HEALTHCARE
Breeani has been working in direct support of increasing access to healthcare and addressing the rural physician shortage for the last seven years, in her role on the Board of Directors for Hui Kahu Malama and as the former Big Island representative for the Hawaii State Rural Health Association. She shared in the excitement of the community that the recent $50 million donation to Hilo Medical Center will facilitate the commencement of the much awaited expansion of the Intensive Care Unit, and create a family birthing center, and neurosurgery program; however, these are just first steps, in beginning to address the healthcare challenges our people face. Our leaders must continue to prioritize and pursue county-led initiatives if we want to be able to take care of our children, our elderly, and our vulnerable. If we want to be confident in the quality of life our county offers - the quality of life our people deserve - we have to invest in healthcare our people can rely on.
While many rural areas around the country are experiencing a shortage of healthcare workers, our county is one of the few where residents often have to fly to receive specialist care. The Hawaii Physicians' Workforce Assessment Project estimates that the county of Hawaii has a shortage of 206 physicians - up from 183 estimated just last year - and the strain of which is being increasingly felt by an aging community - including our physicians. Almost a quarter of our physicians are already over retirement age, and these physician shortages mean an estimated 41% of patient demand is not being met, and that is only increasing with time and population growth.
We are short an estimated 17 primary care physicians, in addition to specialists; which renders extended wait times for appointments for the limited numbers of specialists available on-island; often after a patient had already been delayed in getting a referral from a PCP due to the relative short supply appointment to high demand of patients in need. The Hawaii State Center for Nursing also estimates a shortage of 300 to 400 nurses - an issue that has been on-going for years and the state has attempted to stop-gap with temporary permits to out-of-state nurses - but one that our county needs addressed by long-term, sustainable resolutions.
RURAL PHYSICIAN SHORTAGE
Worker Incentives
In 2023 Governor Green allocated $30 million for the Hawaii Health Education Loan Repayment Program; adding to the annual $800,000 federally funded State Loan Repayment Program. With these funds, Hawaii is expected to begin providing loan repayment to hundreds of healthcare workers across the state. However, while we hope this translates to relief on the horizon, these programs are state-wide, and our county is struggling with the second-highest shortages. We cannot stake our future on optimism alone.
Our county needs to capitalize on this opportunity and further incentivize physicians and nurses taking advantage of these programs, to move here and fill much-needed positions on the Big Island, rather than elsewhere in the state. Tangible strategies must be developed to bolster other vital healthcare roles like community health workers and a strong public health workforce. Long-term, our aim should be building a robust County healthcare infrastructure; focused on prevention and equipping us to proactively address health challenges and emergencies rather than reacting after the fact.
First steps to improve recruitment could include options such as expanding our residency and training programs; offering more enticing fringe benefits; on-site childcare; children's education subsidies; college savings programs; and workforce housing. This would serve to not only attract new prospects, but also just as importantly, to retain our current physicians and nurses, who have had to carry the heavy imbalance of of theses shortages often at personal costs, with overloads significantly affecting their quality of life.
TO FILL HAWAII COUNTY POSITIONS
Certificate Trainings
IN BIG ISLAND HIGH SCHOOLS
Our county should also look ahead to grow our healthcare capacity from our roots right here at home; by providing support to expand the Certified Nurse Aide and Medical Assistant Certificate Training Programs piloted successfully in Waiakea and Honoka’a High Schools with the Community College, to be offered to high schools island-wide. The impact of these programs could be exponential - increased interest and access to stable careers, higher-education, and scholarship opportunities in the healthcare industry; an overall growth in medical knowledge, training, and skills in the community; and consistent cohorts of certified Nurse Aides and Medical Assistants ready to enter the local workforce and provide needed care after high school graduation.