Ka Wai Ola - Office of Hawaiian Affairs, Volume 10, Number 8, 1 August 1993 — Office of Hawaiian Health stripped to bare bones [ARTICLE+ILLUSTRATION]

Office of Hawaiian Health stripped to bare bones

by Patrick Johnston Created to play a central role in ensuring that heahh services reach the native Hawaiian eommunity, the Office of Hawaiian Heakh has instead seen its budget slashed this year as funds have been redistributed to other Department of Health offices in a year of belt tightening and redefined priorities. The reduced budget comes only two years after legislation was passed to expand OHH services, and flies in the face of plans by the office to expand its operations. Now the office has only two staff, a secretary and the director. The Office of Hawaiian Heahh had asked that 10 temporary

staff, on loan from other heahh department branches, be made permanent so that the office could go ahead with plans to eon-

tinue and expand its programs. These included reorganizing its position in the department so that it was directly under the office of the director, a position that would give them greater access to the different DOH divisions and make it easier for them to coordinate with those divisions on heakh issues of importance to Hawaiians. Making the 10 positions permanent would also enahle the office to provide a staff member on all islands, allowing for effective eommunication between the Hawaiian

community and the department. Legislature money committee members contended that the funding requested by the office would expand the office beyond its mandate and that the office would function more

effectively by oper-

ating like ASK 2000, a phone service that allows individuals access to information about various heahh services

available to them. OHH director Fern Clark disputes this, saying that ASK 2000 is only helpful for people who are aggressive about obtaining heakh services, and is not the way to address the difficulties Hawaiians face in getting heakh services in the present system. "Misinformation got to the Senate Ways and Means committee and they denied us the funding," she says. However, committee members argue that all they were doing was putting a hold on creating new positions, not cutting budgets, and that the Department of Health has the authority to create permanent staff in the Office of Hawaiian Heakh if they choose to do so. Explains Senate Ways and

Means committee chair Ann Kobayashi, "I don't know why the Department of Health is blaming us for the problems at the Office of Hawaiian Health. The budget does not prevent them from

transferring person-

nel from other divisions and creating permanent OHH staff. It's up to them to hire

permanent people." Who is ultimately responsible for creating permanent positions is subject to debate at this point and legislators and DOH staff are presently trying to find documentation that will clarify the issue. Whether the clarification of the issue will make any difference for OHH remains to be seen. The transfer of personnel had created tensions in the Department of Heakh as some divisions had to bear the brunt of the changes at continued on page 3

The reduced budget comes only two years after legislation was passed to increase Office of Hawaiian Health services and flies in the face of plans by the office to expand its present operations.

Fern Clark

Office of Hawaiian Health faces staffing crisis

continued from page 1 the Office of Hawaiian Heahh and it is unlikely that these divisions want to go another two years short-staffed. DOH deputy director Masaru Oshiro points out, "In austere years nobody wants to lose any positions and there was a certain

amount of ill feelings among affected divisions." For now, temporary Office of Hawaiian Health personnel will go back to their original health divisions, divisions that were adversely affected when the Office of

Hawaiian Heahh was expanded two years ago. The Office of Hawaiian Heahh was created in 1989 in response to the disproportionately high rate of mortality and heahh problems among the native Hawaiian population. The office was to work with public and private agencies to ensure that heahh services reached the least healthy segment of the population. Says Clark, "Most decisionmakers want 'how manys.' They want to know what you do'. We don't have 'how manys.' We coordinate activities of other offices and agencies to try and get services to Hawaiians." Hawaiians, especially those liv-

ing in remote areas, or the elderly, tend to be suspicious or fearful of modern heahh practices and may delay seeking treatment until they are very sick. "The purpose of OHH is to help humanize heahh care so that it will be less intimidating to native Hawaiians," Clark points out. "Having modern technology

alone is not appropriate." Clark believes special funding for native Hawaiian heahh needs is warranted because they represent the biggest challenge. "If we're going to do a job we ' should start at the hardest part. ... If you

improve the heahh of people who need it most then you improve the heahh of all. We learn from what we do and how we ean help other groups." This year's planned reorganization would help OHH better monitor all Department of Heahh divisions and help them become more attuned to the needs of Hawaiians. One possible temporary solution to the cutbacks is for OHH to share its present office space with the federally-supported native Hawaiian heahh agency Papa Ola Lōkahi. If this doesn't happen OHH will be forced to look for a smaller office.

Ann Kobayashi