HomeMy WebLinkAboutCOM 0575.001 2006-2008 Emily I. Naeole
Council Member
,i
Mailing Address: Busine~~sfzic~rers ~.i C~:°'i
(Former County Building r:~%p•ii 333 Kilduea floehue, Second Floor
25 Aupuni Street Ben Franklin Building
//ilo. Hawaii 96720 Hilo, Hawai `1 96720
Hawai `i County Council
County of Hawai `i
Telephone: (808) 96/-8267 Facsimile: (808) 961-8912
MEMORANDUM
TO: Pete Hoffmann, Council Chair
And Council Members
FROM: ily Naeole, Council Member
DATE: August 29, 2007
SUBJECT: Hawaii Island Journal Article Regarding Bay Clinic
Aloha mail For the council's information, please include with Communication 575 the
attached article, "Bay Clinic Blues, How Bad Is It," published in the August 11-24, 2007
Hawaii Island Journal.
EIN/tce
Cantu. No. 57~.
Ref. Ta G
Ref. Uate AUG 9 ~
Hawaii Caunw is an Equal Opportunity Provider and Employer
Ha2vaz `z Island
. Augvat 11-24,2007 ~ Volumc 9/Number 16. ww w.6ewaiiislaudjourual.com - FREE-
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Community
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tough times
by Alan D. McNarie
r~F patient died in 1996 from a were called to a meeting, she The clientele for the dif-
botched anesthetic injection. says, at which Mihora "just got ferent clinics, she said, were
,E~ ` Askanazi, two other doc- up and said our positions had ,just too different. The Ka'u
'~~i tors and the hospital were been eliminated." The fired clinic, for instance, served
~ conviMed of billing fraud. employees were given their many Marshall Islanders.
°United Memorial's board of paperwork and told to clean "You need a lot of interpret-
directors, its executives and out their desks immediately. ers. The amount of time that
various of its physicians utterly After 10 and a half years, you. spend with apatient-it
failed in their responsibili- they just walked out
"she 'just can't be the same."
ties. to Dr. Askanazi's patients, .said. `No thank you for your Cole oversaw a variety of
and this case demonstrates services, nothirig. Just walked programs, including a diabetes
how serious the consequences out, like we were nothing." prevention program; family
can be when a hospital puts The scene was repeated violence intervention classes;
its financial priorities ahead frequently over the a Reach Out and Read pco-
ofpatient safety and quality next few months. gram, a 598,000 OHA grant to
medical care," wrote health law provide health care for elderly,
atients turned away of mass firings and low morale. columnist Francis J. Serbaroli One Slze StS l~ii2 Hawaiians; and a breast cancer
because the doc- One recently fired employee in the New York Law Journal. "[t used to be that we would program for the Marshallese.
tors are already gave the Journal a list of Mihora was charged with come together for a meeting .She also served as coordinator
booked up at 8 a.m. over 25 employees who quit perjury over his testimony and they would talk about for a large volunteer program
Employees fired without warn- or were fired in the past two in the various cases; charges centralizing, says former Bay in which community members
ing, then escorted out the years, out of a staff of a little were dropped after witnesses Clinic Special Programs Man- did everything from nursing
back door. Community pro- over a hundred. Most were at against him changed their ager Belinda Cole. `But we patients to reading to them.
grams suddenly defunded. Pahoa Family Health Center. testimony. By that time, he couldn't do it. You couldn't "When Mike ]Mihora]
What"s happening Other ex-employees from the was president of Cheboygan keep it central for everythitg." came on, my programs were
with the Bay Clinics? Kea'au facility report similar [Michigan] Memorial Hospital.
The Bay Clinic, Inc., which attrition problems. Fired staff- Mihora came to Bay Clinic ~
runs Hilo, Puna and Ka'u's ers included doctors, nurses, and immediately began j
~ only federally funded comma- administrators, outreach work- centralizing administra-
pity clinics, will get its third ers, secretaries, filing clerks,. tion-and firing people. Most
CEO in two years September an asthma/tobacco special- of the clinics' outreach work-
1, when Paul Strauss takes ist-even a reading specialist. ers (including case manager
over the reigns of the non- Some said they couldn't Lynn Ka'awaloa, who had
profit and its facilities in Hilo, talk to us because of impend- worked at the Pahoa facility
Kea'au, Pahoa and Na'alehu. ing lawsuits, or because they for over a decade) were let go.
Strauss is inheriting a had reached settlements that "We dealt with a lot of home-
troubled organization. The included gag orders. Those who less people that came to the
clinics are the only ones in the did talk painted a picture of a area and had no place to go
area required to serve patients new administration with atop- and were sick," Ka`awaloa says. ` '
regardless of insurance status down orientation and agrow- ° We found them shelter, got i
or income; clients pay on aslid- ittg atmosphere of isolation and ~ them hooked up with Care-A- r~!` : ,
ing scale. The c?inic's current _ insecurity, exacerbated by sad- Van, bought them some food."
interim t;EO, Robert Cooper, den firings and program cuts. ~ She also helped elderly '
notes that the Bay Clinic facili- patients who "fell through the
ties have also become the first Not Liking Mike cracks"-who didn't qualify "
line of care for many newcom- In the spring of 2006, Hilo for Medicaid or Medicare
ers, regardless of whekher Bay Clinic hired Mike Mihora and couldn't get insurance. ~ a° - °
they have insurance, because as CEO, despite his checkered She'd often call drug manu- ~i
there are very few doctors here track record. While head of facturers to get her clients
who are taking new patients. the United Memorial Hospital their medicines through vari-
Yet patients are turned away in Greenville, Michigan, he ous subsidy programs.
because the clinics are booked hired anesthesiologist Jef- She and the other Pahoa case
solid before they can get in the fray Askanazi. Mihora later managers had no warning of
doors. The overcrowding has resigned to join Askanazi's their impending firings. They_
been exacerbated by inadequate lucrative private practice.
facilities and by a high turnover But Askanazi lost his license Dan Domizo at Y
rate among staff, who complain after a Memorial Hospital Bay Clinic' Pahoa facility. ; ,
COVeI'St01'y August a-z4; zoo7 HIJ / 9
y'S _ 'q\,. _ _ MgTOSwAUN0.MCNMIE
• I~ been spent. She then taught the fessionals who have years of
- classes voluntarily, and used experience working in clinics,
her own computer tomain- yet they are given no sort of
fain the data on the project. leeway in running the clinics.
Her organization was Everything has to go back to
! d;„ awarded another $10,000 the central authority-and the.
grant for the next year's pro- central authority was. essen-
grams,but never received- tially disorganized, a poor
the money;from Bay Clinic. communicatog and felt intimi-
For months, she says, she got dated by any new ideas that
no response. Finally a letter weren't already there," he says.
arrived, saying the Bay Clinic Like many others we
had returned the remaining interviewed, he says get-
money for 2005-05 and all of ling a doMor's appointment
the funds for 2006-7 to HCF, was a major problem.
j because Napeahi hadn't submit- . Beyond that; scheduling
j tad certain documents and her policies bollixed long-term
t
k ~ ~ program was redundant with care. If a patient at the Pahoa
~ ~~ti~r ~,p another Bay Clinic program. clinic in OMOber, for instance,
I
' " ''~r`)'~ ` ` 'y Napeahi said she submitted all needed afollow-up appoint-
' requested paperwork and noted went in December, s/he had to
Bay Clinic offered no other wait until December to even
exercise classes in Keaukaha. schedule the appointment.
"If really affected our abil-
eliminated," she says. Both cared," she says. "What can president of Ho'ololi Ola (Life FrRSt,!$it~ f;IOPS ity to manage chronic medi-
she and her assistant, Linda they do about it7 Nobody cared Changing), which taught "I chose family practice so cal problems effectively, and
Lucero, were laid off. that Marshallese were going aerobics classes to Native I could work in underserved I think our community suf-
"Everythingwas so depart- unserved, that there was money Hawaiians as part of the dia- communities," says Stefan fared because of it " he says.
mentalized, nobody really out there that just evaporated." bates prevention program in Carl Harmeling, MD. Hormel- Ia~Ie Oar M~C@
knew what was going on in Some of the federally-funded Keaukaha. Funding for the ing worked for a year and a
the other d4partments-not .programs continued. Cole says instructors and equipment half at the Hilo, Kea'au and The Bay Clinic fired
in detail," Cole complains. the family violence intervention came from a grant from the Bay Clinics. He left in October Mihora last March, but the
"When new people came program kept going because Hawaii Community Founds- 2006 because "it was just so' bloodletting wasn't over.
in, they didn't know about the the instructor worked without lion, administered through frustrating and disappointing Interim CEO Bobby Cooper
grants, they were just inter- pay for months, until it was Bay Clinics. But payments for that I just didn't want to be stogped by Dan Domizio's
sated in eliminating it.... taken over by another agency. the 2004-2005 fiscal year sod- involved with them anymore," office in Pahoa. Domizio
"We tried to raise a big denly dried up before she was He saw the same prob- .was the former Clinical Pro-
ruckusthrough the tunders, I~@AU~C8~18 CO]OIRS~OA paid for all expenses, even lams in all three clinics. grams Director at the Pahoa
' but it seemed like nobody Terri L. Napeahi was though about $2,500 had not "You hire physicians or pro- Say Clinic. llnder the Mihora
wrewrieeg _ ~'~MS
• PROPER BlG ISUIND RUNNING COMPANY xona's apaclanY nm- ttoNA BY THE SEA
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RESTRICTIONS? InWudes S55,OW whdeaale inventory. IMced at:139,900. Ca0 Bwerly KONA t3ALi l4u Z/1, GREAT ocEAN VIt:W. _
frown Owner9War. 5199,999. Call Darlene NIII443d214
Conditions, .Covenants and Restrictions CLOTHING STORE -SHERATON KEAUHOU nnm9e oohs 2 BLOCKS ABOVE MCDONALDS 2 bedroom 2 hem arA
(CC&RS) are normalty Incorporated In the ~ a"d separate ene-
deed when a property is subdivided. CCRs wear pdms iarevery°ne. eWnoW COST-Sta,0O0.imertmry cos9ng
are said to "run with the land", hence, 665,000 ebn9 wm 570,000 in flzhues and egWpmed - en inducted for CENTER OF TOWN sane Raze (behind poncho arW tethl, Olncal
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Denise Nakanlahl Restrictions Can vary gfeatty-from 9ne area KING'S SHOPS RETAIL STORE (nop-eppareq sta,5oo Ilarow Sre~ersa-4zez•
p, cRS, ABR to the next. Advocates of such restrctons ..tvn
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b which all owners must com I are formalized: This concept pw tatn aetcn tst46t i.6t /arp wnh apprvuedzstay 58/3Bam
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of malnta(ning quality neighborhoods is so wag esfablished'that xoMES 2a~~,~~b~,q~„~,~ApDU,bey,
newer subdivisions aro'even Including exteriorhome mairHenance
such as yards and painting as paR of the community assoclaUon HOWALAA ESTATE.sbadraomr3tdm tropkW Renmtwn z,9o9 Waikala EOE-}ago ta,29t et.IeM erw. ~,00D aedn to Buyer ror gad
• duties. Minimum house size, cnvenarlts against barking dogs and s.r. on zo,o9o s.t: lane -Yrmr news - orcered xt 5639,000. alien 987- ~ Onerad n 5210'000' shedgat-2167'
rltsMcfions against the keeping of farm animals are common. Paint 2181. veredse pax C109B ro Ewa ~e
corona, design review and exterior cbthes Imes are common as pw Lanlama'tm63a-t.t6Paea CarNr inlw HaaepaN6epik.
well. Those opposed to such restriction feel R's an urMue restraint IWVE t1ALF.'~ COm°at°d' 3 bectraom z hem home Illlered at s~,oo9. snen 987-216t ,
• on their property rights. They feel whatever they wish tO do on "a`" ~l^^CeS• tza egtwe feel. t1uM, rrooday. Brakerlown- Edon Rack Esitlea ht Rsa: z aq°mn° Ids a<E35,000 each. noaded tdm
their property Is their business. Many people who feel this way ~ en623A,OOO.JertY93r-05B3 aecrlaraaaevwgemms3e-e9m.
are kind enough to buy In remote areas where their aCtIVItI6S will HOVE 71100 sq n house; 4 bedrooms 2 hams on 1.9 acres wim Hawailarr Oceannew Ranchos 3.3 acre bt wMr spectacular shoreline
not affect others. Because man of our subdivisions have narrow and scum pdm vows 579,500 terms possible Beverry ltrown (sl
Y colossalry, na9nMCeM coaetllM vbxs. 5299,090. Beserty Brown 93&8969
lots, unslghUy condf0ons or noisy neighbors can serlousty Impact 936 area ownarra9enl g~ g~ viewbtwelecMCandplara fi4sooo Dodd
property values or even the ability to seR at all. Your ageld should tams available 9rokeriowner.
inform you if Conditions, Covenants and Restrictions appy when yoO ,
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10 / HIJ August a-z4, zoo? COVe~•$tory
rggime, he'd been demoted needs to be out of here?' I terminated "immediately" for "I had patients in rooms" at organization's ability to serve
to physician's assistant. told him,'Okay,'" Domizio "insubordination" and "con- that moment, Domizio says. the public-a charge repeated
~ Cooper asked Domizio recalls. One of the names duct that negatively affects He wasn't allowed to finish by other former employees. .
what he thought needed to be he named was that of Medi- the employee's relationship with them. "They walked me "You can't afford to lose
done: Domizio says he sug- cal Director Toni Brown. to his/her job, his/her fellow out the back door with my 11 providers in a year," he
gpi~sted that some of Mihora's On March 30, Domizio was workers his or/her supervisor(s) box of personal effects." ' maintains. "Recruiting new
appointees needed to go, too. handed a letter signed by or clinic services." The letter Domizio believes long-time providers only partially solves
He told me, 'Can you be Cooper and Brown, notifying specifically cited that Domizio staff were especially targeted, the problem because they're
s~ecific about who it is that ~ him that his employment was - favored Brown's dismissal. and that their loss has hurt the new and they don't have those
i .relationships with the com-
munity... Ifyou're taking care
[ of a guy's diabetes for ten
years, your interaction can be
brief, efficient. You've already
taken care of the basics."
As a result of the firings,
he claims, the clinic has "a
p
diminished ca acity [o meet
~ ~ ~ ~ ° ~ walk-in/ui gent care demands:
' t "I saw, generally speak-
ing, 30-35 patients a day.
All but a few of those were
walk in. Where I saw 30-35,
• µ [now] they're seeing ten."
m~
- ~ • No room
_ While the clinics may
~ ~ " ~ have lost scores of years
of experience, they haven't
• - ~ lost that many warm bod-
- - ies. Cole estimates that the
clinics had employed about
112 staffers when she was
- • - • ~ • . there. Today, according to
Cooper, there are 105.
• • • N . • - • • • "So far we've been pretty
able to compete," he says.
e e s ' * _ s_ e s "There are some medical pro-
- fessionals who really like what
• • we do. Money isn't the most
. Picture your- life on important thingintheirlives."
The difficulties that patients
have in seeing doctors, he
EarthLink High Speed Cable Internet' says,areaproductnotjustof
personnel shortages, but of too
That s not all. Only EarthLink High Speed Cable offers: • free WebLifeT'" online storage of up to 1GB many pattents and not enough
• Free Protection Control Center including odvanced Antivirus, Firewall and $pyware protection waiting rooms. The fourctin-
ics, he says, are "all over-
• Free award-winning customer support, 24/7 crowded." At att four sites, ne
says, "Maybe we need 50 or 100
- s percent more square footage."
g The clinics generally serve
i patients with appointments
first, but if a walk-in is hav-
t ing serious trouble that can't
wait, s/he is either taken Yo the
Hilo Hospital ER by ambu-
~@t" ®tltFt ftbY S/JC tt1~IIDlhS ~ -lance or triaged and taken '
s ahead of other patients.
Q I I 64 ~'2 ~ 3 ~ The Hilo Bay Clinic has
lost its lease, but already
e has found new locations: the
medical facilities are moving
f to the current Social Security
Order Earthtink today and mention the Bnil¢ing nn KinD'Dle, while
°EarthLlnk Prize Special" tO aUtOmatlCOlly retelVe administration is headed to
a building on Ha]li St. fn the
- some of these cool prizes. Call today! long term, he hopes to find
' fundingto build a whole new. -
' Hilo clinic, perhaps on state
~ ® O C E A N 1 •'C tend. The same goes for'Pahoa,
E a r t h L ~ n k ~ TIME wnRNER eABLE which rents its current facili-
THE-POWER OF.Y.OV". ties. The Ka'u clinic, which one
board member said is "falling
dowq," sits on land that the
'Speeds aro up b Sx fasts dran D51768K, or 7x fader d,an OSLI.SMbps baste on avxage speed of a 28.8K and o 56K modem. AcNOI download a~ upland speech CItniC owns; Cooper Says a rieW
moy wry depmiding on ca61e service provider. IF you decidelo down and inslo8 Prakction Conhol Cents, i1 will uninslallarry arreN antivirus aohwaro ysw maykave -facility can be built that's. The -
- on your wmpuM. Probclion Corard Cants Is foi Windows 2000 aid %P operating sysMns only.02001 farlhunk, Iric. Haw rxr.IMink
sssiderdM crisbman is smvicea6le aroos roblem,Of GOUrSe, i8 Cash:
ardy. Olfer good kx ens conputm only. Additional ck•rg• for soflwors inslaAaRan. Mtmnes speeds ~maYy vary. Nd b be aom6ined vAdsaAmr aAen. Ssxoe resYiatians may apply.... P
Prim M ad mt idanHcd b prises assorAed. Pda pocks mailed 23 vroalu aNer inaaAofion. Prism svMte suppler lots. OHm expuas 10171[2007: ~ ~ . "The best SOlutiOll for. -
me is to have Alan and a
batch of hill friends come up
- wkth S25 mit4on w we can
August a-z4, zoo7 HIJ / 11•
COVPd"St01'y r
' Before lfou Build Owner/Builder-Services"
Ei {}'~4''. ~ ~ I''`n~°i .I community clinic experience '
~ . ~ r = I:, A construcfion consulting firm.
x t and should be from Hawaii. , i'~
y ~ # In that, he gets his wish. O Draffing - 4 Cost Management i
4 Strauss is currentl CEO
f = a ~ ~ ~ y , ; ~i. ~ Scheduling 4 Estimating
+ 4 = of Waikiki Health Center,
~ ~ `I Hilo: 982-6549 Kona: 327-1948
another community clinic,
~ ~ # ~~N _ ~ and graduated from Kolani , '9e~ For l'am' ~4 da'f I7i~ A~ Jam' N~1' _
r~ `a~ fit High School on Oahu. ' Island wide service -Free initial consultation
s
* ~ s ~ ~ Meanwhile, the veterans
$ ~ ~ of the Bay Clinic firings have
, , moved on. Harmeling divides
"R~.°`~ r t his time between the Hilo ~
?J-"~!4 a Hospital and his new clinic
a
- for AID$ and HIV patients.
~ ` Napeahi is finishing her MBA • • ~ r ' ~
a, > `;h, and developing an online
~-'2ry ~ lull gallery for Native Hawaiian
i artists. Ka`awaloa is retired, •
~ though she misses community - ~ ` ' • , •
`A: service and would like to return
to it in a part-time position. •
_ ~~k~~.,Tpa Domizio and colleagues are
' i ~ rr ~ V ,i s I ~ planning their own urgent care
center in Pahba. He says they
x,l ~ ~,Iilti ~ ~ need about $200,000 to open
~ , their doors. "We're looking for
grants, donations, a fundraising
committee. A fundraising letter ~ .
Belinda Cole, ing that anyone contacted is being sent out. We'll be hav-
former Bay Clinics "refer the reporter to me." ing pot lucks and car washes." •
special programs manager. But he says the new center
New eompetitor~ will not be competing with
improve all our facilities," The former employees have Bay Clinics. Like most of
he joked to this reporter. their own suggestions for those we talked to, he hopes
The Journal later learned improvement.'hvo suggested that organization will recover
that while we were investi- that the organization should because they're serving a vital ~ ~
gating this story, Cooper had have four new directors: one need in their communities.
sent out an a-mail notifying for each clinic. Carmeling sug- "We would partner up with • • ~ • ~ • •
the staff that a reporter was gested that the next permanent 'Bay Clinic," he says; "if Bay
asking questions, and request- CEO of Bay Clinics should have Clinic is ready for that." ¦
~ ~ ~ ~ ~ ~ ~ ~
~ ~ ~ '
• • ~ •
~j~
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