Health Providers Talk Collaboration

In a historic move, the island’s health care providers gathered last week to discuss how to co-exist peacefully.

The meeting – the first of many – was called by the Department of Health (DOH), stemming from concerns over duplication of services between Molokai General Hospital (MGH) and the Molokai Community Health Center (MCHC).

The assembly at Kulana `Oiwi, attended by residents and public and private health care providers alike, discussed both the strengths and weaknesses of Molokai’s health care. The issue at the heart of the meeting was availability of services and how to best serve the community. Cora Schnackenberg, a resident who attended last week’s meeting, said insurance dictates where many residents can go to for health care, and a variety of services is a benefit for residents.

“We gotta stop cutting throats,” she said. “You can’t monopolize [health care], we gotta work together.”

DOH officials called the meeting to begin forming a comprehensive health care plan among the island’s providers, creating an inventory of services to find any gaps that need filling, as well as to ensure that business is fair for all.

The Positive
MGH’s emergency facilities are not only a necessity, but also offer a high quality of service, as many attendees mentioned. Although Molokai has limited specialist services, such as the lack of an on-island eye doctor, residents do have chemotherapy, dialysis and women’s health available among many other services at MGH.

Matt Yamashita, a MCHC board member, pointed out that Molokai has excellent doctors “across the board.” Others applauded the island’s only pharmacy, Molokai Drugs, a family-run business that provides more than just prescription drugs.

One attendee mentioned Molokai’s growing professional development in the medical field, such as Wai Ola `O Hina, where local students can learn therapy services and find employment on-island.

Among the attendees were MGH and MCHC, representatives from Na Pu`uwai, Veterans Affairs, Hospice Hawaii, Liberty Dialysis and private care providers Chris Chow and Mary Hoffman.

The Negative
Those at the meeting agreed that Molokai’s main challenge with health care is access to services – geographically, socially, culturally and economically.

Yolanda Tanielu, parent co-chair of Molokai Community Children’s Council and whose daughter is in special education, said not only is there no transitional period from special education to adult mental health services, but the mental health facilities here are currently inadequate.

“I don’t give a s*** about your competition, I just want services for my child,” she said to the table of professionals. “It’s not about quantity, it’s about quality…[but] on Molokai, what we get is what we get.”

Joe Lapilio, the meeting’s Department of Health (DOH) facilitator, said budget cutbacks are effective statewide and show no signs of abating. DOH provides the island’s mental health services, school health aid and public health nurses.

Duplication vs. Options
While many believe variety of health care available on the island is positive, others say that is Molokai’s demise.

“Molokai is notorious for [having] turf issues for years,” said Jane Lee, MGH trustee and a co-founder of Na Pu`uwai. “I’d like to [get] rid of duplication services – its wasting money.”

Although many areas on Oahu, Hawaii Island and Maui have island-wide health plans, Molokai’s plan was initiated after the duplication issue arose last year between MGH and MCHC – and a $1 million state grant was withheld from MCHC for building renovations until the issue was resolved. MCHC and MGH both provide primary care, but MCHC Executive Director Desiree Puhi said in a past interview that MGH’s emergency services, internal medicine, and women’s health are not in competition with MCHC’s pediatrician and dental services.

Loretta Fuddy, director of the DOH, said until the plan is formally implemented, the state will not release the second half of the grant.

“We’d like to make sure the resources on-island are used to the best capacity,” she said. “We look at high need areas, develop community health plans and cooperate with the facilities there, to leverage additional federal dollars.”

Judy Caparida, a co-founder of MCHC, said politics are getting in the way of Molokai’s needs.

“If [a health care organization] is going to give us service, that’s that we need,” she said.

While the first meeting was held to begin an inventory of Molokai’s health care options and needs, officials will be holding the next meeting for more of the public to join in the discussion. The public is encouraged to attend the next meeting on June 1, at Kalanianaole Hall at 6 p.m.

(MCHC recently received an additional $500,000 grant for their new facility, not to be confused with their original grant, appropriated in 2009).