To protect patient resident health and well-being, DOH maintains this page to provide information related to Kalaupapa and Kalawao County.
Kalaupapa Updates
Brief History of Kalaupapa and Kalawao County
The Kalaupapa peninsula on the northern coast of Molokaʻi is the current site of Kalawao County and the Kalaupapa Settlement. In the mid-1860s, the Hawaiian Kingdom designated this remote peninsula as an isolation colony for people with Hansen’s Disease (leprosy). At that time, it was believed that removing people believed to have the illness from the rest of the population would prevent the spread of the disease. The establishment of the isolation colony resulted in the displacement of Native Hawaiian communities that had been living on the peninsula for generations.
During this period, the State of Hawaiʻi enacted laws to establish the peninsula as Kalawao County and took steps to ensure that the people who were forcibly isolated would be provided for and allowed to live at Kalaupapa for the rest of their lives.
In 1980, after many years of deliberation and civic input about the future of Kalaupapa and at the request of the patient residents, Congress established Kalaupapa National Historical Park with the goal of preserving the history and the cultural and natural resources of Kalaupapa.
The borders of Kalaupapa National Historical Park exactly match those of Kalawao County.
The current operation of Kalawao County, Kalaupapa Settlement and Kalaupapa National Historical Park requires an extensive and complex collaboration between multiple governmental agencies that play a role in the activities on the peninsula.
Current Involved Agencies and Their Roles
Hawaiʻi State Department of Health (DOH)
DOH is responsible for the care and treatment of the Hansen’s Disease Registry patients, which includes people forcibly quarantined at Kalaupapa prior to the 1969 repeal of the isolation law. As of May 2024, there are eight Kalaupapa Registry patients living. These patients live in Kalaupapa and Oahu and often travel between the two locations. Hawaiʻi State Law (Hawaiʻi Revised Statute 326) defines the role of DOH and includes the provisions that persons isolated at Kalaupapa because of Hansen’s Disease “who desire to remain at Kalaupapa shall be permitted to do so for the rest of their lives” and both those at Kalaupapa and those living in other communities “shall be accorded adequate healthcare and other medical treatment and services for the remainder of their lives.” HRS 326 also designates that the county of Kalawao is under the jurisdiction and control of DOH.
Hawaiʻi State Department of Hawaiian Home Lands (DHHL)
DHHL owns 1,247 acres of land within Kalawao County including the area of Kalaupapa Settlement. DHHL delegates site control to the U.S. National Park Service (NPS) as part of Kalaupapa National Historical Park, per a General Lease.
Hawaiʻi State Department of Land and Natural Resources (DLNR)
DLNR owns 9,394 acres within Kalawao County, most of which is designated Conservation land and includes restrictions on the land to conserve, protect, or preserve important natural and cultural resources in those areas. Kalawao, the site of the original isolation colony, Judd Park and St. Philomena Church, where Father Damien’s grave lies, are part of DLNR lands. DLNR has an agreement with NPS to administer its lands within Kalawao County as part of Kalaupapa National Historical Park.
Hawaiʻi State Department of Transportation (DOT)
The Kalaupapa Airport (LUP) encompasses the 42.2 acres at the tip of the peninsula including the runway, terminal and adjacent lands. The Department of Transportation is responsible for the airport facility operations.
National Park Service (NPS)
The Kalaupapa National Historical Park was founded in 1980 to honor the moʻolelo (story) of the isolated Hansen’s Disease community by preserving and interpreting its site and values. The historical park also tells the story of the rich Hawaiian culture and traditions at Kalaupapa. NPS has agreements with the state agency landowners for operational responsibility within Kalawao County. NPS also owns 22.88 acres in which the lighthouse, as well as the Molokaʻi Light Station, two historic houses, and four outbuildings are located. More information: Foundation Document – Kalaupapa National Historical Park (U.S. National Park Service) (nps.gov)
Maui County
Maui County provides assistance to Kalaupapa for law enforcement, emergency medical services and fire fighting via a mutual aid agreement with DOH.
Other groups
Other groups with an interest in the future of Kalaupapa include but are not limited to:
- Current patients
- Family and descendants of current and former patients
- Descendants of Native Hawaiians who lived on the peninsula prior to it becoming an isolation colony for Hansen’s Disease
- DOH and NPS employees living and working at Kalaupapa
- Ka ʻOhana O Kalaupapa – a nonprofit organization dedicated to promoting the value and dignity of every individual who was exiled to the Kalaupapa peninsula beginning in 1866.
- DHHL Beneficiaries
- Residents of the island of Molokaʻi.
- Ecclesiastical Organizations including Catholic Diocese, Church of Jesus Christ of Latter-day Saints, and the Hawaiʻi Conference Foundation.
- University of Hawaiʻi and other educational institutions
- Molokaʻi Plant Extinction Prevention Program and other conservation organizations
- Religious pilgrims
- People with a strong interest in history, injustice, public health or other related topics
Kalaupapa Informational Briefing
The Hawaiʻi State Department of Health (DOH), in partnership with the Department of Hawaiian Home Lands (DHHL), Department of Land and Natural Resources (DLNR), Department of Transportation (DOT) and the National Park Service (NPS), hosted a Kalaupapa Informational Briefing on October 5, 2024 at Kaunakakai Elementary School on Molokaʻi. Members of the public with an interest in Kalaupapa were encouraged to attend.
The agencies recognize that there are questions about the complex history and jurisdiction of Kalaupapa and what management tasks are overseen by each agency. At this meeting, representatives from DOH, DHHL, DLNR, DOT and NPS shared their current roles and responsibilities in Kalaupapa and Kalawao County and how they are working together to support the patients and steward this special place.
Informational slides can be found here.
Questions and answers from the Kalaupapa Informational Briefing
Future Governmental Agency Roles
While Kalawao County and Kalaupapa have been managed by Hawaiian and Hawaiʻi government public health entities for more than 150 years – initially by the Hawaiian Kingdom and later by U.S. Territorial and State health agencies – oversight of this remote peninsula of land is scheduled to change in the future when the Department of Health (DOH) is no longer needed to provide care for Hansen’s Disease registry patients in Kalaupapa.
When there are no longer patient residents in Kalaupapa, DOH will begin a staged process of exiting Kalaupapa and Kalawao County and transferring its remaining duties and operations to other governmental entities. DOH will continue to coordinate ongoing environmental cleanups in Kalawao County. This transitional planning process requires careful thought, historical research and time to hear input from all stakeholders with an interest in the future of Kalaupapa.
DOH is partnering with a facilitator with extensive knowledge of the history and current status of Kalawao County and Kalaupapa and experience working with the Molokaʻi community to assist the Department and other State Agencies in gathering relevant input, effectively communicating accurate and current information to the community and stakeholders, and facilitating community meetings related to DOH’s eventual withdrawal from Kalaupapa and Kalawao County and the transition process.
Kalaupapa Transition Timeline
Historical Background
1969
The Hawaiʻi Legislature repeals the provisions of State law that required the segregation of individuals with Hansen’s Disease, leaving intact provisions to assure for the ongoing support of the remaining patients. Specifically:
- CARE: It was clearly stated that the policy of the State is “all persons who were institutionalized for segregation by order of the department of health because of Hansen’s Disease and who live in the community shall be accorded adequate healthcare and other medical treatment and services for the remainder of their lives…” – HRS §326-1.5
- RESIDENCY: Provided “…that any patient resident of Kalaupapa desiring to remain at the facility shall be permitted to do so for as long as the person may choose…” – HRS §326-26 (a)
mid-1970s - 1979
After segregation provisions were repealed in 1969, serious discussions begin regarding “the future of Kalaupapa.” Alternatives that were explored at the time included a national park, a state historical park, and the incorporation of Kalaupapa/Kalawao County into Maui County.
1979 – “Alternatives study, Kalaupapa leprosy settlement: working draft.”
The National Park Service publishes a feasibility study that discusses issues of jurisdiction, land ownership and settlement management.
1980-1989
1980- Kalaupapa National Historical Park is established at the request of the Kalaupapa Patients – (Public Law 96-565, codified at 16 .S.C. § 410jj)
In recognition of the State’s statutory commitments to the remaining patients (HRS §326), the federal law makes special provisions for the Department of Health to continue providing health care and residence for the remaining patients at Kalaupapa. The law includes agreement to meet regularly for joint planning and coordination purposes.
1984 – NPS-DOH Cooperative Agreement No: CA8896-4-0001
The agreement outlines the division of responsibilities required to manage operational efforts in Kalaupapa and the planned transition of existing DOH duties and functions to NPS. Both parties agree to meet regularly for joint planning and coordination purposes.
DOH-NPS meet regularly to discuss ongoing operational responsibilities and transition of DOH duties and functions to NPS per their cooperative agreement.
1987 – NPS-DOT Cooperative Agreement No: CA8896-7-8005
The agreement outlines responsibilities for public access to the airport and surrounding land, access to water and agreements for repairs/construction of airport facilities and utilities. Both parties agree to meet regularly for joint planning and coordination purposes.
1989 – NPS-DLNR Cooperative Agreement No: CA8896-9-8004
The agreement outlines responsibilities for the protection, preservation and interpretation of natural and cultural resources within the portions of Kalaupapa National Historical Park which are under the management of the State of Hawaiʻi through its Board of Land and Natural Resources. Both parties agree to meet regularly for joint planning and coordination purposes.
1990-1999
DOH-NPS meet regularly to discuss ongoing operational responsibilities and transition of DOH duties and functions to NPS per their cooperative agreement.
1991 – DHHL General Lease No. 231
In recognition of the Department of Health’s statutory commitments to the remaining patients (HRS §326), the DHHL Lease makes a special provision for the Department of Health to continue providing health care and residence for the remaining patients at Kalaupapa.
“Article Two
8. Repairs to improvements.
… State of Hawaiʻi, by its Department of Health, may repair or expand all existing improvements as deemed necessary for the continuation of the existing uses of such improvements for the care and treatment of persons affected with Hansen’s disease.”
2000-2009
DOH-NPS meet regularly to discuss ongoing operational responsibilities and transition of DOH duties and functions to NPS per their cooperative agreement.
2010-2019
DOH-NPS meet regularly to discuss ongoing operational responsibilities and transition of DOH duties and functions to NPS per their cooperative agreement.
2015 – DOH and NPS invite DHHL, DLNR, DOT to join their regularly scheduled discussions
2016 – DOH and NPS invite Maui County and US Department of the Interior, Office of Native Hawaiian Relations to join their regularly scheduled discussions.
Representatives from all involved Government Agencies meet regularly to discuss ongoing operational responsibilities and transition of DOH duties and functions to NPS per their cooperative agreement.
2020-present
Representatives from all involved Government Agencies meet regularly to discuss operational responsibilities and transition of DOH duties and functions to NPS per their cooperative agreement. Discussions continue among the agencies regarding future governmental responsibilities at Kalaupapa.