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The Honolulu Advertiser
Posted on: Thursday, August 9, 2007

COMMENTARY
Community health centers a lifeline for many

By Beth Giesting

Did you know that in Hawai'i 30 percent of us live in areas where there aren't enough physicians, dentists, or mental health providers?

Or that an estimated 120,000 of us have no medical insurance, while double that number have no coverage for dental care? How about that one in four of us lives in or near poverty, or that we're more likely than residents of almost any other state to be homeless?

Many of us in Hawai'i are lucky enough to be unaware of these problems, but this week — during National Community Health Center Week, Aug. 5 through 11 — is a good time to contemplate them and to celebrate our good fortune in having a network of 13 nonprofit community health centers in Hawai'i.

Community health centers have served Hawai'i for 35 years and were established to take care of the people who, for various reasons, are at greatest risk for not getting the healthcare they need when and where they need it. Our community health centers are on five islands with 50 sites, and provide medical, dental and behavioral healthcare to 100,000 people per year. Most of the people they serve are poor, uninsured or covered by Medicaid, Native Hawaiians and others who face barriers to getting healthcare, such as language, cultural differences, being homeless or having no transportation.

Community health centers have also become the healthcare provider of choice for a lot of people because they provide wonderful service and encourage trusting relationships to develop between the patient and the provider. Contrary to the idea that they are "poor care for poor people," community health centers attract award-winning clinicians who are some of the brightest thinkers and most caring people around. Their systems are centered on the needs of their patients, which may focus more on families, culture and socio-economic realities; and they are in the vanguard of excellence when it comes to chronic disease management and helping patients get good health outcomes.

They are also exemplars in making healthcare accessible, from providing comprehensive health services under one roof, to being open extended hours at convenient locations, to demonstrating linguistic and cultural competence, to offering sliding fee scales that make services affordable.

The 1 million or so Hawai'i residents who don't rely on a community health center also have good reason to celebrate National Community Health Center week: Health centers save more than $150 million per year in healthcare costs here in Hawai'i by improving patient care that prevents unnecessary emergency room visits and hospitalizations — costs that don't get passed along to you in premium hikes and increased co-pays.

Community health centers have other virtues as well, such as local governance by the communities that use their services, supporting more than 2,000 jobs in Hawai'i and $165 million in economic activity, providing career role models and training, and doing a lot with limited resources.

These are all good things to know — during National Community Health Center week, and throughout the year.

Beth Giesting is the CEO of Hawaii Primary Care Association. She wrote this commentary for The Advertiser.