Hawaii’s health care system specifically tailored to serving Native Hawaiians is shutting down its primary care clinic in Hilo next month.
Hawaii’s health care system specifically tailored to serving Native Hawaiians is shutting down its primary care clinic in Hilo next month.
Hui Malama Ola Na Oiwi’s multiple other services, including community outreach, case management, health education and transportation, will continue to operate, but the primary care clinic at 305 Wailuku Drive will close March 8.
Hui Malama Executive Director Michelle M. Hiraishi said Wednesday that the private nonprofit’s board opted to close the clinic last month after years of struggling with withering finances and a crippling doctor shortage.
“We’ve been dealing with this, struggling to maintain our clinic, for many, many years,” she said. “All the community health providers have been facing this kind of struggle.”
With an average of 400 patient visits a month, about 78 percent of Hui Malama’s primary care clients are covered by Medicare or Medicaid, with 2 percent being uninsured, she said.
Unlike traditional community health centers, which enjoy higher reimbursement rates from Medicare and Medicaid, Hui Malama must cover its costs as if it were a private practice, Hiraishi said, severely cutting into its revenues.
Meanwhile, the clinic has had to deal with the severe doctor shortage that other providers on the island continue to face. Hui Malama has largely relied on advanced practice registered nurses to keep the clinic staffed, but that means that many of the patients who come in with advanced illnesses must be referred on to other providers.
“At times, we’ve been able to get an MD-level provider on board, but we just have not been able to retain them usually,” Hiraishi said.
The nonprofit’s board ultimately decided, after several attempts to keep the clinic in operation, that it would be best to keep Hui Malama’s focus centered on outreach and education efforts, rather than on providing primary care, she said.
“It was a really, really lousy, hard decision for our board to have to make, and it came after five years of trying something else every time. We were just struggling to survive,” she said.
All told, five staff members at the clinic will be left without work after Hui Malama’s shuts the doors. They will be allowed to apply for some of the new positions that will open up at Hui Malama’s other locations, she said, although their skill sets may be different from those required by the new jobs.
“We’re hoping that some of them will apply for the new positions we have,” she said.
As for the clinic’s patients, Hui Malama sent out on Jan. 30 a round of about 1,800 letters announcing the closure to anyone who had been to the clinic since 2010.
“As a result of our clinic closure, you will need to find a new primary care provider,” the letter reads.
Included with the letter was a list of community providers who had informed Hui Malama administrators that they were accepting new patients, Hiraishi said.
“Our plan and intent is for every single patient we have in our clinic to have one-on-one contact from our outreach case management staff to make sure they’re aware of the closure, given a list of other resources and providers that may be accepting patients, and to make them aware of the other services we offer,” Hiraishi said. “Unfortunately, we can’t promise everybody that we will find a provider for them. We just don’t have the resources to do that kind of thing.
“We realize this will have a huge effect in the community. We’re trying our best to just not leave any patient out.”
Hiraishi emphasized that Hui Malama would continue to provide its longstanding programs aimed at health education and helping Native Hawaiians to obtain health services. That includes its transportation program, which will pick up patients who live in rural areas and transport them to medical appointments.
Also, on Feb. 22, the nonprofit will host an event on Hilo’s Bayfront from 10 a.m.-2 p.m. through its cancer program, ‘E Ola Kakou. The event will feature a novice canoe regatta and fundraiser to celebrate cancer survivors and their ohana. The organization will also offer free breast exams, as well as referrals and assistance.
“We are still alive and well,” Hiraishi said.
For more information about Hui Malama, visit huimalamaolanaoiwi.org/ or call (808) 969-9220.
Email Colin M. Stewart at cstewart@hawaiitribune-herald.com.