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The Honolulu Advertiser
Posted on: Monday, February 10, 2003

Health director wants to make difference

By Robbie Dingeman
Advertiser Health Writer

It didn't take long for the state's new health director, Dr. Chiyome Leinaala Fukino, to find herself in the middle of her first public policy controversy — a proposed $1.65 million cut to the state's community health centers.

Dr. Chiyome Fukino, state health director, said her department's priorities include long-term care and mental health.

Richard Ambo • The Honolulu Advertiser

Health center officials protested last week, saying it would mean slashing services to the uninsured and other needy people.

By Friday, Fukino said the cuts weren't necessary after all.

The episode underscored Fukino's transition from a private physician caring for patients to a policy-maker grappling with issues ranging from mental health and the environment to bioterrorism preparedness.

Not a political insider or career bureaucrat, she shows patience and a quiet sense of humor as she learns a new arena.

"I've been told that previous directors came into this office and were much smarter at the end of four years, so I'm counting on that," she said.

Fukino, 52, leaves behind a practice in internal medicine and a background as a physician advocate for perpetuating traditional Hawaiian healing practices. She has been told she is the first woman to serve as state health director.

Fukino is a founding member of E Ola Mau (to live on), a nonprofit organization of Native Hawaiian healthcare providers dedicated to improving the health of Hawaiians through research, culturally sensitive healthcare education and the preservation of traditional Hawaiian healing arts.

A colleague, Dr. Patricia Chinn, said she wasn't surprised that Fukino took the job, remembering a talk they had about two years ago. When Chinn asked her what she would do if given the chance, Fukino paused, then said she would devote time to making a difference in improving Native Hawaiian health.

Dr. Chiyome Leinaala Fukino

• Age: 52

• Education: Kamehameha Schools, 1956-68; Brandeis University, 1972; University of Hawai'i John A. Burns School of Medicine, M.D., 1979; UH integrated medical residency program, 1982.

• Professional experience: Physician in private practice in internal medicine since 1985; part-time medical staff, Le'ahi Hospital, 1992-2002; Queen's Physician Group, medical director, 1996-1999; Kahi Mohala, consultant, 1988-1992; Fronk Clinic, physician, 1982-1985; The Queen's Medical Center board, 2002-present.

• Family: Married to Harold Cutler, retired Air Force navigator; son, Rhadames "Hoku" Fukino, 26.

Fukino said she wants to help bring about progress so Hawaiians do not continue to lead in incidence of cancer, heart disease, diabetes and teen pregnancy.

"You need to be looking at ways to make a difference and change some of those statistics, through educational programs, through working with the private sector, whatever it takes," she said.

Fukino speaks softly but quickly and is known for her behind-the-scenes leadership.

Dr. John McDonnell, a past president of the Hawai'i Medical Association, is an allergist in private practice who has known Fukino for about 20 years.

"I know her to be a very deep thinker and quiet thinker, but a person of strong conviction," McDonnell said. "She's slow to come to conviction, but when she gets there, she's firm in it."

He said she's giving up one tough job for another but thinks her skills at listening and finding consensus will serve the state well.

"She's not a politician. She's just sage," McDonnell said. "She's not flashy."

Fukino favors contemporary island dresses and comfortable sandals or tennis shoes. She wears her long, wavy hair past her shoulders, smiles easily and listens carefully.

Chinn, a general surgeon, has known Fukino for about eight years and is impressed with her ability to do what's needed to find solutions to problems. The two have worked together caring for the elderly at Le'ahi Hospital.

Chinn describes Fukino as diligent and caring and wanting to make a difference, especially for other Native Hawaiians.

"She has a natural aloha," Chinn said.

Hardy Spoehr, who serves as executive director of Papa Ola Lokahi, the Native Hawaiian healthcare system, said Fukino brings energy and focus to her work and "is a behind-the-scenes mover to make things happen."

He credits Fukino and E Ola Mau with creating one of the first organizations founded to focus on Hawaiian health issues.

In her new role, Fukino leads 3,150 employees and oversees an annual budget of $632 million.

At the news conference in December at which Gov. Linda Lingle announced her appointment, Fukino said her top three priorities for the department would be long-term care, substance abuse and mental health.

She also said she wants to expand public access to quality healthcare, improve the gathering of health data, and increase collaboration between the public and private sector.

She acknowledges the big tasks ahead and has spent her first weeks in office learning more about the vast department.

"We do have to tackle really difficult issues. Long-term care is an issue. The uninsured is an issue," she said.

Substance abuse looms large.

"The most precious resource that you always have through generations of time is your children," she said. "How do we help them to be healthy, to make good choices?"

Fukino said the department also needs to be an environmental watchdog.

"As a Native Hawaiian, I have a very strong interest in how we preserve these islands," she said.

State House health chairman Dennis Arakaki said Fukino faces a big challenge in trying to continue and expand programs when budget cuts loom over any program that isn't deemed essential.

Arakaki said he worries that health-promotion and disease-prevention programs will be targeted by officials looking to save money where they can.

But Fukino said she understands their importance.

Fukino said she met Lingle for the first time on Nov. 11 at the initial meeting of the committee that was to select a health director. Lingle went to the meeting to thank the panelists for meeting on the Veterans Day holiday and encourage them to choose the best person for the job regardless of job or political affiliation. Then other panelists, friends and colleagues urged Fukino to consider the job herself.

Fukino said she has not been politically active and that she considered the job because "it was an opportunity to really make a difference."

Born and raised in Hawai'i, Fukino said she recognizes how important the environment is to maintaining the health and well-being of people .

"We need to be thinking about enforcement," Fukino said. "If you have laws and you never do anything about it, then after a while people don't pay attention to you."

Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.