Adele Emmsley said that in rural Hana, residents like herself have gone through five primary care physicians in 10 years because doctors living in Hana come and go.

“Right now we’re having a hard time retaining our physicians here,” said Emmsley, vice president of the Hana Health Board. “They end up leaving. It’s too far. We cannot keep them.”

With hundreds of switchbacks and more than 50 one-lane bridges, the two-hour drive to the medical center in Kahului for specialized medical services isn’t always easy, especially for the elderly or those recovering from surgery.

Announced Tuesday, a $188.9 million award to the state is aimed at bridging the lack of quality care in rural areas like Hana. Gov. Josh Green said the funding will help places like Hana and Molokai close the distance.

“Whether someone lives in Hilo, Hana, Hanapepe or Molokai, they should have access to quality primary care, behavioral health services, emergency response and modern technology, not just those who live in Honolulu,” Green said.

The award is coming through the federal Centers for Medicare & Medicaid Services’ Rural Health Transformation Program, as part of a $50 billion national investment to strengthen health care in relatively remote areas.

Green, who is a physician himself, said rural hospitals and clinics are facing rising costs, staff shortages and outdated digital systems that limit their ability to serve patients.

The governor’s administration said the health plan centers on six coordinated initiatives, including Rural Infrastructure for Care Access, expanding emergency medical services, mobile health care, community paramedicine, and behavioral health capacity in rural areas.

The initiative also includes HOME RUN, or the Hawaii Outreach for Medical Education in Rural Under-resourced Neighborhoods, which provides training, residencies, scholarships and mentoring to recruit and retain rural health care professionals.

The administration is also developing a respite housing model to reduce hospitalizations among in-house and post-acute patients.

Green, who has been a family and emergency physician, said his office will coordinate with agencies, providers and communities to carry out the plan.

Green’s office noted that the governor worked directly with health care leaders and the U.S. Department of Health and Human Services to help shape the services as a nationwide initiative, ensuring rural communities in all 50 states would be eligible for funding.

Emmsley said the Hana Hospital building is so old she was born in it in the 1970s.

A cardiologist comes once a month, and there’s a physical therapist who lives in Hana.

She said luckily, Hana has the services of an emergency medical helicopter that can pick up patients at its rural airport and take them to Maui Memorial within an hour.

She said the hospital is more like a clinic with three to four rooms and the community needs workforce housing to support health providers.

Emmsley said telehealth services are used mainly for mental health counseling.

“We’re in between physicians now,” she said. “Maybe with the award, it can possibly help in that way.”