10 health centers
lament loss of
$1.6 million in
state funding

Waianae, Kalihi and Maui sites
would lose the most under a plan

---

By Helen Altonn
haltonn@starbulletin.com

The state's 10 community health centers say they cannot stand to lose the $1.6 million in funds that have been cut by Gov. Linda Lingle as part of her attempt to balance the state budget.

The last state Legislature had appropriated the supplemental funds to help the centers meet growing demands for services.

"Unfortunately, we didn't get the money spent fast enough," said Beth Giesting, executive director, Hawaii State Primary Care Association. "We went through contracting and by the time everybody was poised to deliver services, the new administration came in, saw it as unspent appropriations, and decided the money was needed to be used for balancing the budget.

"Obviously, it's quite a blow to the health centers. They were counting on this since the end of the Legislature and providing services accordingly."

Legislators took money from the state's rainy day fund last year to help support health and social services programs. Many health centers had spent all the money budgeted for 2002-03 to care for the uninsured by October, Giesting said.

Hardest hit by the cuts are the Waianae Coast Comprehensive Health Center, the Kalihi-Palama Health Center and the Community Clinic of Maui, which serve the greatest number of poor and medically uninsured residents in Hawaii.

Richard Bettini, chief executive of the Waianae center, said state Health Director Chiyome Fukino called him yesterday to tell him the program's entire supplemental appropriation was cut. He said Fukino indicated the appropriation of $425,000 was eliminated because of a delay in getting the services contracted, suggesting "there was not truly an emergency need."

Bettini said, however, the center has been trying for months to get a contract out of the Health Department. He said the center continued to provide services to uninsured patients because the department reported in November that it was going to begin executing contracts for the supplemental money.

"Now we're left holding the bag," he said. "We've already accrued, as far as state services, about $240,000 through December ... with the assumption of drawing down the funds.

"In 24 years of management at the Waianae Coast Health Center, this is the most arbitrary and poorly managed budget cut I've ever seen," he said. "What really bothers me and is totally inappropriate, there was no meeting with us, no discussion with us."

Health department officials had no comment last night or this morning.

Bettini said the Waianae center serves 24,000 people annually, with two-thirds below poverty-level income.

The Kalihi-Palama Health Center, another major facility for the poor and uninsured, is losing $481,374, said May Akamine, executive director.

"There is no way we can sustain services and access to services for those who need it, who are down and out, homeless, immigrants, people who work less than 20 hours a week with no mandated health benefits," she said.

Akamine said her center ran out of state money in October. "It was supposed to last a full year, but it didn't." The supplemental money was essential to carry the services through to July, she said.

"It's a grave situation," she said. "To me, the governor needs to be educated to really look at the impacts of decisions she makes."

The health centers will have to look at reduced services and possible layoffs if the cuts are not restored, the directors said.

Giesting said it is important to understand Hawaii has a serious problem with people who have no health insurance, a 40 percent increase in five years.

"They literally have no place else to go than a community health center or emergency room. ... Obviously, the Legislature recognizes this. We'd really like to work with the administration to make sure they understand these needs."

Giesting said, "The feds have already stepped up to the plate. The state needs to take some responsibility."

Akamine and Giesting said they met with Fukino and Lillian Koller, state human services director, and both seemed to be advocates for underinsured and uninsured patients. They have not met with the governor, they said.

House Health Chairman Dennis Arakaki (D, Kamehameha Heights-Kalihi Valley), also a board member of Kokua Kalihi Valley Health Center, said legislators "definitely will be looking into where these cuts were made. Many of us feel we really have to protect the most vulnerable in our population."