Ka Wai Ola - Office of Hawaiian Affairs, Volume 9, Number 8, 1 August 1992 — Hui Malama Ola Na ʻOiwi offers cultural approach to Big lsland health care [ARTICLE+ILLUSTRATION]

Hui Malama Ola Na ʻOiwi offers cultural approach to Big lsland health care

by Pearl Leialoha Page Hawaiians on the Big Island have eight friends they ean eall on for help in getting health care. They are the case managers and outreach workers of Hui Malama Ola Na 'Oiwi. The name means "caring for our people." Having spent the last six months gathering data on the needs of Big lsland Hawaiians, the federally funded group is gearing up to meet those needs in four ways.

The first way is by offering limited primary health care to Kona residents from its office in Captain Cook. In July, the Hui was finalizing a method for contracting doctors by the hour to offer health checkups and simple outpatient care on a set schedule. It is also looking at a variety of payment methods that take into account other resources. Say a client is low on cash but has 100 lbs of coffee beans or half a bag of taro, a system of exchange could be set up to barter for health services, Kinney said. Calabash eontributions is another way to supplement other payment methods based on sliding fees, cash and insurance.

Sonny Kinney, executive director of Hui Malama Ola Na 'Oiwi hopes that signing doctors on as contractors will meet Department of Health requirements. A second way is by offering transportation to those who otherwise couldn't go to a doctor. The Hui currently has two vans operating in Hilo and Kona. The Hui also assists with

transportation to Honolulu should the need arise.

Traditional Hawaiian heahh care In addition, the Hui has created a network of traditional healers, experienced in ho'oponopono, lomilomi and la'au lapa'au. It's called the 'Ohana Group. "It's a pool of professionals," Kinney describes. "Eaeh person is treated as a professional consultant in his area," Kinney said.

"We have found that about 35 percent of clients ask about native Hawaiian traditional care," he reports. A practitioner of ho'oponopono himself, Kinney says the Hui offers the Hawaiian process of righting relationships to 23 clients in Hilo and Kona so far. Hawaiians who eall for a referral are given the name and number of a native healer in their area. Hui

Malama Ola Na 'Oiwi makes sure that all in the pool get referrals. Payments are then worked out between the client and the healer directly, Kinney explained. "We are very pleased that we ean offer these traditional services," he said. Finally, Hui Malama Ola Na 'Oiwi

has invited closer cooperation from existing health care providers to better serve the health needs of Hawaiians. How the program began Hui Malama Ola Na 'Oiwi is one of five groups begun in response to The Native Hawaiian Health Care Act of 1988. Federal funding under the act

did not become available until 1990. Meanwhile to get the ball rolling a consortium comprised of the Office of Hawaiian Affairs, Alu Like, state Department of Health, University of Hawaii, and a group of Hawaiian health professionals called E Ola Mau, formed Papa Ola Lokahi in 1989 with legislative funding. The group offered planning funds and technical assistance to five island organizations. Eaeh one developed service plans to serve Hawaiians on

their own islands along with budgets for January through June 1991. In July eaeh had submitted budgets and plans for the next fiscal year. "Our mandate is to inform the Hawaiian community about available health care," Kinney explained, and to make that heahh care accessible. Appropriate follow-through is also important to ensure that a Hawaiian client is getting the specific care he

needs and isn't having problems following doctor's orders, Kinney says. Many do not comply with taking medication regularly, Kinney said. "This is a big problem."

Working with Big Isiand clinics In order to get the greatest mileage from the $516,000 in federal funds and another $45,000 in contributions, Kinney has tried to work in tandem with other Big Island clinics. "We've attempted to get our outreach workers in those systems. That relieves us from the pressure to open up a separate system," he explains. That's why the group's Hilo office recently moved. Its new offices are just upstairs from the Bay Clinic, a federally qualified heakh center in Hilo. The move fosters cooperation between the elinie and Hui Malama, Kinney says.

"We get Hawaiians that need medieal care, and we transfer them to the Bay Clinic," he explains. "When they get Hawaiians that need our help because they don't have health insuranee or need a special kind of care, they send them to us." Although Hui Malama Na Ola 'Oiwi doesn't offer health insurance, it does help

Hawaiians who qualify for Medicaid and Medicare apply for benefits. It also helps them find a elinie or doctor who is accepting Medicaid and/or Medicare patients. Many health care providers only aeeepī a given percentage of these types of patients a month. The Hui also makes referrals to other health care providers in the vicinity as well, Kinney added. "The main thing is to hook up the person with need to a provider," he said.

Kinney has duplicated this kind of set-up with the Pahoa Bay Clinic in F\ina and the Lucy Henriques Medical Center in Waimea. He plans to open another office at the Hamakua Medical Center in October 1993 and another office in Na'alehu and North Kohala. "The island is so large, we've had to set up offices throughout the island," Kinney said. Offices are located in Hilo, Pahoa, Captain Cook and Waimea. Kinney estimates there are 30,000 Hawaiians who live on the Big Island, the largest native population outside of O'ahu. There is also a general shortage of doctors and especially dentists practicing on the Big Island, he added.

Hui Malama Ola Na 'Oiwi outreach workers have spent the last six months gathering detailed information on 3,000 Hawaiians. The questionnaire is pages long and includes 47 questions. In the next six months, Kinney hopes to add 2,000 more to the data base to help track trends and service needs. Thus far the data has identified 10 immediate needs. They are: dental care, treatment to control diabetes, more outreach workers, ears, nose and throat care, diet and nutrition,

access and availability of doctors, treatment and preventive measures for high blood pressure, maternity care, immunizations, stress reduction and drug and aleohol treament and prevention. To address some of these needs, the Hui has assisted the state in setting up workshops run by the heahh department. Turn out for these has been good, Kinney reports.

The overall strategy is to improve Hawaiian health to the level of other ethnic groups in the state, Kinney summarized. Hui Malama Ola Na 'Oiwi hopes to develop a non-threat-ening process of increasing awareness of health needs, both spiritual and physical, among Hawaiians on the Big Island.

"The island is so large, we've had to set up ofjices throughout the island. " Sonny Kinney estimates there are 30,000 Hawaiians who live on the Big lsland, tlie largest native populaūon outside of O'ahu.

Hui Malama Ola Na 'Oiwi Big lsland Offices Who to eall: In Hilo Sonia Easley, case manager Bay Clinic 31 1 Kalanianaole Ave. Tel. 969-9220 Services offered: Referrals to Hawaiian healers as well as conventional health care, ho'oponopono, transportation as needed In Puna Bernice McKeaque, outreach worker Pahoa Bay Clinic P.O. Box 1455 Pahoa, 97678 Tel. 965-9711 or 965-9477 Services offered: Referrals to Hawaiian healers as well as conventional health care In Kona Jane Kunitomo P.O. Box 447 Kealakekua 96750 Tel. 323-3618 or 323-3806 Services offered: Referrals to Hawaiian healers, as well as conventional health care, ho'opx)nopono, limited primary care to start soon, transportation as needed In Waimea Noelani Mason Lucy Henriques Medial Center Tel. 885-0489 Services offered: Referrals to Hawaiian healers, as well as conventional health care

"We're trying a cultural approach that ailows bartering for health care services." — Sonny Kinney