So many people lack basic medical care in the Chinatown area that Kalihi-Palama Health Center last week opened a new clinic there to address the problem.

The clinic is within walking distance or a short bus ride for many of the 10,000-plus Chinatown residents believed to lack regular care because they are poor, uninsured or speak little English. A multilingual staff offers comprehensive medical and dental services to patients.

"There is an unmet need," said Emmanuel Kintu, the health center's executive director. "These residents are under the radar. You don't see their suffering."

Federal officials were so impressed with Kalihi-Palama's Chinatown plan that in May, they approved a request for a $650,000 annual grant to operate the clinic. The grant is good "in perpetuity," meaning the nonprofit will get the funds year after year as long as the facility meets federal standards.

But when Kalihi-Palama applied to the state Legislature this year for a $750,000 grant to equip the clinic, the charity got nothing.

It was forced to take out a private loan to buy equipment and supplies.

The need to provide basic care to an underserved population wasn't enough to persuade legislators to fund even a portion of Kalihi-Palama's request.

FUNDING FOR SOME

Yet lawmakers approved more than $40 million worth of other grants, including $500,000 for the Pacific Aviation Museum, $250,000 for Hawai'i Theatre Center, nearly $175,000 for the Hawaii International Film Festival and $50,000 for the Alliance for Drama Education.

Representatives from some of the funded organizations say they applied for the grants like all the other nonprofits, were fortunate to get picked and noted that the money will pay for important services or projects.

"We waited in line like everyone else," said Ken Yuen, administrative officer with comedian Frank De Lima's student enrichment charity, which requested and received approval this year for a $120,000 grant. The money helps cover the costs for De Lima to perform at about 160 schools a year.

While some organizations get grants on a regular basis, Kalihi-Palama has never received one.

The contrast between who gets funding and who doesn't underscores what many say is a flawed system for earmarking usually millions of dollars each year to Hawai'i's nonprofit community.

The Legislature gets numerous applications annually for the grants but has no formal criteria for selecting which ones to fund. A handful of legislators make those decisions behind closed doors, and numerous organizations don't get a dime. How those decisions are made are a mystery to many in the industry.

Legislators involved in selecting the charities say they consider the merits of the projects and try to spread the money so no one island or district is overrepresented.

But, they add, some worthy projects invariably will go unfunded because the Legislature gets so many requests and can't fund them all.

To help guide their decisions, legislators say they use the priorities of the Democratic majority packages in the House and Senate. This year, for instance, the House priorities were public education, housing and the environment.

Despite all the other groups that received funding, Kalihi-Palama's Kintu was unwilling to criticize the Legislature's decision to bypass his organization's request. He said his nonprofit has to do a better job next session of educating lawmakers about the merits of the Chinatown clinic.

Kintu also said he was pleased other community health centers received grant approvals because the centers share the same goal of improving care for Hawai'i residents.

This year's Legislature authorized more than 130 grants, many for basic social services dealing with the sick, the poor and the downtrodden. Among the appropriations was $1 million to help Waianae Coast Comprehensive Health Center renovate its facilities. Lawmakers also approved grants focusing on economic, recreational and cultural projects.

OTHERS LEFT OUT

Not among the approved requests was the roughly $300,0000 sought over two years by Mothers Against Drunk Driving. The nonprofit sought its first grant-in-aid to expand MADD's anti-drunken driving programs, hoping to counter the recent rise in alcohol-related traffic fatalities in Hawai'i.

But despite positive feedback from legislators, MADD got nothing.

"I don't understand how the process works," said Carol McNamee, the group's local founder. "All we can do as a new player in this area is go back (next year) and try again."

Another charity that likely will try again is Hana Health, a nonprofit that has a thrice-weekly meal and activities program for seniors.

Hana Health is raising money to build a nutrition center in the remote East Maui community and received a $250,000 grant several years ago from the Legislature to help with rising construction costs.

This year, it sought $1 million for the project, and with about $2 million in federal and private funding raised to date, that would have enabled the nonprofit to begin construction, according to Cheryl Vasconcellos, Hana Health's executive director.

"It's very disappointing that it didn't come through," Vasconcellos said.

The center would replace a 75-year-old home where staffers use a tiny kitchen to make 30,000 meals a year.

Because of a lack of space, the seniors now gather under a gray tarp outside, even on rainy, windy days. The uneven ground, gravel and dirt make navigating the area difficult for some participants, especially those who use wheelchairs, walkers and canes.

"It's really bad," said Hana resident Sina Fournier, who walks with the aid of a cane. "If we had a building, it would be wonderful."

Reach Rob Perez at rperez@honoluluadvertiser.com.

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