S.C.R. NO.



S.D. 1














     WHEREAS, the town of Wahiawa in central Oahu has a rich history rooted in pineapple, tourism, and the military, but now serves as a microcosm of Hawaii's challenges as it transitions to a more diverse economy that can remain relevant on a global stage; and


     WHEREAS, approximately 43,000 individuals live in the Wahiawa community, of which fifty-four percent are living in a United States Department of Health and Human Services-designated Medically Underserved Population; and


     WHEREAS, the federal Medically Underserved Population designation reflects the inadequate number of primary care clinicians practicing in Wahiawa and the area's poor socio-economic indicators, including that thirty-five percent of the Medically Underserved Population are on Medicaid and forty-four percent are at or below two hundred percent of the poverty level, according to the 2010 United States Census; and


     WHEREAS, the Wahiawa area includes the State's largest population of active military and dependent family members, who are covered by Tri-Care health insurance and must travel to Tripler Army Medical Center for healthcare access, despite military dependents' preference to access care in Wahiawa; and


     WHEREAS, the Legislature and the Administration have included Wahiawa as an area for economic growth through revitalization and development of agriculture in Hawaii which will increase job growth and generate more need for access to healthcare; and


     WHEREAS, the five elementary schools in Wahiawa are Title 1 schools and the percentage of students who qualify for free or reduced cost lunch programs is greater than eighty-two percent of the students; and


     WHEREAS, in focus group discussions with the principals of all Wahiawa schools, the principals have discussed substantial behavioral issues and unnecessary absenteeism that could be better managed if there were adequate primary and behavioral healthcare access available; and


     WHEREAS, the homeless population in Wahiawa continues to increase due to the easy access to state benefit offices and the free food services offered by area churches, but recent community meetings also indicate that the homeless have an increasing need for primary healthcare; and


     WHEREAS, although no recent statistics exist, there is a growing population of Micronesians moving into Wahiawa and like other past immigrants, they are least integrated into the local community and their perspective of health is intertwined with beliefs and spirits that influence their state of being, making the delivery of culturally competent healthcare services essential for this population; and


     WHEREAS, limited access and availability of healthcare services in Wahiawa are increasing at a rapid pace, since the scarce number of physicians available to the community are at capacity, ready to retire, are not accepting new patients, limit the type of insurance accepted, and cannot serve all of the uninsured who are unable to pay in full; and


     WHEREAS, a survey and report entitled "Wahiawa Community Health Needs Assessment", by Nora Rodli, RN, a University of Hawaii Manoa APHN practicum student, dated May 18, 2015, describes how dire the situation has become with the following data:


     (1)  Eighty-six percent of respondents seek medical care outside of Wahiawa;


     (2)  Only sixty-one percent have visited a doctor for a routine physical examination within the past year, twenty-two percent between one and two years ago, and seven percent more than five years ago;


     (3)  Almost twenty percent needed to see a doctor within the past year but did not do so due to cost;


     (4)  Forty-two percent reported that they delayed getting needed medical care within the past year, with two of the major reasons being an inability to get an appointment soon enough and long wait times at the clinic or doctor's office;


     (5)  While ninety-six percent have medical insurance, this includes twenty-one percent on Med-QUEST, nineteen percent on Medicare, and five percent on Medicaid; and


     (6)  Only fifty-six percent visited a dentist within the past year, sixteen percent between one and two years ago, fifteen percent between two and five years ago, and four percent have never been to a dentist; and


     WHEREAS, survey respondents in the same report also indicated the top five chronic health diagnoses in the Wahiawa community as high blood pressure or hypertension, at forty-one percent; high cholesterol, at thirty-two percent; asthma, at thirty-two percent; obesity, at twenty-eight percent; and diabetes, at twenty-six percent; and


     WHEREAS, as the only acute-care hospital serving central Oahu and the North Shore, the Wahiawa General Hospital emergency department often serves as the de facto primary care provider for individuals in the Wahiawa population who have no other access to a primary care provider; and


     WHEREAS, emergency room visits for preventable and non-emergency visits for chronic conditions that may be managed by primary care providers expends the Wahiawa General Hospital's limited resources; and


     WHEREAS, as reported in the July 6, 2015, Honolulu Star Advertiser, over the past year, the financially-strapped Wahiawa General Hospital was forced to restructure its Family Medicine Residency Program, cancel its Home Health and Physical Therapy outpatient programs, and reduce staffing; and


     WHEREAS, the State of Hawaii Department of Health is working with the United States Department of Health and Human Services, Health Resources and Services Administration, Bureau of Primary Health Care, to designate the Wahiawa and neighboring Waialua areas as Health Professional Shortage Areas, a designation that indicates individuals living in the area have increased over-utilization of costly emergency room services and are in greater need of multi-disciplinary care team based approaches, and a designation that may ultimately save third party payers hundreds of thousands of dollars through a decrease in use of unnecessary services; and


     WHEREAS, on behalf of and in coordination with the community of Wahiawa, in 2011, Faith Action for Community Equity launched a year-long planning effort, funded by the federal Health Resource and Services Administration, to bring community stakeholders together, assess health care and other service needs, and identify culturally competent strategies to identify if there was a healthcare access need; and


     WHEREAS, through this community organizing and outreach process, the definite need for a community health center was established and the Wahiawa Center for Community Health was born; and


     WHEREAS, the Wahiawa Center for Community Health was incorporated on January 25, 2012, and recognized by the Internal Revenue Service as a 501(c)(3) nonprofit entity with the express purpose of creating a federally qualified health center in Wahiawa to bring affordable, high quality, and accessible care to the people of Wahiawa, regardless of ability to pay and on a sliding discount scale; and


     WHEREAS, the mission of the Wahiawa Center for Community Health is:  "In the spirit of Aloha and compassion, the Wahiawa Center for Community Health provides access to affordable, quality health care and wellness services to promote a healthy community"; and


     WHEREAS, the inception of the Wahiawa Center for Community Health is the direct result of a vision held by the late United States Senator Daniel K. Inouye, who wanted to ensure that the geographically isolated area of Wahiawa was adequately served; and


     WHEREAS, this vision is now considered a Senator Inouye Legacy Project by the Hawaii congressional delegation; and


     WHEREAS, the specific objectives of the Wahiawa Center for Community Health include:


     (1)  Purchasing portions of the Wahiawa Medical Building, which is a condominium medical building located on California Avenue in the center of Wahiawa;


     (2)  Repurposing and renovating the initial two offices in the building, which will be the Wahiawa Center for Community Health initial medical clinic and administrative offices; and


     (3)  Furnishing and equipping the renovated facility to provide clinical, dental, and behavioral health services and other community driven wellness and health programs; and


     WHEREAS, completion of the initial 5,700 square foot facility will create the Wahiawa service area's first comprehensive health care provider, and the only clinical provider in the area that is truly accessible by all, particularly individuals who are typically not welcomed by the traditional health care system, including the uninsured or underinsured, those at or below two hundred percent of the federal poverty level, and others experiencing barriers to care like geography and culture; and


     WHEREAS, at full operational capacity, the Wahiawa Center for Community Health's services will include a multi-disciplinary team approach that includes primary care, including pediatrics and obstetrics and gynecology, behavior health, oral health care, care coordination, and on-site pharmacy services; and


     WHEREAS, at full operational capacity, and using standard methodologies associated with federally qualified health centers nationwide, Wahiawa Center for Community Health will directly create about seventy full-time jobs and indirectly create about another thirty nine full-time jobs, contributing about $11,000,000 annually to the local economy and about $365,000 to state and local tax coffers; and


     WHEREAS, grassroots efforts over the past three years have resulted in increased exposure and government support for the Wahiawa Center for Community Health; and


     WHEREAS, the Wahiawa Center for Community Health now has a fully-functioning board of directors consisting of thirteen individuals who are leaders in the community, residents, volunteers, and individuals otherwise concerned about the availability of primary healthcare services in Wahiawa and its neighboring rural communities; and


     WHEREAS, on March 10, 2014, the City and County of Honolulu certified the Wahiawa Center for Community Health as a Community Based Development Organization under title 24 Code of Federal Regulations section 570.204(c)(1), thereby making the Wahiawa Center for Community Health eligible for Community Based Development Organization funding from the United States Department of Housing and Urban Development, Disaster Recovery Division, to carry out a neighborhood revitalization, community economic development, or energy conservation project; and


     WHEREAS, the United States Department of Housing and Urban Development has designated Wahiawa as one of two areas on Oahu that is a Neighborhood Revitalization Strategy Area, a designation given to an area where there is a demonstrated commitment by residents, property owners, small businesses, and other community stakeholders to forge partnerships that will help revitalize their neighborhood by fostering the growth of resident-based initiatives to identify and address the community's housing, economic, and human services needs; and


     WHEREAS, on September 27, 2014, the United States Department of Agriculture, Rural Development, designated the Wahiawa Center for Community Health as a Rural Community Facilities Project and as such will enable Wahiawa Center for Community Health to qualify for and encumber federal Affordable Care Act funds for ongoing development and operation of a rural healthcare facility; and


     WHEREAS, in 2014, pursuant to Act 122, Session Laws of Hawaii 2014, the Legislature approved a grant pursuant to chapter 42F, Hawaii Revised Statutes, for the Wahiawa Center for Community Health, appropriating $250,000 for the planning, design, and construction expenses for facility repairs, renovations, and other related improvements to the Wahiawa Medical Building; and


     WHEREAS, this body finds that establishing the Wahiawa Center for Community Health is in the public interest and for the public health, safety, and general welfare to assist in the improvement of the health care system for residents of the State; now, therefore,


     BE IT RESOLVED by the Senate of the Twenty-eighth Legislature of the State of Hawaii, Regular Session of 2016, the House of Representatives concurring, that this body strongly supports the establishment of the Wahiawa Center for Community Health to provide primary healthcare services to the medically underserved population of Wahiawa and the surrounding rural communities; and


     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Governor; Director of Health; Director of Human Services; Director of Business, Economic Development, and Tourism; Chairperson of the Board of Agriculture; Superintendent of Education; United States Senator Mazie Hirono; United States Senator Brian Schatz; United States Representative Tulsi Gabbard; United States Representative Mark Takai; Board of Directors of the Wahiawa Center for Community Health; Board of Directors of Faith Action for Community Equity; and Chief Executive Officer of every hospital and health insurance company conducting business in Hawaii.

Report Title: 

Wahiawa Center for Community Health; Primary Medical Care Services; Underserved Population