Hana home dialysis sets a Feb. 20 start

After years of appeals and conflicts within the community, Hui Laulima O Hana on Friday set Feb. 20 as the date it hopes to open a family-based home dialysis site in Hana.

The community group has been leading the effort to provide the blood treatment for Hana kidney patients who have been trekking into Wailuku three times a week for their lifesaving dialysis service.

The dialysis campaign leaped a final hurdle Friday when the state Board of Land and Natural Resources cleared the way for home dialysis in a house in Wakiu previously designated for use by a physician.

Working with Liberty Dialysis, which operates dialysis centers around Hawaii, Hui Laulima O Hana proposed using the house, originally built as a physician's home, for the home dialysis service. The house is on state land but for 80 years was under an executive order to Maui County for a physician.

Maui County agreed to retrofit the house for use for dialysis services, and notified Hana Health - which was using the house for a physician's residence - to vacate the facility. The tenant had relocated in December.

Officially, the land board meeting in Honolulu approved cancellation of a governor's executive order that set aside the nearly1-acre site for a physician's home. Mayor Charmaine Tavares initiated the request last year.

The board then approved an order to allow the county to use the property "for health and safety programs for residents of Hana" and to provide a lease to Hui Laulima O Hana.

"We're so excited because we are just getting so close to our dream, it's happening," said Lehua Cosma, founder of Hui Laulima O Hana. "I just thank everyone who believed in this, that made us not give up."

Madge Schaefer, project manager for the Hana Dialysis Home and chairwoman of the Governor's Maui Community Advisory Council, said she is pleased as well. "We felt certainly the land board would agree to this change, because it's still in the health arena."

She said providing the service in Hana will change the quality of life for two Hana dialysis patients who now must be driven to the Liberty Dialysis center in Wailuku three times a week. One other resident needs periodic treatments, and there are four more patients suffering kidney disease who may need dialysis in the near future.

"I think it's going to be remarkable. When you don't have to deal with four hours in a car on the same day you are having dialysis treatment. Instead, they'll have a 10 minute (commute)," Schaefer said.

There is still much more to do. Schaefer said a lease needs to be worked out with the county, but she said Mayor's Executive Assistant Stan Zitnik is prepared to move on approving a lease to the hui.

Zitnik and Council Member Bill Medeiros, who holds the East Maui residency seat, testified before the land board in support of the actions.

The submittal to the land board recommended a 20-year lease expiring in 2029 for $1 per year.

Schaefer said bids are rolling in for renovation work, and she has had lots of volunteers who have come forward to help. The hui is seeking donations of a stove, refrigerator and furniture for the home.

Electrical and plumbing improvements still are needed to accommodate the dialysis machines. The home needs to be fumigated and aides need to be trained before treatment can start, Schaefer said.

The county committed to providing necessary improvements to the wastewater system and for compliance for the handicapped.

In 1927, the property in Wakiu was set aside to the county for a county physician's residence. A single family residence and a cottage on the site were built in 1938. When the state initially took responsibility for the Hana Health Center, the county was allowed to use the home as a temporary residence for police officers assigned to the Hana District.

But the state turned over management of the medical center in 1988 to the Hana Community Health Center, now operating as Hana Health, which again began to use the house for its physicians. But the Hana Health board would not agree to provide dialysis services in Hana, saying it would be too costly - leading to the founding of Hui Laulima O Hana and its campaign to bring dialysis to the remote East Maui community.

Hui Laulima's efforts were boosted in October 2008, when the federal Centers for Medicare and Medicaid Services approved its home dialysis program - a proposal to have the community and families of patients provide the needed support staff.

In its approval, the federal agency said it is the first time such an arrangement has been approved, but it could serves as a model for providing dialysis treatments to patients living in rural areas nationwide.

Information on Hui Laulima O Hana can be found at www.huilaulima.org/. To assist or to provide donations for the home dialysis project, call Schaefer at 874-9293.

* Melissa Tanji can be reached at mtanji@mauinews.com.