Maybe all you need to know about the Kaua’i Community Health Center in Waimea is that, when arrangements were being made to send a photographer there for pictures for this story, the doctor was out, making a house call. There
Maybe all you need to know about the Kaua’i Community Health Center in Waimea is that, when arrangements were being made to send a photographer there for pictures for this story, the doctor was out, making a house call.
There are doctors who still make house calls?
The center aims to serve the entire island, particularly those who may not have health insurance or are underinsured.
Like other doctor’s offices, people aren’t turned away if they need care but don’t have money. At the center, the bill depends on the patient’s ability to pay, not on the going rates for a certain exam, test or procedure.
The focus is on care for people in need, said David Peters, executive director of the center and Ho’ola Lahui Hawai’i, the non-profit agency originally established to address Native Hawaiian health issues on Kaua’i.
“We want to see people well,” said Peters, who stressed that the health center is open to people of all nationalities, those with or without medical insurance, and anyone else in need of medical attention.
“We don’t deny care to anybody,” said Peters, 40, who is excited that the center, located in the Kawaiola Medical Office Building adjacent to West Kaua’i Medical Center at Kaua’i Veterans Memorial Hospital, is serving more than just Native Hawaiians.
“I think it’s a great project,” he said.
Kaua’i Community Health Center opened in September last year, after around a year in the planning stages. Dr. Momi Ka’anoi, the house-calling family practitioner in charge of the facility, and staff began seeing patients last month.
Ho’ola Lahui Hawai’i, which has employed Peters for four years, saw a need for a community health center and established one itself when no other organization appeared eager to, he said.
While the original intent was to have a health center to address the special health needs of Native Hawaiians (who have a greater-than-average incidence of diabetes, hypertension and other maladies than other ethnic groups), the idea expanded to include anyone from any race with the need for any type of medical help the center can provide. That includes dentistry, substance abuse counseling and treatment, mental-health services and prenatal care, Peters said.
There is a statewide push to get health insurance into the hands of all, especially children, who without insurance or the ability to pay for doctor’s visits might not get primary care from medical professionals.
The alternatives can be deadly. Those who put off seeing a doctor or dentist until pain or suffering become unbearable sometimes die, lose limbs or teeth, must stop working, or become victims of serious medical conditions that could have been prevented or treated if discovered early on.
That can put additional stress on individuals and families, sometimes creating irreparable chasms between family members, Peters said.
Obviously, a trip to the emergency room costs much more than a preventive checkup in a doctor’s office. Still, those without insurance or the ability to pay for primary-care medical treatment often put off doctor visits until pain of an advanced condition forces them to seek attention.
And some people with full medical insurance delay getting medical or dental attention because of past painful or unpleasant experiences with medical professionals, Peters commented.
“It’s really more important for the community” than the center for people to seek medical insurance programs for low-income families, or avail themselves of programs like those offered through the center.
The center is part of Hawai’i Primary Care Association, whose motto is “promoting primary care for all Hawai’i’s people.”
Peters said innovative healthcare solutions are sometimes necessary to address health concerns complicated by a lack of family medical insurance.
For example, increasing economic development in a particular area means more jobs, and more full-time jobs mean more families getting mandatory medical insurance that comes with those full-time positions.
In order to spread awareness of the services the health center provides, the staff recently walked door-to-door in Kekaha, Peters said.
He hopes for satellite clinics in other parts of the island. Waimea was chosen for the first center, he said, because the area has fewer primary-care providers than other parts of Kaua’i. Ho’ola Lahui Hawai’i felt the need was greater on the west side and liked west Kaua’i’s cohesive community.
Primary care is the initial entry point into the health system, what Peters calls the “first line of defense” against illness, akin to what a family practice physician offers.
While no one is turned away because of an inability to pay, Peters stressed that services aren’t free, but are based on a patient’s or family’s ability to pay.
“This is not a handout. There is a cost to it,” he said.
By the same token, he hopes that those with medical needs and no way of paying for services don’t stay away because of pride or other emotions.
“I wouldn’t want them to feel shame to come in,” he said.
Supported in part by state and federal grants, the program accepts most insurance. And it needs the revenue from insured and underinsured patrons and from sliding-scale payments from uninsured patients in order to continue services.
Ho’ola Lahui Hawai’i has a large van that offers mobile dental services, spending four days a week in Waimea and one day a week in Anahola. Dr. Peter Saker and a dental assistant man the van.
Peters said that, with revenue from other services, it’s hoped the Waimea center can add dental facilities and a hygienist to allow the center to handle more dental patients. The facility currently has a full-time staff of eight people.
The doctors working for the center could probably make more money in private practice, but it’s not money that motivates them, Peters said.
“They care about the community, and that’s why they do it. They went into medicine to make a difference in people’s lives,” he said.
Since the larger clinics and hospitals realize the value of primary care in saving time and money and helping to catch minor health problems before they become emergency-room situations, they have been supportive of the center’s efforts, Peters said.
Staff Writer Paul C. Curtis can be reached at mailto:pcurtis@pulitzer.net or 245-3681 (ext. 224).
