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The Honolulu Advertiser
Posted on: Monday, July 21, 2008

COMMENTARY
Hale Na'au Pono is a model of healthcare

By Poka Laenui

About a year ago, the state's two leaders for mental health transformation visited Hale Na'au Pono to explore transformative possibilities to the existing system. I pointed to 20-plus years ago, when the response to that very question resulted in our spin-off from the state's community mental health centers. "Study the results rather than reinvent the wheel," I said.

Today, that center is Hale Na'au Pono — the only such center to be nationally accredited.

We have more services than any other mental health organization in Hawai'i.

For adult services, we provide three levels of clinical services from the most to the least intensive. Our 72 group-home beds cross the community, to help prevent homelessness. Our Clubhouse is internationally certified to meet the social needs of consumers. Our seven acres of farmland give consumers opportunities to return to the land.

Children's programs includes psychiatric and psychological services, 25 therapeutic foster homes and an eight-bed group home. We also run a developmentally disabled program.

We even have a neighborhood place providing leadership and coordination of services for families and others in need in the community, a way of diverting families from Child Protective Services oversight.

We provide a much-needed alcohol, tobacco and drug treatment in this community. Consumers come from the courts, other social agencies, families or are self-motivated.

Hale Na'au Pono is ranked first in the nation by the National Managed Healthcare Congress for organizations with an annual budget under $10 million. We have received national recognition numerous times in professional publications. We developed a national training curriculum in partnership with the National Asian American and Pacific Islanders Mental Health Association. When the Department of Health wanted to adapt a U.S. "best practice" treatment model, it came to Hale Na'au Pono. The resulting "Voyage to Recovery" model is taught at the University of Hawai'i, praised at state conferences and primed for export by the health department across the Pacific.

When asked for written comments on transformation, Hale Na'au Pono submitted 18 pages of comments saying the state should monitor its department in the practice of its aloha policy. It is very difficult to expect such practice by the service providers when the divisions themselves do not practice aloha, practice inconsistencies in their treatment with the service providers, are stingy in their authorizations, take an exceedingly long time to pay bills and have a bad attitude toward providers.

We also called for culturally proper services, saying, "the Hawaiian practice of ho'oponopono should be an option for group/family treatment available to consumers and their families irrespective of the ethnic or indigenous background of the consumer. When such practices are put in place as the treatment modality, the practitioners who should be authorized to provide such treatment should be defined from within the culture from which the treatment springs . . ."

Today, the Department of Health is trying to destroy Hale Na'au Pono. "They won't open their books to us," declared Dr. Chiyome Fukino, director of the state Department of Health. On June 6, the health department completed its review of all the books they asked for. Eight months before, November 2007, they also reviewed the books.

Other complaints: "Too many high school graduates, not enough college graduates, sub-par service quality." But the department said it would provide exceptions, then never followed up. Our quality of service has never suffered because of our staff who are high school graduates.

"Sentinel events are not reported accurately," said the health department, which also declared all consumers were "dependent adults." We fought this decision as stigmatizing and unlawful. They reversed themselves. The health department employee quit and left town. We have not misreported.

Time and again, DOH tried to force its way into the consumers' confidential records. Hale Na'au Pono rebuffed its efforts when appropriate.

The Department of Health has pulled the plug on Hale Na'au Pono's largest clinical service, not for any specific cause, but for "necessity and convenience." Our strident protection of consumers, of confidential records, and our excellent record of service, does not support grounds of "necessity and convenience" to cancel our contract.

State mental health system transformation? Yes indeed, starting with Department of Health's leadership style, its lack of aloha, and its practice of retaliation against service providers.

Poka Laenui is executive director of Hale Na'au Pono. He wrote this commentary for The Advertiser.