in which someone will not admit that something sad, painful, etc., is true or real
3. : the act of not allowing someone to have something
Hawaii has an official state bird, a state fish, etc., why not a state “psychology?” I would nominate denial for that slot, if it were available. It’s a perfect fit so many ways.
In psychology, denial is considered destructive, so one has to first acknowledge the condition and them move beyond it. Hawaii, and Honolulu in particular, seem to refuse to confront and eliminate its neglect or destructive acts that potentially threaten each of us as citizens of the state and city.
I thought this last night as I listened to a siren wailing on the H-1—an ambulance was changing its siren pattern, seemingly in a desperate attempt to get through stopped traffic opposite the School Street on-ramp. It took a painfully long time before a path was opened for it. I felt sorry for the patient within. I also realized that we, as citizens, have become complacent in turning control of our quality of life over to a government that strangely lacks the “aloha spirit” we are supposed to be know for.
What follows is a chronicle to support that diagnosis. What is needed is some therapy.
First, recognize that we have a problem
I had just watched the segment on Democracy Now reporting New Jersey’s Governor Christie’s apology for his staff’s retaliation against the mayor of Fort Lee by closing lanes on the George Washington Bridge, thereby creating impenetrable traffic jams in Fort Lee. It seems that ambulances were delayed, possibly (probably?) resulting in at least one death. What a horrible and small-minded thing to do, simply because the Fort Lee mayor, a Democrat, wouldn’t endorse Republican Christie in the election. From a CNN article:
The lane closure scandal rocking New Jersey Gov. Chris Christie's administration is raising questions whether gridlock delayed paramedics' effort to save a 91-year-old woman who was in cardiac arrest and later died.
[CNN, Did woman, 91, die because of traffic delays in N.J. bridge scandal?, 1/9/2014]
The connection with “denial?” Honolulu already has a debilitating traffic problem, and the desperate attempts by that ambulance driver to vary the siren and get some attention was a loud reminder of that. And yet Koa Ridge, Hoopili and 22 or more condo towers planned for Kakaako and vicinity, which will add thousands of additional cars to the roads, are allowed to move forward.
With the closure of ER facilities and a birthing center in Central Oahu, ambulances have to make their way to the hospitals in central Honolulu. When the H-1 no longer moves at all, lives will be lost, it’s predictable. We don’t know if the long ambulance ride to Kapiolani for mothers in troubled birth situations has already cost lives.
That’s the second meaning of denial from the sidebar above: “psychology : a condition in which someone will not admit that something sad, painful, etc., is true or real.”
Yes, we have a problem here, and it would be refreshing if government would admit it and take action. Note that denial is not a problem for developers who support politicians who created the PLDC and the HCDA to bypass the interests of ordinary citizens in favor of those same rich developers. In a rare moment of rebellion, citizens made the Legislature repeal the PLDC, but the HCDA lives on.
What do those acronyms mean? “HCDA” is short for “our job is to grant exemptions from sound zoning and other laws and regulations that the people have put in place to preserve their environment and quality of life.”
If the HCDA is truly the “Hawaii Community Development Authority,” how to explain the Governor’s reluctance to appoint a community representative and a small business representative to the Kakaako board as required by the Legislature?
Denying homesteads to Native Hawaiians
Aside from developers, denial is what the state does for any disadvantaged population. This is the third meaning from the sidebar: “3. : the act of not allowing someone to have something.”
If you’ve followed the sad saga of the state’s neglect of its obligations, which it agreed to as a condition of statehood, to grant Native Hawaiians the homelands that they are entitled to, the operative word again is denial. Just say no. Never mind legal or moral obligations. It was painful to hear the personal stories during the Kalama trial of many of the beneficiaries who remained on a waiting list most of their lives, until they were too old to qualify for a mortgage for a home, or too old to farm the land. The state simply and casually denied them what was theirs under state and federal law.
How strong is this denial? The number of leases that have been awarded in total by DHHL in its entire history totals only about 7,200. The waiting list is approximately 20,000. The Kalama case is still in progress and may not wrap up until decades have passed. Yes, people have died while on the waiting list for homesteads, and the state is not scrambling to make things right. Quite the opposite. It appears also that Native Hawaiians don’t qualify for speedy justice.
Denying the Houseless
Housing First is nothing new
What is Housing First, and why does it make sense for Honolulu? According to the Wikipedia:
Housing First approaches are based on the concept that a homeless individual or household's first and primary need is to obtain stable housing, and that other issues that may affect the household can and should be addressed once housing is obtained. In contrast, many other programs operate from a model of "housing readiness" — that is, that an individual or household must address other issues that may have led to the episode of homelessness prior to entering housing.
Pioneered by Dr. Sam Tsemberis, a faculty member of the Department of Psychiatry of the New York University School of Medicine, and the organization Pathways to Housing in New York City in the early 1990s, Housing First for the chronically homeless is premised on the notion that housing is a basic human right, and so should not be denied to anyone, even if they are abusing alcohol or other substances. The Housing First model, thus, is philosophically in contrast to models that require the homeless to abjure substance-abuse and seek treatment in exchange for housing.
Housing First, when supported by the United States Department of Housing and Urban Development, does not only provide housing. The model, used by nonprofit agencies throughout America, also provides wraparound case management services to the tenants. This case management provides stability for homeless individuals, which increases their success. It allows for accountability and promotes self-sufficiency. The housing provided through government supported Housing First programs is permanent and "affordable," meaning that tenants pay 30% of their income towards rent.
Although the model dates from the 1900s, the concept is quite old. As described in the Amazon.com description of 
Scott R. MacKenzie’s Be It Ever So Humble: Poverty, Fiction, and the Invention of the Middle-Class Home,
Before the rise of private homes as we now understand them, the realm of personal, private, and local relations in England was the parish, which was also the sphere of poverty management. Between the 1740s and the 1790s, legislators, political economists, reformers, and novelists transferred the parish system’s functions to another institution that promised self-sufficient prosperity: the laborer’s cottage.
Mayor Caldwell’s feeble commitment to finally employ the evidence-based Housing First solution for only 75 people was revealed in recent newspaper articles to be no commitment at all: the money would come from funds paid by Affordable Housing Partners LLC to acquire the City’s affordable housing projects. That deal may be in jeopardy, and if it should fall through, the City’s Housing First plan falls through as well, it appears.
Neither the City of Honolulu nor the state have put significant resources into assisting its homeless citizens to move off the streets and into stable housing. Instead, perfectly fitting that third part of the definition, the City has mounted an incessant and heartless campaign to seize and destroy the few possessions this most vulnerable of populations have with them. These raids, sometimes carried out in darkness in the wee hours of the night, are likely unconstitutional. A federal court may rule on the constitutionality of the City’s raids within this year.
The sidebar explains that the concept of affordable housing as a way to alleviate poverty is nothing new, and was consciously employed at least as far back as the mid 1700s. Honolulu has yet to catch up.
While politicians and newspaper letter writers abhor looking at the homeless living at the edge of the city’s sidewalks, they are firmly in denial that those tents are there because the city has denied the houseless any other place to stay. I’ve spoken to many of the tent residents, and not one of them wants to live at the edge of a sidewalk.
How much to state lawmakers care about Hawaii’s homeless citizens? I can’t leave the topic without noting that a state representative, Tom Brower, brought Hawaii worldwide attention when he took matters into his own hands:
Hawaii Rep. Tom Brower Takes A Sledgehammer (Literally) To Homelessness Problem (Huffington Post, 11/18/2013).
Denying that Honolulu’s housing is intended only for the rich
The plan appears to be to cater to the housing demands of the rich for the profit of the development community and, indirectly, to support politicians, and not to address the needs of working-class rentals. The media repeatedly apply the term “affordable housing” to housing units that are far from affordable except for the well-off.
Many jobs simply don’t provide income sufficient for a family to pay the rent, much less put food on the table. This increases homelessness of course, but it also condemns many residents to a life of inescapable poverty.
Yet the fiction is allowed to continue—the media are complicit in denying the selloff of Honolulu’s future housing stock to the rich. “1. : a statement saying that something is not true or real.”
Every so often the newspaper devotes its front page to a large artist’s rendering of the latest giant condo tower. The accompanying article continues the fiction that the developer will provide a certain number of “affordable” units.
We don’t see articles reporting how many people have been provided with housing units affordable by 
Instead, gradually, low-income housing stock is allowed to disappear. The sale of city housing units to winning bidders Affordable Housing Partners LLC was reported to run the risk that some units may be lost. But who in the city government cares? They basically want to rid themselves of the expense of operating low-income housing.
Denying that we are entitled to preserve open spaces
If we don’t move to preserve open space in Honolulu, it could soon disappeared. The HCDA (remember them?) is quite willing to cut up a park to give part to a commercial light show venture. If the local Neighborhood Board blinks, the lawn at Jefferson Elementary School could be snatched away for development.
State and local government should have a policy of preserving open space both as a quality of life issue for residents and to protect tourism, but also because public space is a common possession of the people.
One function of sound urban planning is to control growth that threatens public infrastructure networks and public open spaces.
Denying that tourism will be impacted by overbuilding
City and state government jeopardizes the future of the very industry that supports our economy by rubber-stamping every development project that is proposed, whether on prime farmland or concentrated in Kakaako and vicinity. There seems to be a belief that the roads can become gridlocked and the skyline turned into blue glass and concrete and yet tourism will remain vibrant even as Hawaii ceases to be viewed as “Paradise.”
All it would take would be a few articles in tourist publications in Japan to bring the industry crashing down. Should that happen, Hawaii may come to resemble other impoverished Pacific islands that do not have the benefit of a reliable tourist economy.
The Felix special education lawsuit was a case of denial
The 1993 Felix lawsuit, resulting in the Felix Consent Decree, ran a dozen years. It was filed because the State was denying special education services to virtually all Hawaii’s students who required them to benefit from their education.
Even as the consent decree ran on, the Legislature skirmished with the federal court by attempting to thwart the expenditure of state funds to remedy their own neglect. The lege relented, it appeared, only when Judge David Ezra let it be known that he could attach state property if they didn’t cough up the needed cash. Faced with the potential seizure of their koa wood furniture, lawmakers reluctantly paid up.
When the case was filed, the State caved immediately. It was obvious that they had denied services, and there was no defense.
Sadly, even as the consent decree ran its course, several of the named plaintiffs, as well as hundreds, if not thousands, of parents, had to file for due process hearings or take the state to court in order to obtain services for their children. The state Department of Education continues today to fight parents who object to the denial of lawfully required services for their children in the schools.
State denies mental health services
As reported here, the state Department of Health cut back on adult mental health services so severely that independent data demonstrated that deaths had increased.
“Hawaii went from running one of the nation's best behavioral health systems to one of the worst”
There's still some carryover from when Gov. Linda Lingle's administration cut back on community health services, said Louis Erteschick, executive director of the Hawaii Disability Rights Center. He said the worst cuts eliminated the Assertive Community Treatment teams, reduced case management hours, and trimmed eligibility from about two pages of covered diagnoses to about two paragraphs.
"Some of Hawaii's mentally ill homeless individuals became ineligible for case-management and housing services," he said. "If they had depression, PTSD or drug-induced problems, it wasn't covered. Only the most severely impaired got help."
Scott Wall, vice president for the Community Alliance For Mental Health, said that's when Hawaii went from running one of the nation's best behavioral health systems to one of the worst.
[Star-Advertiser p. A14, Isle system needs housing services, advocates say, 9/1/2013]
The use of the passive voice erases responsibility for an action:
"Some of Hawaii's mentally ill homeless individuals became ineligible for case-management…”
A better way to say this would be to emphasize the fact that the state denied these individuals case management services. The state’s denial of services comes with consequences—and they knew it.
A measureable and significant increase in avoidable deaths was reported in testimony given [at an] informational briefing on state administration cutbacks in adult mental health services on Tuesday, March 16, 2010. This briefing was an opportunity for the public to give testimony, following previous briefings by the administration.
The first testimony was taken under oath, and after just a few minutes the news came out—a 36% increase in deaths 2009 over 2008 has been recorded.
These avoidable deaths can be attributed to cutbacks in state services to adult mental health patients.
…
Unless something is done, predictably, more people will die because of these service cuts.[Hawaii’s deadly cuts in mental health services demand state response, 3/18/2010]
A re-run of part of my Nov. 12, 2012 article:
Poverty and homelessness cannot be cured by cutting back government services
The reality is that provision of mental health services to the disadvantaged (including the homeless) is something that the state has been drastically cutting back for a number of years. Let’s jump back to the Christmas holiday of December 28, 2009 when then Governor Linda Lingle was about to shut down mental health services on the island of Molokai:
Hawaii has already cut back as much as 75% of its adult mental health services according to some estimates. This has left many consumers without the supports they previously depended upon, and made them more reliant on the surviving programs. The network of Clubhouses is part of that community system.
It’s one thing to reduce services, but Lingle’s cuts are pulling the supports completely out for those who have relied on the Molokai Clubhouse.
The Department of Health had cut back on adult mental health services so severely that on Molokai, the Clubhouse was basically the only place consumers (including the homeless) could obtain state services. Disappeared News learned of the closing just a couple of days before the planned shutdown and the release of the staff. The closing was averted, I think it’s safe to say, by force of blogging. The state tried again and again to close the Molokai Clubhouse (click the link).
Elsewhere, including on Oahu, and up to the present, the DOH began turning consumers away from the clubhouses verbally—that is, without creating a paper trail. Someone might show up and be told, for example, that they had the wrong insurance and were denied entrance. Advocates had little to no evidence of what was going on.
Denying health care to Micronesians
Hawaii’s deadly cutback in health services to Micronesians and other residents from COFA (Compact of Free Association) nations broke into worldwide news as a human rights issue with this story by Al Jazeera:
In 2009, blaming a downturn in the economy, former Hawaii governor Linda Lingle's administration notified COFA residents of drastically reduced health care access. Many complained they were given inadequate notice and without explanation in their own language. COFA patients visited their doctors only to find they no longer had the health care they relied on for cancer treatment, dialysis, medication and other life-saving treatment and medication.
The cuts resulted in a class action lawsuit which won a preliminary injunction in federal district court that would ensure access to essential health services. To date, the case remains on appeal in the 9th Circuit Court.
[Al Jazeera, Micronesians in Hawaii face uncertain future, 10/3/2013]
At the time of Lingle’s cutback, it was reported that 27 people died as a result of receiving her letter denying them dialysis or other life-saving care.
It’s been a long article, I know, but I felt compelled to set down some of the many ways that Hawaii remains in denial of what it must do to ensure the quality of life of its own citizens. While developers appear to be well looked after, the rest of us are made to pay the so-called “price of paradise.” It’s clear to me that there is a pattern and practice of neglect.
The only solution is for citizens to become more assertive—become advocates—before the results of government overbuilding and other neglect begin to irreversibly affect us. When was the last time a condo tower was torn down? Never? So if we think these things are harmful, we better see that they are not built in the first place. If we want to assist those without homes to move off of the streets, complaining in letters-to-the-editor about eyesores won’t help. The City needs to take action. We need to push them to do so. Etc., etc., etc.
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