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Molokai health center awarded $4M grant

DeCoite: It’s ‘absurd’ to award funding in wake of complaints

The Molokai Community Health Center received a $4 million federal grant amid recent complaints for its handling of physician shortages, treatment of medical professionals and staff, and its lack of timely responses to patient appointments

The Molokai Community Health Center has received a $4 million grant from the federal government after passing an inspection in January 2019, months before patients started complaining of poor service that prompted the state to launch an investigation.

The three-year grant was awarded by the Health Resources Services Administration, the federal agency that oversees community health centers and is under the U.S. Department of Health and Human Services.

During an annual on-site review by HRSA last year, the health center said that it “demonstrated full compliance with its program requirements, including clinical staffing, quality assurance, required and additional health services, key management staff, board authority and composition and financial management.”

“These grant dollars enable MCHC to continue to provide our comprehensive services to residents of Molokai, delivering much-needed care to our patients regardless of their insurance status or ability to pay,” CEO Helen Kekalia Wescoatt said in a news release last week. “We look forward to working with our partners and patients to improve the health of the Molokai community.”

Community members in recent months have criticized the health center for its handling of physician shortages, treatment of medical professionals and staff, and its lack of timely responses to patient appointments and requests for prescriptions. Full- and part-time physicians and nurse practitioners have resigned over the past year, leaving the medical clinic without a full-time physician and forcing the remaining nurse practitioner to take on the role of chief medical officer.

In August, the clinic had to shut down for four days after the nurse practitioner was forced to call in sick.

Residents and lawmakers have called for the resignation of Wescoatt and board President Greg Kahn, though Wescoatt has declined to do so.

As complaints mounted, the state Department of Health conducted inspections of the health center in September and October and was denied access multiple times to both the facility and its documents. Investigators found violations in the areas of organizational structure, staffing and responsibilities and provision of services. They also found that the last time the facility had a physician as its medical director was in August 2017.

Wescoatt said last month that the health center was working to complete a plan of correction for the violations. The center reportedly hired a physician for the chief medical officer position in December.

State Rep. Lynn DeCoite, whose district includes Molokai, expressed dismay over the timing of the grant.

“The fact that HRSA has authorized this grant is absurd,” DeCoite said. “If MCHC is in ‘full compliance,’ then show us, the community, the report showing that.”

DeCoite added that “our Congressional leaders need to step up and help get some answers.”

“I’ve asked them numerous times for assistance with HRSA and have not gotten any responses from them,” she said. “With the numerous complaints that have come forward and the investigations from DOH and the AG’s office there is much to be concerned about. Our community is still left without answers and with no trust in our community health center.”

“Until I see documentation otherwise,” DeCoite added, “I feel giving them any more funding is putting money into a sinking ship.”

Martin Kramer, HRSA director of communications, said that HRSA conducted a site visit between Jan. 29-31, 2019, which the agency does “at least once per project/designation period” to assess whether a facility is complying with the Health Center Program.

“HRSA independently monitors Health Center Program grantees throughout the year to identify potential issues, including noncompliance with Health Center Program requirements,” Kramer said. “This monitoring is conducted through a variety of available resources, including the review of grantee data reports, independent annual financial audits reports, routine conference calls and site visits.”

Since Molokai is currently on a three-year project period, the next site visit has not been scheduled but will occur about 18 months from the health center’s project period start date of March 1. When asked about the contrasting reviews of the health center on the federal and state level, Kramer said that “the state DOH may have additional requirements beyond the Health Center Program requirements, including, for example, oversight by a full-time physician as medical director.

“HRSA program requirements allow for other clinicians, like nurse practitioners, to serve as medical directors,” Kramer explained.

He said the agency would continue to monitor the health center’s operations.

“HRSA cannot comment on what state officials may or may not do, but again, health centers are expected to follow all federal, state and local laws,” Kramer said.

U.S. Sen. Mazie Hirono also said she would keep an eye on the health center.

“Rural communities across our country like Molokai depend on federally qualified health centers to access quality, affordable health care,” Hirono said. “I have been, and will remain, in close contact with local stakeholders to address the community’s ongoing concerns with Molokai Community Health Center.”

Over the past three years, the health center’s operational budget has grown by 15 percent, according to the center news release. The health center’s program funding is part of an award totaling $4.4 million annually, with 69 percent of the budget financed with nonfederal resources.

* Colleen Uechi can be reached at cuechi@mauinews.com.

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