Health Plan Up in the Air

Duplication of health services is not an issue for Molokai, said Loretta Fuddy, state Director of Health, last week. That announcement comes after health providers on Molokai have been concerned about duplication for the past two years, and have participated in several meetings mandated by the state to hash out a comprehensive health care plan for the island.

Health care providers and concerned residents gathered one more time at the Mitchell Pauole Center last Wednesday, to try and agree on a plan where health care professionals would form partnerships for services, as well as collaborate on funding.

A duplication issue is a “myth,” Fuddy said at the meeting. “There’s not one cookie cutter, not one provider, that will do everything, and that’s because we all have our likes and dislikes.”

Fuddy also announced that the rest of the Molokai Community Health Center (MCHC)’s grant, allocated by the state in 2009, is heading to the governor to be released.

Action Steps
While a smaller crowd gathered than the last meeting on June 1, participants broke into three groups to discuss what Molokai’s plan should look like and three action steps.

Desiree Puhi, executive director of the MCHC said the plan should honor the pledge signed by MCHC and Molokai General Hospital (MGH), in which executives meet twice a year and boards meet once a year.

However, Randy Lite, vice president of MGH, said meeting a few times a year is not enough.

“The providers on this island need to work closer,” Lite said after the meeting. “The first steps should not be at the executive level…but [between] those with similar job descriptions. It would be much, much better for the entire island if we work together,” he added.

Community members also suggested conducting a survey to review the types of services needed, continuing the discussion about the island’s gaps in health care.

“The day that we don’t have to leave the island to get health care is the day that we’re saturated, and we’re far from that,” Puhi said, meaning the island has not reached its limit for the number of health care providers it can support.

State officials at the meeting said implementation is “in the community’s hands.” The current plan, while not yet on paper, calls for the formation of a group that meets several times a year to discuss policies, priority of health initiatives, partnerships and financial resource opportunities. Whether the group will consist of solely health care professionals, or public members as well as health care professionals was not determined.

Some participants were skeptical the plan would actually be implemented. 

“To do this plan we have to have more resources than what is in this room, [and] not just money,” said Kawika Liu, medical director at MCHC. “There’re a lot of plans sitting on a lot of shelves.”

Resident Cora Schnackenberg questioned the department’s motive for the plan, saying she was concerned future funding allocated to MCHC and other Molokai organizations would have contingencies placed upon it. Fuddy said, as in this case, grants are allocated to be distributed through certain departments, who often review the project that received the grant before requesting the money be released.

Still others were unclear who the enforcer of the plan’s action steps will be, or what would be the “punishment” if meetings were not held.

Lorrin Pang, Maui County district health office for the Department of Health, agreed to facilitate future meetings and encouraged the Molokai Community Rural Health Association to help get the group’s organization started.

MCHC Funding
The comprehensive health care plan was also linked to a 2009 grant allocated to MCHC. Fuddy has said previously that the grant would not be released until Molokai’s health care plan was implemented. But at the meeting last week, Fuddy said she requested that Governor Abercrombie release the remaining $450,000 to the health center. It is currently being reviewed by the Budget and Finance office before being sent to the governor for signature.

“We’re relieved [and] grateful,” Puhi and Liu said together.

The grant, which is Capital Improvement Project (CIP) funding, was allocated to help renovate the old Pau Hana Inn, which MCHC bought in 2009, giving them more space for their dental, medical and behavioral health practices.

“We didn’t say that the money was contingent on [the plan], what we did say is we’d like to initiate a planning process to make sure that the resources are well used on this island,” Fuddy said at last week’s meeting. She added that CIP money is released quarterly or in installments, but not in a lump sum.

“As they say, the check is in the mail, but it’s a slow boat from China,” Fuddy said.

Cyrus Siu, MCHC’s chief financial officer, said they are hoping another grant they were given this year, an additional $500,000, will be released soon. With both grants, the last 5 percent of the construction should be completed.