SHC Community Health Needs Assessment

Transcription

SHC Community Health Needs Assessment
Shriners Hospitals for Children® - Honolulu
Prepared by: Pat Miyasawa and Jaclyn Pang
Community Health Needs Assessment
Mission and Vision
Mission:

Provide the highest quality care to children with neuromusculoskeletal conditions,
burn injuries and other special healthcare needs within a compassionate, familycentered and collaborative care environment.

Provide for the education of physicians and other healthcare professionals.

Conduct research to discover new knowledge that improves the quality of care and
quality of life of children and families.
Vision:

Shriners Hospitals for Children will be the unquestioned leader, nationally and
internationally, in caring for children and advancing the field in its specialty areas.
Table of Contents
3 • Commitment to the Community
9 • Process and Methods
15 • Key Findings
27 • Action Plan
30 • Acknowledgements
31 • Exhibits
Shriners Hospital for Children Honolulu - CHNA
Shriners Hospitals for Children
1310 Punahou Street
Honolulu, HI 96826
Tel.: 808-941-4466
shrinershospitalsforchildren.org
Page 2
Our Commitment to the Community
Who we Are
Driven by the passion to enhance the lives of children who are affected by special health care needs,
Shriners Hospitals for Children (SHC) has been providing philanthropic care for 90 years. The
groundbreaking of the first hospital in Shreveport, Louisiana in 1922 was rooted in the pressing need
for orthopedic care, due to the after effects of the widespread polio virus at the time. Since then,
Shriners’ unwavering commitment to care, research, and education, has expanded into a program of
twenty-two hospitals in three countries, caring not only for orthopaedic conditions, but also burns, spinal
cord injuries, and cleft lip and palate, regardless of a family’s ability to pay.
Page 3
Honolulu
Within the United States, the Honolulu Hospital serves the state of Hawaii, where 78% of the Hospital’s
treated children reside. The Honolulu Hospital, established in 1923, is the second Hospital established
within the Shriners’ twenty-two hospital system. The Hospital is a state-of-the-art, 24-bed pediatric
orthopedic hospital situated in the heart of the main island, Oahu, in the Makiki district. The Hospital
treats children through the age of twenty-one with neuromusculoskeletal conditions and certain other
health care needs.
The State of Hawaii
Figure 1
The state of Hawaii is an island chain comprised of eight main islands: Hawaii, Maui, Molokai,
Lanai, Kahoolawe, Oahu (where SHC is located), Kauai, and Niihau. Islands are classified into four
counties, all of which SHC — Honolulu serves. The four counties are Kauai, Honolulu, Maui, and
Hawaii. SHC’s service area excludes three islands: 1) Kahoolawe, as it is still a developing island
and 2) Niihau and Lanai, as they are privately owned. Figure 1 above shows the categorization of
islands by county.
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Bridging Access Gaps for Our Children
80.0%
80%
70.0%
70%
60.0%
60%
50.0%
50%
40.0%
40%
30.0%
30%
20.0%
20%
10.0%
10%
0.0%
Population
Population Distribution
Distribution by
by County
County
Children served by
County
Children served by
County
0%
Hawaii Honolulu
Maui Kauai
HawaiiKauai
Honolulu
Maui
Figure 2
Aware of access to care challenges that our neighbor island children face, SHC provides on-site
outreach clinics and arranges or assists with travel and lodging expenses for patients to Oahu,
where the Hospital is situated, as necessary. By offering this all-encompassing support, the
population distribution of children throughout the counties is a close match to the percentage
distribution of children served per county by SHC, as seen in Figure 2, indicating that outreach
programs are bridging access gaps. The percentages are based on 2012 data.
Page 5
Our International Children
Figure 3
To date, SHC-Honolulu has treated over 30,000 children. Approximately 20% of our patients reside
outside the continental United States and Hawaii. Beyond the United States, the Honolulu location
cares for children from the Asia Pacific region. As with our neighbor island children, this population
is reached via outreach programs and sponsored travel. Figure 3 is a map of the outlying areas that
SHC serves.
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The Purpose of this Community Health Needs Assessment (CHNA)
As part of the 2010 Patient Protection and Affordable Care Act (PPACA), all organizations, including tax
exempt Internal Revenue Service code 501(c)(3) entities, operating one or more state-licensed hospital
facilities, are required to adhere to newly established mandates.
Under the PPACA, a hospital organization is required to conduct a CHNA for each of its hospital
facilities once every three years. The CHNA must be in writing and made available to the general
public.
A hospital organization is also required to adopt an implementation strategy to meet the needs
identified through the CHNA. The implementation strategy is a written plan that describes how the
facility plans to meet the CHNA identified health need(s) or conversely, a plan that explains why the
facility does not intend to meet certain identified need(s).
The implementation strategy is considered adopted on the date the strategy is approved by the
organization’s board of directors or by a committee of the board or other parties legally authorized by
the board to act on its behalf. The formal adoptation of the implemenation strategy must occur by the
end of the taxable year in which the written CHNA report was made available to the public.
The CHNA requirements are effective for taxable years beginning after March 23, 2012. These
requirements are encapsulated on the IRS Form 990, Schedule H. The Shriners Home Office has
elected to make the first CHNAs available to the public on our website by June 30, 2013. Transcending
the essential purpose of the CHNA; however, is SHC — Honolulu’s ultimate vision of the report.
Page 7
Our Vision of the CHNA
Although SHC-Honolulu’s mission is to serve children with neuromusculoskeltal conditions, the
community that we service is more broadly, children with special needs. In concert and collaboration
with our sister hospitals in the state, we are committed to meeting the special health-care needs of this
community, a large portion of which are medically underserved, low-income, and minority populations,
including populations with specific needs associated with chronic diseases. As a result, we are
partnering and soliciting input from passionate experts who advocate on behalf of Hawaii’s special
needs pediatric population. These experts represent broad interests of the community that we serve
and are individuals with special knowledge and expertise in public health.
The CHNA findings will be used as a springboard for the development of initiatives that can be
undertaken to enhance the health status of our community. The CHNA will be the catalyst that guides
us toward evolving and/or enhancing our services to meet the disparate needs of the pediatric specialneeds communities that we serve.
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Process and Methods
Internal Processes and Methodologies
Forming the Assessment Advisory Committee
The Healthcare Association of Hawaii (HAH), the state’s hospital and provider trade association,
spearheaded the community-wide CHNA which included ALL hospitals and hospital systems in Hawaii
that were subject to the PPACA CHNA requirements. The Chief Financial Officers of each hospital
were the charter group in the initial HAH collaborative launch.
In line with the HAH community-wide approach, the Assessment Advisory Committee at Shriners
Honolulu was also centralized within the Fiscal Department. In addition to topic expertise, the
department is familiar with the Internal Revenue Service’s Schedule H Form 990 requirements. Beyond
the immediate team, the Hospital Administrator, Gene Raynaud, provided critical oversight to the
Assessment Advisory Committee.
Shriners Organization-Wide Collaboration
The Shriners Home Office’s Department of Planning and Business Development led the systematic
coordination effort by providing milestone maps, demographic data, website links, templates, online
discussions, and weekly teleconferences. This discussion amongst facilities was vital in promoting idea
diffusion, particularly of data collection methodology. For process consistency, the Home Office
purchased a comprehensive toolkit that was made available for use by all hospitals. This toolkit
provided step-by-step guidance for completing the assessment. The Home Office also developed a
report template for use by all hospitals. Ultimately; however, the completion of the report’s narrative and
data presentation (within the template-established sections) was the responsibility of and at the
discretion of each hospital. Board approval of each hospital’s report is required prior to posting on the
Shriners website.
Page 9
Honolulu Internal Assessment
Continuously attuned to the health needs of the children with special needs population that we serve,
SHC — Honolulu conducted an abbreviated, internal CHNA back in September 2012. Our facilityinitiated assessment captured the prevalence of developmental issues our children face, a dire need
we became aware of in part due to our constant and ongoing interfacing with our community partners.
The PPACA mandated external assessment, the CHNA, required analysis of our hospital’s served
population from a broad perspective so that all other community disparities could be uncovered.
The findings from the PPACA mandated CHNA corroborated our initial assessment findings, and
deepened our understanding of all issues faced by our served population.
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External Processes and Methodologies
Key Informants
SHC’s CHNA community partners are all well-respected and knowledgeable individuals with special
expertise in public health. Additionally, they represent the broader interests of and are advocates for
Hawaii’s pediatric special needs community, served by SHC. They provided rich information into the
community health needs of the special needs population. Secondary data findings statistically
validated the information that we received from our key informants. A brief synopsis of their
biographies are as follow:

Louise Iwaishi, MD:
Dr. Iwaishi is Shriners Honolulu’s Chief of Pediatrics. She is acutely versed to the needs of the
pediatric population and was a critical partner in solidifying the infrastructure and the direction of
the assessment. Her expert roles include being Director of the Community Pediatrics Institute
at the University of Hawaii’s John A. Burns School of Medicine. Additionally, she is the Medical
Director at the State of Hawaii Department of Health (DOH), Family Health Services Division
and the Principle Investigator for the state health department’s Maternal Child Health (MCH)
Leadership Education in Neurodevelopmental Disabilities (LEND) program, a federally funded
interdisciplinary graduate training program. Dr. Iwaishi also provides consultation to the State
Departments of Health, Education and Human Services and participates in numerous local,
state and national organizations related to children with special health care needs especially
those who are medically fragile.

Leolinda Parlin:
Working closely with Dr. Iwaishi, Ms. Parlin is the co-Director of the Hawaii MCH LEND
Program. Ms. Parlin also serves as the Project Director of the HRSA (Health Resources and
Services Administration) funded Hilopaʻa Family to Family Health Information Center (F2FHIC)
and is the State Coordinator for Family Voices of Hawaii, an advocacy organization for Hawaii’s
CSHCN and their families. The F2FHIC serves as the Hawaii State Medicaid Ombudsman,
assisting consumers and providers across the state in accessing services. As Project Director
of the F2FHIC, Ms. Parlin represents members of medically underserved, low income, minority
populations and populations with chronic disease needs.
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
Dorothy Colby, RN, MPH:
Dorothy Colby is the DOH Children with Special Health Needs Branch, Children and Youth with
Special Health Needs Section supervisor. She and her staff were instrumental in conducting
the children with special health care needs surveys and planning activities in the statewide
assessment that the DOH Family Health Services Division leads every five years for the
Maternal and Child Health Services Title V Block Grant Program. She provided the SHC team
with a copy of the assessment, which was one of the team’s main secondary resources.
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Statewide Collaboration
SHC was part of the statewide collaborative assessment effort spearheaded by the HAH (Healthcare
Association of Hawaii). Working with the state’s Department of Health, HAH contracted a Californiabased consultant firm, the Healthy Communities Institute (HCI), who produced county and statewide
level assessment reports on behalf of twenty-six (26) of twenty-eight (28) Hawaii hospitals. The results
of this joint effort allowed for a consensus of community needs to be established and discussed
between SHC and the state’s twenty-five other local non-profit hospitals.
The results of HCI’s reports provided SHC with a global perspective of the demographics and
healthcare needs of Hawaii’s entire population. Despite the comprehensiveness of the reports, most
statistics provided were not applicable to SHC’s served population, as the data was based on the
population-at-large and was not pediatric special needs specific. However, indicators applicable (to our
population) within the report were selected and incorporated into SHC’s CHNA. Also, the broad topic
areas of disparities were beneficial from a comparative stance, as it served as a foundation to
determine whether needs pertinent to the pediatric community were already being addressed and/or
will be addressed by SHC.
Secondary Sources
Data for indicators pertinent to the pediatric population were captured from multiple sources, each
source in agreement with one another. Basic demographic data was acquired from the market analysis
conducted by Shriners’ Home Office in conjunction with statistics provided in the HCI’s report. Data
specific to our community was captured from the National Survey of Children with Special Health Care
Needs, which was published by the Hawaii Department of Health’s Maternal and Child Health Branch,
who are required to conduct a state wide assessment every five years to facilitate the allocation of
Federal Title V funds. Findings from these key sources aligned with needs emphasized by key
informants, as well as the state’s education department reports.
Page 13
Kaiser Permanente’s (KP) CHNA Toolkit
SHC was fortunate to receive copies of KP’s toolkit, a print resource utilized by KP to guide their many
facilities through the CHNA process. SHC utilized the format of Kaiser’s appendix Common Indicators
table as a template for data collection and presentation.
The Kaiser Common Indicators table roughly included a hundred categorized indicators. This format
was an invaluable resource to the team as it was well categorized and easy to understand - an effective
way of presenting the findings. Categories and indicators from the KP toolkit were omitted, modified
and/or added based on their pertinence to SHC’s pediatric special needs community.
Community Resources

The collaborative work product of the HAH led assessment was a fundamental resource widely
utilized by Hawaii’s nonprofit hospitals. Concurrence of the resource’s role as a foundation for
future initiatives within the community-at-large was reached at HAH conferences, which
included Hawaii hospital representative attendees. Exhibit A, located at the end of this
assessment, presents the community resource list provided by the statewide HAH assessment;
for relevancy purposes, only pediatric-specific community resources are included in the
attached exhibit.

In close proximity to our facility is the Kapiolani Medical Center for Women and Children, a fullservice pediatric hospital. Respective assessments will serve as a baseline for post
collaborative initiatives, to merge & maximize resources and to minimize duplication of efforts.
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Key Findings
Primary Data
Face-to-face Interviews and follow-up teleconferences with our key informants disclosed that there is a
prevalence of developmental disorders in Hawaii’s pediatric population, as well as a dire shortage of
pediatric neurologists and developmental pediatricians in Hawaii. These key informant findings were
corroborated by the HAH CHNA Statewide report, which identified two priorities for children with special
health care needs:

To promote the identification of children with developmental delay and

To promote the transition of adolescents with special health care needs to adult health care.
Several secondary datasets further corroborated the information from our key informants and the HAH
summary of findings.
Page 15
Secondary Data Findings
The secondary data findings for SHC — Honolulu were primarily derived from five central sources
(listed on page 19), all of which cross-validated one another. Table A summarizes the secondary data
findings.
TABLE A
Topic/ Category
Subcategory
General
Demographics
Ethnic
Composition
Language/Origin
Education
Poverty
Social & Economic
Factors
Insurance
Indicator
Total Population
Total Population, Male
Total Population, Female
Total Population, 0-14
Total Population, 15-17
Total Child Population, 0-17
%
#
100.0% 1,380,057
51.0%
703,829
49.0%
676,228
18.7%
258,071
3.8%
52,442
22.5%
310,513
Total Child Population (0-17) with
special needs that include
emotional, behavioral or
developmental issues
3.7%
11,489
Total Child Population (0-17) with
special health care needs (CSHCN)
White
African American
American Indian and Alaska Native
12.3%
25.0%
1.9%
0.3%
38,193
345,014
26,221
4,140
Native Hawaiian and Other Pacific
Islander
Asian
All Others
Two or more races
Linguistically Isolated People
Foreign born People
High school graduates
Bachelor's degree or higher
Below Federal Poverty Level
Children in Poverty
Child Population Uninsured
CSHCN Population Uninsured
9.3%
38.1%
1.3%
24.1%
6.2%
17.7%
89.8%
29.4%
9.6%
12.3%
2.3%
1.0%
128,345
525,802
17,941
332,594
85,564
244,270
1,239,291
405,737
132,485
38,193
7,142
382
CSHCN Insured with coverage that
is not adequate
25.9%
9,892
Page 16
CSHCN who are not screened early
and continuously for special
health care needs
18.9%
7,218
CSHCN (ages 0-2) that have not
received Early Intervention
Services
68.5%
26,162
CSHCN (ages 0-2) that have not
received Special Education
Services
74.5%
28,454
CSHCN who have unmet
preventative dental care needs
6.7%
2,559
CSHCN who don't receive services
needed for transition to adulthood
(ages 12-17 only)
62.7%
7,929
3.6%
67.6%
1,375
5,234
Adolescents (grades 9-12) who did
not eat fruit or drink 100% fruit
juices during the 7 days before the
survey
6%
3,147
Adolescents (grades 9-12) who did
not eat vegetables during the 7
days before the survey
7%
3,671
Adolescents (grades 9-12) who
drank a soft drink three or more
times per day during the 7 days
before the survey
6%
3,147
Adolescents (grades 9-12) who do
not participate in at least 60
minutes of physical activity on any
given day
18%
9,440
13%
47.40%
41.70%
6,817
18,103
15,926
CSHCN who have unmet needs for
physical, occupational or speech
therapy
Children (ages 1-5) who were not
screened for being at risk for
developmental, behavioral and
social delays using a parentreported standardized
developmental behaviors screening
tool during a health care visit
Consumption
Health Behaviors
Physical Inactivity
BMI
Health Status of CSHCN
Morbidity
Adolescents (grades 9-12)
considered obese
Allergies
Asthma
Page 17
ADD or ADHD
Developmental delay
Behavioral or conduct problems
Food allergies
Prevalence of anxiety problems
22.90%
15.50%
12.70%
12.10%
11.40%
8,746
5,920
4,851
4,621
4,354
Autism or other autism spectrum
disorder
Depression
Migraine headaches
8.10%
7.20%
7.10%
3,094
2,750
2,712
Intellectual disability or mental
retardation
Epilepsy or seizure disorder
Heart problem or heart disease
Arthritis or joint problems
Brain injury or concussion
Cerebral Palsy
Blood problems
Diabetes
Down syndrome
Cystic fibrosis
Muscular dystrophy
Orthopedic Impairment
4.50%
2.30%
2.20%
1.50%
1.50%
0.90%
0.80%
0.70%
0.40%
0.20%
0.10%
0.50%
1,719
878
840
573
573
344
306
267
153
76
38
191
Conditions highlighted in red font in the Table A "Health Status of CSHCN" category are developmental issues
that our target CSHCN population face. These developmental issues, SHC’s prioritization process to assess and
rank these Table A developmental needs and SHC’s implementation strategies to address those needs that were
ranked and prioritized for action are further discussed in Table C on pages 21 – 25.
Page 18
The five data sources utilized to create Table A were:
1. The 2010 National Survey of Children with Special Health Care Needs (NS-CSHN) report:
Data for this report is collected by each state’s Department of Health (DOH) Maternal and Child
Health Branch (MCHB) to facilitate the allocation of Federal Title V funds. The data is initially
gathered to produce a health needs assessment report, which is required of states’ MCHBs every
five years. The data from all reports can be viewed at http://www.childhealthdata.org.
2. The State of Hawaii Maternal and Child Health Needs Assessment:
This assessment was prepared by Hawaii’s DOH Family Health Services Division, which is the
state’s maternal and child health agency. It is from this published report that the NS-CSHN report is
produced. Detailed narrative within this CHNA provided rich insight into the issues afflicting SHC’s
served population.
3. The Health Association of Hawaii’s State of Hawaii Community Health Needs Assessment:
Conducted in 2012-2013, this CHNA was the collaborative work product of all Hawaii nonprofit
hospitals. It provided substantial information regarding the state’s health status via indicators and
key informant reports. SHC weighted the primary data in this report heavily, as the informants were
selected by Hawaii’s top public health experts.
4. Home Office provided 2012 Demographic Snapshot:
Characteristics of SHC’s catchment area were presented by this data source. It offered the most
recent data of Hawaii’s demographics, as well as a breakdown of the state’s population distribution.
The data was generated by purchased software from the © The Neilson Company.
5. The 2011 Hawaii Youth Risk Behavior Survey (YRBS):
The Center of Disease Control conducts the YRBS survey biannually. The findings capture the risk
status of each state’s youth population by monitoring six types of health risk behaviors. SHC’s Table
A Topic/Category Heath Behaviors indicators on page 17 were based on this data source.
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TABLE B
The table below contains the data produced by the Hawaii Department of Education’s most recent
performance report for the period of January 2012-June 2012. It is based off of Special Education
eligibility, and is broken down by disability categorizations. Children receiving services and educational
support under the Individuals with Disabilities Education Act (IDEA) comprise 12% of enrollment within
Hawaii’s public schools. This report was not utilized as a principle source, as it was only representative
of half of Hawaii’s CSHCN population (19,380 out of 38,193). Although some of the categories don’t
differentiate between specific conditions (e.g. multiple disabilities), the data that is specific (e.g. autism
spectrum disorder) further corroborates the significant prevalence of children in Hawaii with
developmental disabilities.
Disability
Specific Learning Disability
Developmental Delay
Other Health Disability
Autism Spectrum Disorder
Intellectual Disability
Emotional Disability
Speech or Language
Disability
Multiple Disabilities
Hard of Hearing ("Deaf")
Orthopedic Disability
Visual Disability including
Blindness
Traumatic Brain Injury
Deaf-Blindness
#
%
8384
2855
2691
1385
1121
1090
43.3%
14.7%
13.9%
7.1%
5.8%
5.6%
721
579
330
95
3.7%
3.0%
1.7%
0.5%
67
53
9
0.3%
0.3%
0.0%
Page 20
Prioritization Process
Table C summarizes the secondary data findings from Table A into broader categories of community
need. The areas of greatest health disparities, listed below are based on key informant interviews and
community partner input. Organizing key findings and considerations into the format below proved
beneficial, as it served as the baseline for discussion during the prioritization stage of the assessment.
TABLE C
Category of
Need
Discussion
OBSERVATIONS:
•An unmet care need, about 19% of CSHCN are not
screened early and continuously for special health
care needs.
SHC
Unaddressed
Need?
Yes
SHC
Prioritization
Ranking
1
• The 2010 MCHB report states that promoting "the
identification of children with developmental delay"
is another priority amongst Hawaii children.
Early
Screening/
Developmental
Disability
conditions
amongst
CSHCN
• Conditions distinguished in red font within the
"Health Status of CSHCN" category Table A indicator
comprise developmental issues that our CSHCN face.
• Early identification of the "right" diagnosis is
important, as it is the key through which a child may
access appropriate, required services- including
early intervention services and special education
services, which are a high, unmet care needs
amongst our CSHCN population. A child's ability to
lead a fulfilled life is enhanced with early
identification and the subsequent interventions.
SHC'S CONTRIBUTION:
• The results of the HAH collaborative community
CHNA and our review of the secondary data sets
listed on pages 16-18 validated the results of an
earlier, abbreviated CHNA conducted by the
Hospital in 2012.
Page 21
• The abbreviated CHNA highlighted significant
unmet developmental and behavioral needs,
including dire shortages of developmental
screenings and assessments, currently faced by
CSHCN.
• The results of this current, comprehensive CHNA
corroborates our initial CHNA findings. We are
therefore adding pediatric neurology and
developmental pediatrics to the services presently
offered by SHC. (Pediatric neurologists and
developmental pediatricians specialize in diagnosing
developmental issues).
OBSERVATIONS:
• The 2010 MCHB report states that promoting "the
transition of adolescents with special health care
needs to adult health care" should be a priority for
Hawaii children with disabilities.
Yes (for
developmental
disorders)
2
No
None
• There are nearly 8,000 (63%) CSHCN who don't
receive services needed for transition to adulthood.
Transitional
Services
•Hawaii's Department of Human Service's Division
of Vocational Rehabilitation reports that their
largest served age bracket, at 23%, is comprised of
14-17 year old children. This division provides
support services to individuals with disabilities who
are seeking employment.
SHC'S CONTRIBUTION:
• SHC has an existing transition program for our
currently served children. This program will be
enhanced to serve the unmet developmental needs
of CHSCN that surfaced during SHC’s CHNA.
OBSERVATIONS:
• Vulnerable populations include ethnic minority
groups, uninsured and low-income persons.
SHC'S CONTRIBUTION:
Vulnerable
Populations
• Shriners mission and philanthropic philosophy
guides us to provide care without regard to race,
color, creed, sex or sect, disability, national origin or
the ability of a patient or family to pay. SHC’s
financial assistance program assists families who
cannot afford to pay for their child's treatment.
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OBSERVATIONS:
No
None
No
None
• In 2010, the State of Hawaii received an "F" grade
from the Pew Research Center, as only one out of
their eight key policy indicator benchmarks were
met. This observation was referenced in the HAH
CHNA report. (The Pew Research Center is a
nonpartisan organization that conducts public
opinion polling and demographic research. )
Dental Care
SHC'S CONTRIBUTION:
• At SHC, our goal is to comprehensively treat the
whole child so as to reduce surgical complications
and to maximize outcomes. In 2012, SHC launched
its dental program to treat and/or remove the
infected teeth of patients prior to their operations.
Subsequently, the need for certain dental services in
our community has decreased.
OBSERVATIONS:
• Another known area of concern, the obesity
epidemic is driven by poor health behaviors.
• According to the 2010 state health department's
Maternal and Child Health Branch's (MCHB)
assessment report, one of the state's priorities
include "reducing the rate of overweight and obesity
among young children ages 0-5."
Childhood
Obesity
• Unaddressed poor health behaviors can eventually
lead to conditions, such as heart disease, stroke, and
diabetes, which are ranked as the most severe, and
the fourth most severe health topics in Hawaii
respectively, by the HAH CHNA report.
SHC'S CONTRIBUTION:
• Bettering the lives of our children from an allencompassing approach is what SHC strives to do.
SHC is staffed with a Clinical Dietician who performs
nutritional assessments. The dietitian also plans
customized diets and educational activities to teach
our children and their families about healthy eating,
with the hope of instilling dietary knowledge and
empowerment that will transcend their care at SHC
and be applied towards their daily lives.
Page 23
• As an added measure, SHC's onsite Family Center
and Recreation Therapy department has programs
in place to encourage patients to eat wisely and get
them involved in physical activity. The Family Center
also routinely purchases locally grown fresh produce
for patients and their families to consume.
OBSERVATIONS:
No
None
• Neighbor Island residents face access challenges
due to: (1) the concentration of health services on
the Oahu island and (2) financial constraints (in part
due to vulnerable population status and/or travel
expenses to receive care on Oahu).
• In Hawaii, the shortage of physicians and causal
factors are well documented, particularly in the
"Hawaii Physician Workforce" report published in
2010 by the University of Hawaii's John A. Burns
School of Medicine (JABSOM). This report highlights
the magnitude of the state's shortage issue in which
600 physicians, or 20% of the total supply is
needed.
Access to Care
• According the JABSOM report, there exists a high
prevalence of unmet need for the Pediatric
specialty, especially for our Neighbor Island children.
For example, on the island of Hawaii, general
pediatrics ranks as the fourth highest unmet need
amongst the 39 specialties listed, with a 40%
physician shortage. The disparity is projected to
widen significantly within the next ten years.
SHC'S CONTRIBUTION:
• SHC has been providing Outreach clinics to
Neighbor Island children since 1971 to address the
access issues that our children face.
• A fourth surgeon will soon be joining SHC's team
of compassionate care providers. Subsequently, two
medical doctors will be on site at all times, which
will enhance care access for Neighbor Island and all
the children that we serve.
Page 24
• To further improve the coordination of care
services, SHC has approved plans to implement a
centralized scheduling system. Instead of
independent scheduling of care services amongst
departments, appointments will be scheduled
centrally, enhancing access to care by making the
scheduling process seamless for our children.
Allergies
Respiratory
Diseases
Behavioral /
Mental Health
& Mental
Disorders
OBSERVATIONS:
•According to secondary source findings, allergies
are cited as the most prevalent condition amongst
our served population.
SHC’S CONTRIBUTION:
•SHC does not currently have any initiatives or
resources in place to address the allergy needs of
CSHCN.
OBSERVATIONS:
•According to secondary source findings, asthma is
cited as the second most prevalent condition for
CSHCN.
SHC’S CONTRIBUTION:
•SHC will treat respiratory problems that arise in
conjunct with treating an orthopedic condition.
However, we presently do not have stand-alone
initiatives or resources In place to treat asthma and
other respiratory needs of CSHCN.
OBSERVATIONS:
• According to secondary source findings, ADD
(attention deficit disorder), ADHD (attention deficit
hyperactivity disorder), behavioral or conduct
problems and depression are listed as prevalent
conditions for CSHCN.
SHC'S CONTRIBUTION:
Yes
N/A*
Yes
N/A*
No
None
• While SHC does not have a behavioral health
program per se, we have a consulting psychiatrist on
staff to address the needs of our patients.
Page 25
*Rationalization for Prioritization Process
Categories marked with an N/A*in the “SHC Prioritization Ranking” column indicate a lack of existing
resources and/or expertise to treat at SHC.
In regards to the CHNA conducted by SHC — Honolulu, the prioritization process was based on
discussions, evaluations, and other deliberations with our key informants, community partners, and
internal assessment team. The evaluation criteria was naturally driven by availability of internal
resources and available expertise. A team decision was made to focus on developing plans to address
developmental disabilities and transitional planning needs for our community CHCSN. We recognized
and acknowledged that we did not have the resources or expertise to address needs such as allergies,
which also surfaced during the assessment process.
Page 26
Implementation Plan
Developmental Disabilities
GOAL:
OBJECTIVE:
To increase the availability
of care for children with
developmental disabilities in
Hawaii.
By August 2013, begin offering
pediatric neurological care
services to children with
developmental disabilities in
Hawaii.
TACTICS/ TIMELINE:


By July 2013, Public
Relations specialist will
implement marketing
strategies to inform
community-at-large of
anticipated pediatric
neurologist and
developmental pediatric
services.
By August 2013, begin
offering services to Hawaii
children with developmental
disabilities.
EVALUATION MONITORING PLAN:
 Analyze referrals of patients with developmental disabilites to determine whether there is a
need to reinforce or enhance communications for specific groups
 Gauge communication effectiveness through post-service line public opinion survey
 Evaluate patient satisfaction and patient experience metrics for operational trouble-shooting,
admission process and patient care improvements
Page 27
Transition Services
GOAL:
OBJECTIVE:
To enhance current
transitional service offerings
for Hawaii’s children with
special health care needs.
By August 2013, expand
exisiting transitional service
program to cover larger
population of Hawaii’s children
with special health care needs.
TACTICS/ TIMELINE:


By August 2013, the Care
Coordination department will
finalize transition program
revision plans to assure
consistency of information
that is distributed to and
collected from current base
of patients.
By August 2013, the Care
Coordination department will
enhance the transition
program to include
information and assistance
that is developmental
disability-specific.
EVALUATION MONITORING PLAN:
 On a case-by-case basis, internally assess effectiveness of transition assistance via direct
discussion with patients and their families.
 Distribute surveys to patients and their families to gauge satisfaction ratings towards
transition services that they received.
Page 28
Internal Partners for Transition Expansion

Merlene Jose, RN:
Ms. Jose’s health care knowledge is comprehensive and includes direct patient care, as well as
education and supervision in the healthcare setting. She is familiar with the needs of the
medically fragile pediatric community, and applies this invaluable expertise as the Care
Coordination Manager at Shriners Honolulu. Shriners’ current transitional program is managed
by Ms.Jose. Ms. Jose will be the operational leader for the transitional program’s expansion
efforts.

Lisa Abbott, APRN:
Ms. Abbott has over 20 years of experience in the healthcare field with a wide range of
knowledge in working with clients with complex medical conditions, as well as vulnerable
populations. Ms. Abbott is currently a Family Nurse Practitioner at Shriners Honolulu. She was
the Choices program nurse under an initiative piloted at Shriners Hospitals for Children at
Lexington. The Choices program was part of a nationwide initiative to raise awareness about
the medical home, ages and stages appropriate care throughout childhood including transition
to adult care in the community. The Choices program was a precursor to the hospital’s Care
Coordination department. With her rich insight, Ms. Abbott was an integral resource during the
evaluation process.
Page 29
Acknowledgements
External Partners:




Healthcare Association of Hawaii
Louise Iwaishi, MD
Leolinda Parlin
Dorothy Colby, RN, MPH
Internal Partners:
 Merlene Jose, RN
 Lisa Abbott, APRN
Page 30
Exhibits
Exhibit A
The HAH HCI report included a state-wide list of “Identified Community Resources” as an appendix.
The appendix contained lists that were provided by three state organizations - Aloha United Way, the
Hawaii Department of Health, and the Centers for Medicare and Medicaid Services.
Exhibit A excerpts the HAH HCI appendix so that only pediatric specific community health care facilities
and resources are listed.
Page 31
Appendix D: Identified Community Resources
Statewide Health-Related Resources Identified from Aloha United Way1
The following list includes selected resources available to residents of the State of Hawaii, as identified from Aloha United Way. However, it is
not an exhaustive directory of all statewide programs. To find more resources, please visit http://www.auw211.org/.
Topic Area(s)
Organization/Program
URL
Children's Health
CHILD & FAMILY SERVICES
www.childandfamilyservice.org
Children's Health
HAWAII KIDS COUNT
http://uhfamily.hawaii.edu/projec
ts/kidscount/home.aspx
Children's Health
PREVENT CHILD ABUSE HAWAII
www.preventchildabusehawaii.org
Diabetes
AMERICAN DIABETES ASSOCIATION - HI
www.diabetes.org
Diabetes
NATIONAL KIDNEY FOUNDATION OF HAWAII - OAHU
www.kidneyhi.org
(808)593-1515
Diabetes; Children's
Health
JUVENILE DIABETES RESEARCH FOUNDATION INTERNATIONAL HAWAII CHAPTER
www.jdrfhawaii.org
(808)988-1000
Injury Prevention &
Safety; Substance Abuse
MADD HAWAII
http://www.madd.org/localoffices/hi/
(808)532-6232
Maternal, Fetal & Infant
Health
H-KISS
http://hawaii.gov/health/familychild-health/eis
(808)594-0066
Oral Health
HAWAII DENTAL ASSOCIATION
www.hawaiidentalassociation.net/
(808)593-7956
Other Chronic Conditions
AUTISM SOCIETY OF HAWAII
www.autismhi.org/
(808)228-0122
Other Chronic Conditions
EPILEPSY FOUNDATION OF HAWAII
www.hawaiiepilepsy.com
(808)528-3058
1
Data was accessed February 2013
Phone
(808)951-0200
Health-Related Resources Identified by Hawaii Department of Health
The following list includes organizations that have active contracts with the Hawaii Department of Health in 2013.
Geography
Topic Area(s)
Hawaii County
Maternal, Fetal & Infant Health; Access to Health
Services; Family Planning
BAY CLINIC, INC.
Hawaii County
FAMILY PLANNING EDUCATION SERVICES
Hawaii County
HAMAKUA HEALTH CENTER
Hawaii County
Maternal, Fetal & Infant Health; Children's Health
FAMILY SUPPORT SERVICES OF WEST HAWAII
Hawaii County
Mental Health
ALAKAI NA KEIKI, INC (EAST HAWAII)
Hawaii County
Mental Health
ALAKAI NA KEIKI, INC (WEST HAWAII)
Hawaii County
Substance Abuse; Family Planning
BISAC
Hawaii State
Access to Health Services; Family Planning
AIDS COMMUNITY CARE TEAM
Hawaii State
Children's Health; Access to Health Services
EASTER SEALS HAWAII
Hawaii State
UNITED CEREBRAL PALSY ASSOCIATION OF HAWAII
Hawaii State
HEALTHY MOTHERS, HEALTHY BABIES COALITION OF HAWAII
Hawaii State
PLANNED PARENTHOOD OF HAWAII
Hawaii State
UNIVERSITY OF HAWAII AT MANOA/LEEWARD COMMUNITY COLLEGE
Hawaii State
UNIVERSITY OF HAWAII HILO
Hawaii State
BOYS AND GIRLS CLUB OF HAWAII
Hawaii State
CATHOLIC CHARITIES OF HAWAII
Geography
Topic Area(s)
Hawaii State
CHILD AND FAMILY SERVICE
Hawaii State
CHILD AND FAMILY SERVICE KAUAI
Hawaii State
Hawaii State
THE INSTITUTE FOR FAMILY ENRICHMENT
Hawaii State
YWCA OF HAWAII ISLAND
Hawaii State
Mental Health
Hawaii State
Substance Abuse
BOYS AND GIRLS CLUB OF THE BIG ISLAND
Hawaii State
CHILD & FAMILY SVCS
Hawaii State
Substance Abuse; Teen & Adolescent Health
BOYS AND GIRLS CLUB OF HAWAII
Honolulu County
ACES
Honolulu County
ALAKAI NA KEIKI, INC.
Honolulu County
B.C.P., INC. DBA BAYADA HOME HEALTH CARE
Honolulu County
CARE HAWAII, INC.
Honolulu County
COMPREHENSIVE AUTISM SERVICES & EDUCATION, INC. DBA C.A.S.E., INC.
Honolulu County
DEBORAH T. TOM DBA DEBORAH T. TOM, MS, PT
Honolulu County
DR. BRENDA LOVETTE DBA LOKAHI CONSULTING GROUP, INC.
Honolulu County
EASTER SEALS OF HAWAII - HONOLULU CENTRAL
Honolulu County
EASTER SEALS OF HAWAII - HONOLULU EAST
Honolulu County
EASTER SEALS OF HAWAII - KAILUA
Honolulu County
EASTER SEALS OF HAWAII - KAPOLEI
Honolulu County
HAWAII BEHAVIORAL HEALTH, LLC
Honolulu County
HELPING HANDS HAWAII
Honolulu County
IMUA FAMILY SERVICES
Geography
Topic Area(s)
Honolulu County
JIHEE KIM NGUYEN
Honolulu County
JUNE UYEHARA ISONO, INC. DBA AUDIOLOGY CONSULTANT AND SERVICES
Honolulu County
KAPIOLANI MEDICAL SPECIALISTS
Honolulu County
MARY MARASOVICH DBA OAHU SPEECH LANGUAGE PATHOLOGY
CONSULTANTS
Honolulu County
PACIFIC GATEWAY CENTER
Honolulu County
QUALITY BEHAVIORAL OUTCOMES, LLC
Honolulu County
SAYURI'S NUTRITIONAL CONSULTATION, LLC
Honolulu County
THE INSTITUTE FOR FAMILY ENRICHMENT, LLC
Honolulu County
WAIANAE COAST EARLY CHILDHOOD SERVICES, INC. - WAIANAE
Honolulu County
Honolulu County
COMMUNITY CLINIC OF MAUI
Honolulu County
KALIHI PALAMA HEALTH CENTER
Honolulu County
KOKUA KALIHI VALLEY
Honolulu County
KOOLAULOA HEALTH AND WELLNESS CENTER
Honolulu County
MOLOKAI GENERAL HOSPITAL
Honolulu County
WAIANAE COAST DISTRICT COMPREHENSIVE
Honolulu County
WAIKIKI HEALTH CENTER
Geography
Topic Area(s)
Honolulu County
Honolulu County
THE INSTITUTE FOR FAMILY ENRICHMENT
Honolulu County
Maternal, Fetal & Infant Health; Exercise,
Nutrition, & Weight
WAIANAE COAST COMPREHENSIVE HEALTH SERVICES
Honolulu County
Nutrition, & Weight
WAIMANALO HEALTH CENTER
Honolulu County
Mental Health
ALAKAI NA KEIKI, INC (CENTRAL OAHU)
Honolulu County
Mental Health
ALAKAI NA KEIKI, INC (HONOLULU)
Honolulu County
Mental Health
ALAKAI NA KEIKI, INC (LEEWARD OAHU)
Honolulu County
Mental Health
CHILD AND FAMILY SERVICE (CR - CRISIS MOBILE)
Honolulu County
Mental Health
Honolulu County
Mental Health
CHILD AND FAMILY SERVICE (CR - CRISIS MOBILE)
Honolulu County
Mental Health
HALE KIPA, INC.
Honolulu County
Mental Health
HAWAII FAMILIES AS ALLIES (BG30&31)
Honolulu County
Mental Health
HAWAII FAMILIES AS ALLIES(PK)
Honolulu County
Mental Health
HELPING HANDS HAWAII
Honolulu County
Mental Health
PARENTS AND CHILDREN TOGETHER (CR - FFT)
Honolulu County
Mental Health
PARENTS AND CHILDREN TOGETHER (EAST OAHU)
Honolulu County
Mental Health
PARENTS AND CHILDREN TOGETHER (WEST OAHU
Honolulu County
Mental Health
SPECIAL EDUCATION CENTER OF HAWAII
Honolulu County
Mental Health
THE INSTITUTE FOR FAMILY ENRICHMENT (TIFFE)
Honolulu County
Substance Abuse
PARENTS AND CHILDREN TOGETHER
Honolulu County
MALAMA NA MAKUA
Honolulu County
ALOHA HOUSE, INC.
Geography
Topic Area(s)
Honolulu County
ALU LIKE, INC.
Honolulu County
BISAC
Honolulu County
CARE HAWAII
Honolulu County
FAMILY EDUCATION CENTER OF HAWAII
Honolulu County
HALE HO'OKUPA'A
Honolulu County
HINA MAUKA
Honolulu County
MYFS
Honolulu County
OHANA MAKAMAE
Honolulu County
PO'AILANI
Honolulu County
TIFFE
Honolulu County
YMCA
Kauai County
LIFE FOUNDATION
Kauai County
MALAMA PONO HEALTH SERVICES
Kauai County
EASTER SEALS OF HAWAII - KAUAI
Kauai County
KAUAI COMMUNITY COLLEGE
Kauai County
KAUAI RURAL HEALTH
Maui County
MAUI AIDS FOUNDATION
Maui County
IMUA FAMILY SERVICES - LANAI
Maui County
IMUA FAMILY SERVICES - MAUI
Maui County
LANAI WOMEN'S HEALTH CENTER
Maui County
MAUI COMMUNITY COLLEGE
Geography
Topic Area(s)
Maui County
MOLOKAI GENERAL HOSPITAL
Maui County
MAUI FAMILY SUPPORT SERVICES
Maui County
Nutrition, & Weight
MAUI FAMILY SUPPORT SERVICES, INC.
Maui County
Nutrition, & Weight
MOLOKAI OHANA HEALTH CARE, INC.
Maui County
Mental Health
ALAKAI NA KEIKI, INC (MAUI)
Maui County
Mental Health
MAUI YOUTH AND FAMILY SERVICES, INC.
Maui County
Mental Health
PARENTS AND CHILDREN TOGETHER (MAUI)
Maui County
MAUI YOUTH AND FAMILY SERVICES
unknown
unknown
ALAKAI NA KEIKI, INC (EAST HAWAII)
unknown
unknown
CHILD & FAMILY SVCS
unknown
unknown
unknown
unknown
CHILD AND FAMILY SERVICE KAUAI
unknown
unknown
FAMILY PLANNING EDUCATION SERVICES
unknown
unknown
unknown
unknown
HEALTHY MOTHERS, HEALTHY BABIES COALITION OF HAWAII
unknown
unknown
MAUI FAMILY SUPPORT SERVICES
unknown
unknown
PARENTS AND CHILDREN TOGETHER (CR - FFT)
unknown
unknown
PLANNED PARENTHOOD OF HAWAII
State of Hawaii Licensed Health Care Facilities Reported by the Centers for Medicare & Medicaid Services2
The following list includes the places of service reported by the Centers for Medicare & Medicaid Services for the State of Hawaii. However, it is
not an exhaustive directory of all facilities in the county.
County
Facility Type
Facility Sub-Type
Facility Name
Address
Hawaii
County
Federally Qualified Health Center
FEDERALLY QUALIFIED HEALTH
CENTER
BAY CLINIC FAMILY HEALTH
CENTER
73 PU'UHONU PLAZA, ROOM 204
HILO HI 96720
Hawaii
County
CENTER
KA U FAMILY HEALTH CTR
95-5583 MAMALALOA HWY
NAALEHU HI 96772
Hawaii
County
CENTER
KEAAU FAMILY HEALTH CENTER
16-192 PILIMUA STREET KEAAU HI
96749
Hawaii
County
CENTER
KOHALA FAMILY HEALTH
CENTER
53-3925 AKONI PULE HIGHWAY
KAPAAU HI 96755
Hawaii
County
CENTER
PAHOA FAMILY HEALTH
3 GOVERNMENT ROAD PAHOA HI
96778
Hawaii
County
Home Health Agency
HOME HEALTH AGENCY
HILO HOSP HHS-KONA SUB-UNIT
P O BOX 69 KEALAKEKUA HI 96750
Hawaii
County
Home Health Agency
HOME HEALTH AGENCY
HILO MEDICAL CENTER HOME
CARE
45 MOHOULI STREET, SUITE 201
HILO HI 96720
Hawaii
County
Home Health Agency
HOME HEALTH AGENCY
INTERIM HEALTHCARE HILO
519 MANONO STREET HILO HI
96720
Hawaii
County
Home Health Agency
HOME HEALTH AGENCY
INTERIM HEALTHCARE KONA
75 5995 KUAKINI HIGHWAY SUITE
KAILUA KONA HI 96740
Hawaii
County
Home Health Agency
HOME HEALTH AGENCY
KOHALA HOME HEALTH CARE
OF NORTH HI COMM HOSP
67-1125 MAMALAHOA HIGHWAY
KAMUELA HI 96743
Hawaii
County
Home Health Agency
HOME HEALTH AGENCY
WEST HAWAII HOME HEALTH
SERVICES
P O BOX 69 KEALAKEKUA HI 96750
2
th
The Centers for Medicare & Medicaid Services published this list in the 4 Quarter of 2012.
County
Facility Type
Facility Sub-Type
Facility Name
Address
Hawaii
County
Home Health Agency
HOME HEALTH AGENCY
WEST HAWAII HOME HEALTH
SVCS
82-5899 OLD GOVERNMENT ROAD
CAPTAIN COOK HI 96704
Honolulu
County
CENTER
KOKUA KALIHI VALLEY
COMPREHENSIVE FAMILY
SERVICES
1475 LINAPUNI STREET, BLDG A,
#105 HONOLULU HI 96819
Honolulu
County
CENTER
KOKUA KALIHI VALLEY
COMPREHENSIVE FAMILY
SERVICES
1846 GULICK AVENUE HONOLULU
HI 96819
Honolulu
County
CENTER
WAIPAHU FAMILY HEALTH
CENTER
94-428 MOKUOLA STREET, SUITE
108-B WAIPAHU HI 96797
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
CARERESOURCE HAWAII
680 IWILEI ROAD, SUITE 660
HONOLULU HI 96817
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
CARERESOURCE HAWAII
702 SOUTH BERETANIA ST, SUITE
3-A HONOLULU HI 96813
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
CASTLE HOME CARE
46 001 KAMEHAMEHA HIGHWAY,
SUITE 212 KANEOHE HI 96744
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
HOSPICE HAWAII INC
860 IWILEI ROAD HONOLULU HI
96817
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
INTERIM HEALTHCARE
HONOLULU
1441 KAPIOLANI BLVD SUITE 1320
HONOLULU HI 96814
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
KAHUKU HOSPITAL HHA
56-117 PUALALEA STREET KAHUKU
HI 96731
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
KAISER HOME HEALTH AGENCY OAHU
2828 PA'A STREET #2048
HONOLULU HI 96819
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
KAPIOLANI HOME HEALTH
SERVICES
94-479 UKE'E STREET, SUITE 201
WAIPAHU HI 96797
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
KOKUA NURSES INC
1210 ARTESIAN STREET, SUITE 201
HONOLULU HI 96826
County
Facility Type
Facility Sub-Type
Facility Name
Address
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
MALUHIA HOME HEALTH CARE
1027 HALA DRIVE HONOLULU HI
96817
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
PRIME CARE SERVICES HAWAII
INC
3375 KOAPAKA STREET, SUITE I570 HONOLULU HI 96819
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
ST FRANCIS HOME CARE
SERVICES
2226 LILIHA STREET, SUITE 505
HONOLULU HI 96817
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
STRAUB HOME HEALTH AGENCY
641 KAILUA ROAD KAILUA HI
96734
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
UPJOHN HOME HEALTH AGENCY
210 WARD AVE HONOLULU HI
96814
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
WAHIAWA GENERAL HOSP HHA
128 LEHUA ST WAHIAWA HI 96786
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
WAHIAWA GENERAL HOSPITAL
HHA
1008 CALIFORNIA AVENUE, UNIT
A101 WAHIAWA HI 96786
Honolulu
County
Home Health Agency
HOME HEALTH AGENCY
WAIANAE COAST
COMPREHENSIVE HEALTH CTR
86-260 FARRINGTON HIGHWAY
WAIANAE HI 96792
Honolulu
County
Hospital
VA PACIFIC ISLANDS HCS
459 PATTERSON ROAD HONOLULU
HI 96819
Honolulu
County
Hospital
WAIMANO TRAINING SCHOOL &
HOSP
PEARL CITY HI 96782
Honolulu
County
Hospital
Childrens
KAPIOLANI MEDICAL CENTER
FOR WOMEN & CHILDREN
1319 PUNAHOU STREET
HONOLULU HI 96826
Honolulu
County
Hospital
Childrens
SHRINERS HOSPITAL FOR
CHILDREN
1310 PUNAHOU STREET
HONOLULU HI 96826
Kauai
County
Home Health Agency
HOME HEALTH AGENCY
HAWAII PROFESSIONALS
HOMECARE SERVICES, INC
2970 KELE STREET, SUITE 213
LIHUE HI 96766
Kauai
County
Home Health Agency
HOME HEALTH AGENCY
INTERIM HEALTHCARE LIHUE
4370 KUKUI GROVE STREET SUITE
LIHUE HI 96766
County
Facility Type
Facility Sub-Type
Facility Name
Address
Kauai
County
Home Health Agency
HOME HEALTH AGENCY
ST.FRANCIS HOME CARE
SERVICES - KAUAI
4473 PAHE'E STREET, SUITE N
LIHUE HI 96766
Maui
County
Home Health Agency
HOME HEALTH AGENCY
HALE MAKUA HOME HEALTH
SERVICE
1520 EAST MAIN STREET WAILUKU
HI 96793
Maui
County
Home Health Agency
HOME HEALTH AGENCY
INTERIM HEALTHCARE KAHULUI
360 PAPA PLACE SUITE 205
KAHULUI HI 96732
Maui
County
Home Health Agency
HOME HEALTH AGENCY
INTERIM HEALTHCARE MOLOKAI
40 ALA MALAMA STREET
KAUNAKAKAI HI 96748
Maui
County
Home Health Agency
HOME HEALTH AGENCY
KAISER PERMANENTE HOME
HEALTH AGENCY MAUI
55 MAUI LANI PARKWAY WAILUKU
HI 96793
Maui
County
Home Health Agency
HOME HEALTH AGENCY
LANAI HOME HEALTH AGENCY
P O BOX 763 LANAI CITY HI 96763
Maui
County
Home Health Agency
HOME HEALTH AGENCY
MOLOKAI HOME HEALTH
AGENCY
65 MAKAENA STREET
KAUNAKAKAI HI 96748

SHC Community Health Needs Assessment

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