PD BACKGROUND REPORT (PL-SPP-2023-000039 & PL-USE-2023-000010)

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Special Permit Application and Use Permit Application Hamakua Health Center, Inc. for the portion of the Project located within the State Land Use ("SLU")Agricultural District and County Agricultural (A-20a) zoning district. Under the County's Agricultural A-20a zoning, pursuant to Hawaii County Code ("HCC") § 25-5-72 (d)(7),medical clinics, and buildings and uses normally considered directly accessory thereto shall be permitted,provided however, that a Special Permit is issued for such use. Under the SLU Agricultural District regulations pursuant to Hawaii Revised Statutes ("HRS") § 205-6(a) and Hawaii Administrative Rules ("HAR") § 15-15-95(a), the County of Hawaii Planning Commission ("Commission") is authorized to permit "certain unusual and reasonable uses within [the State's] agricultural . . . . districts other than those for which the district is classified" for land areas less than 15 acres, as is the case for this Project. All applications approved by the Commission for land areas greater than 15 acres or for lands designated by the State Land Use Commission as Important Agricultural Lands, are forwarded to the State Land Use Commission for final decision, but that is not applicable to this Project. See HRS § 205-6(d) and HAR § 15-15-95(b). III. USE PERNHT REQUEST Concurrent with the processing of the Special Permit application, HKH is seeking a Use Permit for the establishment of the Permanent Clinic component of the Project, including accessory structures and uses, for the portion of the Project within the State Land Use Urban District and County Single-Family Residential (RS-15) zoning district. Pursuant to HCC § 25-5-3(b)(8), medical clinics and buildings and uses normally considered directly accessory thereto shall be permitted in the RS zoning district, provided however, that a Use Permit is issued for such use. IV. STATEMENT OF OBJECTIVES AND REASONS FOR THE REQUEST In general, health centers provide tremendous value and impact to the local communities they serve, including employment opportunities, economic stimulus, savings on Medicaid costs, and access to care for vulnerable populations. The positive values and impacts realized by these community health centers, especially in serving the rural North and South Kohala and Hamakua communities, are summarized by the statistical contributions and savings report prepared by Capital Link'. In particular, the Capital Link report notes that HCC provided significant contributions and savings, including 96 jobs, $12.7 million in total economic impacts, $1.7 million in tax revenues, a reduction by 24% and savings 1 Capital Link,is a non-profit organization that work with health centers and primary care associations to plan for sustainability and growth,access capital,improvement and optimize operations and financial management and articulate value. _________________________________________________________________Page 2 of 38