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Wednesday, November 8, 2000

Clinic for poor
marks 25th year

The Kalihi-Palama Health Center
is a lifeline for the area's
47,000 residents

By Helen Altonn

A community movement led by the late Rev. Richard Wong to establish a clinic for the poor will be celebrated tomorrow with the Kalihi-Palama Health Center's 25th anniversary.

Today, with staff members able to speak 14 languages, the nonprofit center provides a lifeline for the area's 47,000 residents, many of them immigrants.

Wong believed that "when the poor go into town to see a doctor, they are the last ones to get serviced, so he wanted to start a clinic to help the poor and homeless," recalled "Uncle" Henry Aarona, facilities coordinator at Kaumakapili Church, where Wong served, and a founding member of the health center.

In 1975, Wong and a group of concerned citizens formed Hale Ho'ola Hou (House of New Life), which provided medical services in one portion of Kaumakapili Church, separated by sliding doors, Aarona said.

"The clinic started growing and growing and growing ... "

Patient visit totals

Patient visits at Kalihi-Palama Health Center totaled 1,537 the year it opened in 1975 in Kaumakapili Church.

After it moved in 1994 to its current site at 915 North King St., visits totaled:

Bullet 1995: 54,322.
Bullet 1996: 62,901.
Bullet 1997: not available.
Bullet 1998: 52,542.
Bullet 1999: 52,963.
Bullet 2000, to date: 58,039.

Operating revenue, excluding capital:

Bullet 1995: $3,170,630
Bullet 2000: $6,495,614


About 150 -- about 90 full-time equivalents, the rest part-timers

Source: Kalihi-Palama Health Center

Over the years, dental and family planning, optometry, pediatrics, mental health, midwifery, perinatal and behavioral health, social work and other services have been added to the walk-in clinic.

Outgrowing the church space, the clinic, by then called the Kalihi-Palama Health Center, moved in December 1994 to an 8,000-square-foot facility at 915 North King St.

The move doubled the number of exam rooms and spurred a rapid increase of patients with low income, no health insurance and language barriers.

May Akamine, the center's executive director, cited a 10-fold leap in the number of patients receiving health and social services.

The center has a sliding fee schedule based on income and family size, but more than half the patients are uninsured and have a difficult time paying bills and putting food on the table, Akamine said.

The minimum fee is $25. "Even if someone can't pay $25, we ask them to pay something."

But no one is turned away, she said.

Although many changes have occurred, the facility's mission still is "to provide quality, integrated health and social services to our community and all others in need of health care," Akamine said.

"Our focus is on preventative and primary health care, provided in a respectful, caring and culturally-sensitive environment."

Beth Giesting, executive director of the Hawaii State Primary Care Association, guided much of the center's growth as its executive director from August 1983 to January 1995.

When it was in the church, she said, "Growth always was very tricky because we were filled to the rafters."

Those who started the center "were so wise," Giesting said. "They hit the mother lode of need when they set up the health center there ..."

The center is successful because "they never say no," Giesting said. It sets no boundaries for patients, accepting them no matter where they live and regardless of circumstance.

But with "no end to the need," the center must keep adding space, she said.

The Dental and Optometry Clinic recently was renovated and will be blessed during tomorrow's celebration.

Without the health center, Giesting said, "There would be some very serious problems at the hospitals. They would be seeing a lot more patients in emergency rooms and having a lot more trouble with them (because of different languages)."

Dr. Michael Walter, a pediatrician and medical director of the Kalihi-Palama Health Center, said, "It's a wonderful place to work and to have a relationship with patients ..."

Last year, the center had about 8,000 visits from children -- many from immigrant and low-income families with no insurance.

The state's QUEST health care program and federal Children's Health Insurance Program (CHIP) make a big difference, enabling more preventative care and protection against catastrophes, Walter said.

But universal health insurance is needed, he said, because "there are too many kids who aren't in the system, who are out there without any coverage. It's almost like sitting on a time bomb.

"You know a certain percentage are going to have serious medical problems ... Some have nothing to fall back on. It's not just children but families as well."

Like the hospitals and other health care facilities, the center has struggled with funding problems because of inadequate federal, state and private insurance reimbursements, Akamine said.

"The biggest thing that has happened the past year -- that we're very proud of -- we became an official federally qualified health center," she said.

This means increased federal funding under the community centers program. In addition to federal base-funding of more than $600,000, the center received about $100,000 in September to integrate mental health substance abuse into health care, she said.

The center also received a full three-year accreditation by the Commission of Accreditation for Rehabilitative Facilities, which underscores its quality, Akamine said.

While celebrating the center's big strides, she said the staff wanted to go back to its roots, so they visited Kaumakapili Church a few months ago.

"Uncle Henry," Giesting and many of the center's first staff members shared stories about the early days.

"It really touched my heart," Giesting said. "I really felt connected with the old church, rediscovering our beginnings."

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