Kalaupapa is established as a leprosarium, which is a residential community for those diagnosed with leprosy. Some are brought as children while others arrive as adults, and all are guaranteed a home for life. Part quarantine, part life-long prison, and part community, residents are forcibly removed from their families and strictly quarantined. Quarantine for leprosy is in one part an attempt to prevent the spread of infection, but is also largely due to fear. Family can visit the facility, but they must remain in separate quarters.

Kalaupapa will house 8,000 patients over 150 years. The quarantine will be lifted in the late 1960s, but many residents will choose to remain there. At the time of this writing, Kalaupapa is still open with living residents, and is managed by the park service.