Funding sought for residency program

By COLIN M. STEWART

Tribune-Herald staff writer

Hawaii Island residents continue to struggle with finding access to health care, and the problem is only getting worse.

“The joke is that you’re either well or expired before you get your (doctor) appointment,” Sharon Vitousek said grimly. “It’s not really that funny, because it’s close to the reality.”

As chairwoman of the Hawaii Island Healthcare Alliance, Vitousek works closely with a variety of providers, insurers, businesses and other members of the health care community. Together, they have supported for the last four years a rural, family practice medical residency program aimed at attracting young doctors to the island and keeping them here.

“It is one of the most reliable ways of addressing the access to primary care problem on our island,” she said.

Now, she said, members of that network, and others, are sharing their testimony to keep the program going. A joint hearing of the state House Committees on Health and Higher Education is scheduled for this morning to discuss a bill seeking further funding for Hilo Medical Center’s Family Practice Residency Program.

Ideally, said House Bill 2368 sponsor Jerry Chang, D-S. Hilo, Waiakea Kai, Kaumana, Keaukaha, funding would be included as a line item in the state’s annual budget. That would provide the program and its training ground for new doctors — the Hawaii Island Family Health Center, which has yet to host a class of medical residents since the program’s inception in 2006 — with a steady source of funding, he said. But so far, program supporters have had to fight for every bit of funding they can find.

“We’d like to have as much (money) as possible, but we leave it for the finance committee to come up with a proper number,” Chang said Monday.

Joining Chang in introducing the bill are Big Isle delegates Denny Coffman, Cindy Evans, Faye Hanohano, Bob Herkes, Mark Nakashima and Clift Tsuji.

Backers of the program say they’d like to have at least $250,000 for fiscal year 2012-13, Chang said. But, they’ve had to make do with less for the last several years as a result of Hawaii’s budget crunch. In addition to raising funds through civic organizations like the Hilo Rotary Club, as well as the Hilo Medical Center Foundation, the residency program has stayed afloat thanks to a grant provided by TriWest Healthcare Alliance. That grant, however, comes with the caveat that the program also receive support from the state to the tune of no less than $70,000. That, Chang said, has typically been all that the Legislature has been willing to part with each year.

“Things are more difficult (financially), and we do realize that,” Chang said. “In the past, the Legislature was very generous in appropriating.”

Initially, legislators had appropriated $4 million for the program, but after withholding the first funding installment for fiscal year 2008, Gov. Linda Lingle’s administration announced in November 2008 it would not be releasing any of the money because of declining state revenues. Since then, the local community has been left to largely fend for program funding itself.

The program’s 2011-12 budget currently stands at about $1.6 million, said HMC Assistant Hospital Administrator and Medical Group Practice Director Boyd Murayama.

In testimony submitted for today’s hearings, Hilo Medical Center CEO Howard Ainsley says that Hawaii Island faces a potential loss of 134 physicians per year, as they retire.

“The current and projected shortage of physicians simply means less access to care for Hawaii County residents that already suffer from a disproportionate rate of disease and disability than others in the state,” he said.

According to data provided by the 2011 North Hawaii Outcomes Project, he said, these health disparities include:

— Higher death rates from heart disease, stroke, diabetes, overall cancer, infant mortality, suicide and traffic-related accidents;

— lower life expectancy;

— higher teen birth rates;

— and, higher confirmed child abuse rates.

“The Hilo Medical Residency Program is Hawaii Island’s best way to alleviate the critical shortage of physicians, as our research tells us that medical residents who train in rural environments overwhelmingly stay and practice in the region,” he added.

According to Hilo Medical Center Foundation Director Lori Rogers, failure isn’t an option for the residency program.

“When it comes to health care for people on the island, you just don’t give up,” she said. “The voices have to continue, we have to keep bringing this up. We will continue on and keep fighting the fight. We can’t fail.”

In addition to helping fund the program, which will provide on-the-job training for doctors interested in pursuing a rural family practice, the HMC Foundation has joined with area civic groups and businesses to renovate the hospital’s “River Cottage.” Located behind HMC on a bluff overlooking the Wailuku Rover, the four-bedroom house will serve as affordable housing for medical residents as they complete their training. Following repairs, painting and refurnishing of the building, the foundation will hand the building over to Hilo Medical Center at a 7 a.m. ceremony on March 2.

Meanwhile, the January addition of Dr. Kristine McCoy as the residency program’s director allowed organizers to pursue accreditation. Once that year-long process is complete, the residency program could welcome its first class of doctors in the summer of 2014.

Email Colin M. Stewart at cstewart@hawaiitribune-herald.com.