Hana Health is hoping to recruit more health care workers through housing and education opportunities, as well as expanding the facility and its services, as it seeks to address the issues of doctor shortages and lack of resources that are plaguing the nation and state.

“There is an extreme shortage of family practice physicians throughout the country, as well as the State of Hawaii and Maui County,” Executive Director Cheryl Vasconcellos said. “Given the remoteness of the Hana district, the lack of any housing affordable or otherwise, and limited education and employment opportunities for family members, Hana Health faces significant challenges in this regard.”

Hana Health generally operates with one medical doctor and one physician’s assistant, but has recently added a family nurse practitioner, which is one more provider than is needed based on the size of the clinic, she said. The facility currently has an adequate level of providers but is recruiting for a full-time doctor after the departure of a longtime physician last month.

Now that the clinic has expanded services to Hana High and Elementary Schools, as well as launched its mobile clinic to service outlying communities and kupuna with limited mobility, having the third medical provider “has been very helpful,” Vasconcellos said.

There is also a full-time dentist, a part-time marriage and family therapist, a part-time licensed clinical social worker, a pediatric dentist, an OB-GYN and an optometrist who provide services once a month. 

Vasconcellos said a longtime physician voluntarily left last month, leaving some patients disappointed, but Hana Health continues to provide the full range of medical services, including 24-hour calls. 

The administration has been recruiting for another full-time physician in order to further expand capacity and reduce the burden of 24-hour call operations.

The clinic’s medical director, who is also a doctor, will be providing clinical services beginning this week, she said. 

They are currently looking to hire at least one medical assistant and a physical therapist as primary health care and urgent care, both provided by Hana Health, are always in high demand. Based on the clinic’s last community needs assessment, residents are asking for more physical therapy options. 

Now that the new 3,800-square-foot Hana Rehabilitation and Support Center is nearing completion, the clinic will be able to offer these services as well as behavioral health opportunities. 

The $5.3 million facility will also include space for chiropractic care, cardiac rehabilitation, short-term medical respite and specialty services using the telemedicine technology. 

Administrative offices will also be relocated to the new building.

“We expect to have this service operational in early 2023 once the new building is complete,” she said. “The new Rehab Center will go a long way to providing space for service expansion, especially physical therapy, behavioral health services and complimentary/traditional medicine, but it really is not enough.”

To reduce the amount of travel to Wailuku, Hana Health is planning to add cardiology and dermatology services within the year, which will be provided once a month to start based on patient needs and demand. 

A part-time psychiatrist and a part-time psychologist are also “on the wish list” to help address some of the more serious mental health conditions they are seeing in East Maui, she said. 

Patients will always need to have their higher acuity needs met by Maui Memorial Medical Center in Wailuku, such as incidents of stroke and heart attack, births, surgeries requiring anesthesia, or other emergency services, but “our job is to stabilize and transport” along with American Medical Response.  

Still, housing is a serious issue across Maui County when it comes to recruiting medical providers, she noted, adding that at least two potential candidates withdrew their applications because of the lack of housing. 

Hana Health is looking to remedy the problem by developing more clinic space and its own workforce housing on the current health center site.  

“We have the space, we now need to secure the necessary funding in order to complete construction documents, get permitted, install the infrastructure and build the homes,” Vasconcellos said. 

There is also a lack of residency opportunities statewide, she noted, forcing graduates from the University of Hawaii John A. Burns School of Medicine to complete their residencies on the Mainland rather than staying on the islands.  

“Once they leave Hawaii, most choose not to come back,” she said. 

And, the lack of medical assistants throughout the country and state can result in the employment of registered nurses who operate at a higher level than is often needed at a significantly greater cost.  

Hana Health has been lucky in this regard because they have enough nurses, she said, but this cannot be said for many clinics and hospitals in Hawaii and across the nation.  

Regardless, East Maui is trying to “grow our own” by connecting with local schools and guiding the next generation on how to pursue the medical field.

“We are hoping for more collaboration with Hana High School in order to attract students to the health care field, which not only pays very well, but enables community members to stay in Hana and serve their ohana,” she said.

* Dakota Grossman can be reached at dgrossman@mauinews.com.