- Associated Press - Friday, February 7, 2014

HILO, Hawaii (AP) - A Hilo clinic offering medical care tailored to Native Hawaiians plans to shut down next month after years of struggling with finances and a crippling doctor shortage.

Hui Malama Ola Na Oiwi will continue programs aimed at helping Native Hawaiians obtain health services. That includes a transportation program, which picks up patients living in rural areas and takes them to medical appointments.

But it will close its primary care clinic on March 8.

“We’ve been dealing with this, struggling to maintain our clinic, for many, many years,” said executive director Michelle Hiraishi. “All the community health providers have been facing this kind of struggle.”

About 400 patients visit the clinic each month, the Hawaii Tribune-Herald (https://bit.ly/1gUkJAs) reported. Nearly 80 percent are covered by Medicare or Medicaid. Two percent are uninsured.

Traditional community health centers enjoy higher reimbursement rates from Medicare and Medicaid. But Hiraishi said Hui Malama must cover its costs as if it were a private practice.

The clinic has relied on advanced practice registered nurses because of the doctor shortage, but that means that many patients who come in with advanced illnesses must be referred to other providers.

“At times, we’ve been able to get an M.D.-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.

Five clinic staffers will be left without work. 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 for the new jobs.

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Information from: Hawaii Tribune-Herald, https://www.hawaiitribune-herald.com/


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