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    November 2017
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North Hawaii Community Hospital Answers Questions Following Controversial Decision to Serve Maternity Patients by Zip Codes

North Hawaii Community Hospital answered the following questions regarding their decision to only serve patients in certain zip codes for maternity care.

Q: What is North Hawaii Community Hospital’s mission?

A: NHCH’s mission is “to improve the health status of the people of North Hawai‘i by improving access to care and providing high quality services at a reasonable cost.”

Q: Why is NHCH limiting OB patients to those who live in their service area?

A: North Hawaii Community Hospital was designed to support a maximum of 550 births each year. Last year, 663 babies were delivered, and that number is on pace to exceed 700 births this year. Overcrowding in the Family Birthing Unit raises safety concerns and puts a strain on our ability to provide outstanding clinical care to every family delivering at NHCH.

Q: Are you closing the Waimea Women’s Center or laying off midwives?

A: No, we are not closing the Waimea Women’s Center or laying off midwives. We are committed to our maternal care program and to keeping midwifes as an integral part of our team.

Q: How did NHCH arrive at this decision?

A: Six weeks ago, NHCH formed an internal Maternal Care Work Group comprised of three doctors, one midwife, six nurses and three staff members to evaluate NHCH issues of overcrowding, safety, patient satisfaction and financial and resource implications. NHCH deliberated the Maternal Care Work Group recommendations along with additional input from the NHCH Community Advisory Board, NHCH Board of Directors and public input facilitated by the Waimea Community Association. Before the executive team arrived at the hospital’s decision to ease overcrowding by defining the NHCH maternal care service area, they determined that maternal care is available on Hawaii Island.

Q: What is NHCH’s defined service area?

A: NHCH’s service area is defined by the Hawaii County Emergency Medical Response Zone, which is the area north of a line roughly running from Laupahoehoe on the Hamakua Coast across the Saddle to Kukio in North Kona. Effective immediately, NHCH’s Waimea Women’s Center will only offer maternal care services to women whose primary address is within the EMT area:

  • 96719—Hawi
  • 96727—Honokaa
  • 96738—Waikoloa
  • 96743—Kamuela
  • 96755—Kapaau
  • 96764—Laupahoehoe
  • 96774—Ookala
  • 96776—Paauilo
  • 96780—Papaaloa
  • And Kukio and Hualalai only.

Q: What are some examples of area excluded from NHCH’s service area?

A: East Side ‐ Ka’u, Volcano, Puna, Pāhoa, Hilo and Ninole are not included in NHCH’s service area. West Side ‐ North Kona (i.e., Kona Palisades Subdivision, Kaloko), Kealakekua and South Kona are not included in NHCH’s service area.

Q: Who is affected by this new service area definition?

A: The new policy affects new OB patients who live outside NHCH’s service area. An OB patient is someone receiving care for a pregnancy: prenatal, delivery or postnatal. Effective May 11th, those who live outside NHCH’s service area and become pregnant will be unable to receive prenatal care at Waimea Women’s Center or deliver at NHCH’s Family Birthing Unit. However, if a woman lives outside the NHCH service area and is currently an established pregnant patient of the Waimea Women’s Center, she can continue to receive prenatal care at Waimea Women’s’ Center and deliver at NHCH’s Family Birthing Unit.

Q: What if I live outside NHCH’s service area and have received care at Waimea Women’s Center for previous pregnancies, including delivering at NHCH’s Family Birthing Unit?

A: NHCH is unable to accept any OB patients, new or previous patients, from outside our service area effective May 11th, 2012.

Q: I live outside NHCH’s service area, where will I receive obstetric care?

A: Please refer to the below list of current providers in Hilo and Kona.

Physician/Provider Specialty Phone Office Location

Hilo Providers

  • Dr. Lucy Bucci Family Medicine 932‐4215 Hawai‘i Island Family Medicine 45 Mohouli St, Suite 101, Hilo
  • Dr. Julie Chee Family Medicine 932‐4215 Hawai‘i Island Family Medicine 45 Mohouli St, Suite 101, Hilo
  • Dr. Ian Ebesugawa OB/GYN 969‐2055 75 Puuhonu Place, Hilo
  • Dr. Randall Hirata OB/GYN 969‐7763 82 Puuhonu Place, Hilo
  • Dr. Eric Helms OB/GYN 934‐3280 Bay Clinic 73 Puuhonu Place, Suite 204, Hilo
  • Dr. Kristin McCoy Family Medicine 932‐4215 Hawai‘i Island Family Medicine 45 Mohouli St, Suite 101, Hilo
  • Dr. Karen Nakamoto OB/GYN 935‐7765 82 Puuhony Place, Hilo
  • Dr. Fred Nitta OB/GYN 961‐5922 670 Ponahawai Street, Suite 200, Hilo
  • Dr. Quye Tran OB/GYN 933‐2100 670 Ponahawai St, Suite 115, Hilo

Kona Providers

  • Dr. Christina Collins OB 331‐2300 75‐5905 Walua Rd, Suite 3, Kailua Kona, HI
  • Dr. Michelle Gilbert OB 334‐4400 Kaiser Permanente 75‐184 Hualalai Road, Kailua Kona
  • Dr. Deborah Lachance OB 334‐4400 Kaiser Permanente 75‐184 Hualalai Road, Kailua Kona
  • Dr. Santad Sira OB 329‐6447 75‐ 184 Hualalai Road, Ste 202, Kailua Kona

Q: Who is NOT affected by this restriction?

A: Anyone living within the defined service area is not affected. If a woman is currently pregnant, is already being seen at the Waimea Women’s Center for obstetric care, and lives outside NHCH’s service area, she can continue to be a patient and deliver at NHCH’s Family Birthing Unit.

Q: Can I receive GYN care at Waimea Women’s Center if I live outside your service area?

A: Yes, NHCH is accepting established and new gynecological patients who live outside our service area, since this service is not at capacity. The Waimea Women’s Center offers the following gynecological services: annual exams, pap smears, breast examinations, birth control counseling, menopause management, urinary incontinence management and more.

Q: I am a Kaiser patient who lives outside your service area. May I transfer to the Waimea Women’s Center in my third trimester and deliver at NHCH?

A: We are no longer accepting patients who live outside our service area. However, if you are a Kaiser patient who lives within our service area, you may transfer to Waimea Women’s Center and deliver at NHCH’s Family Birthing Unit.

Q: What is needed to verify my address?

A: You must present a driver’s license or legal photo ID with your current primary address. If your license or state ID does not have your current primary address, you must present a current utility bill that includes your name and address.

Q: When does this policy go into effect?

A: This new policy to address overcrowding in the Family Birthing Unit goes into effect May 11, 2012.

Q: Are other medical services at NHCH based on NHCH’s service area?

A: Other medical services at NHCH are not at capacity; therefore, NHCH will continue to accept patients who live outside the service area for all other medical service areas, which include: gynecological services in the Waimea Women’s Center, general surgery, orthopedics, emergency department, and so on.

Q: Will NHCH continue to use midwives?

A: NHCH is committed to maintaining Certified Nurse Midwives as an integral part of our maternal care program.

Q: Can you recommend a midwife as I am considering a home birth?

A: NHCH does not support home births. None of our midwives provide home birthing services.

Q: Is this decision to define service area access purely a financial one?

A: Overcrowding, patient safety and quality of care are NHCH’s primary reasons for establishing this new policy. Financial and resource implications are also factors. Overcrowding in the Family Birthing Unit has taken a financial toll with NHCH losing $7.2 million over the past three years.