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Hawaii’s lieutenant governor and a local doctor are making plans to open a temporary free medical clinic in Kalihi to assist people who have lost their jobs and health insurance as a result of the COVID-19 pandemic.

More than 220,000 people have since March. Health insurance in Hawaii is frequently tied to employment, due to a state law that mandates coverage for people who work more than 20 hours a week. The recent uptick in Medicaid applications during the pandemic signals more people are looking for ways to cover their health insurance.

That’s the patient population that Lt. Gov. Josh Green and Dr. James Ireland, the doctors spearheading the Aloha Free Clinic — which they call a “pop-up clinic” — hope to assist.

They estimate as many as 40,000 people among the 220,000 unemployed may have lost their health insurance in recent weeks. And a significant number may not qualify for Med-QUEST or be able to afford other options.

“It’s basically all of the people who over the last 60 days have lost their jobs or will lose their jobs and have subsequently lost their insurance,” said Ireland, a nephrologist and also the medical director for the Aircraft Rescue and Firefighting of the Airports Division at the state Department of Transportation.

“It’s the folks who were working and had insurance but have existing medical problems that need ongoing care and need ongoing medications. They’re the ones we want to be there for, especially because we know if they go without, they could permanently damage their health.”

Their goal is to set up a clinic in a matter of weeks, open the first week of June and operate for three months.

The clinic will provide in-person and telemedicine services from volunteer doctors and nurses with specialties that range from infectious disease to pediatrics to wound care. The clinic is not meant to be a COVID-19 treatment center.

An Army Of Volunteers

In August, Green and Ireland say they’ll reassess if there’s still a community need.

As of Tuesday, 140 doctors and nurses had already contacted Ireland to express interest in volunteering. At least 10 Hawaii Pacific University advanced nursing students will volunteer and receive clinical credits for their time. An anonymous donor offered to cover rent for three months.

Ireland says about $130,000 has been raised in pledged donations from the community, but did not provide specifics. No state funding is involved.

5 Minute Pharmacy across the street on Gulick Avenue announced the pharmacy would donate generic medications to the clinic.

Derek Tengan, who also owns the pharmacy inside of Kokua Kalihi Valley Comprehensive Family Services, estimated his pharmacy would be able to donate about 10,000 medications to cover patients by the end of August.

“Our niche market is to help the people who are underserved and underinsured,” Tengan said. “This is right in line with what we do.”

Competition With Nearby Clinics?

But two other community clinics within about a 1-mile radius already offer those kinds of services, while serving uninsured patients and providing health care regardless of ability to pay.

Across the nation, clinics have been financially battered by the coronavirus. Community health centers such as Kalihi-Palama Health Center are already reeling from a significant drop in foot traffic — patient visits there are down as much as 60% — and those visits allow them to continue in business.

The opening of the temporary free clinic was first announced last week.

On Tuesday, it was clear that the nearby community health centers were not told of the plans in advance.

Kalihi-Palama Health Center Director Emmanuel Kintu joined the tour on Tuesday and stated his initial concerns about such a temporary service for patients who need long-term support and wraparound services for their chronic conditions, as well as support in accessing public services.

“When I first heard about this I was really concerned that the community did not have the opportunity to sit down and look at the need,” he told Green and Ireland.

But now, Kintu says, he sees it as an opportunity.

“I can say little to nothing that they’ll be offering is what we don’t already offer,” Kintu told Civil Beat after the tour. “But in this case, there is the fact that there are people who are unemployed and uninsured who have never been to a community health center.

“If there is a way in which this clinic can help to link some of those people to the community health centers, they will have provided a service. That’s where I think there might be something here that might be really useful.”

Dr. David Derauf, who leads Kokua Kalihi Valley Comprehensive Family Services, added, “You might think I’m just going to jump in here and take care of rashes, runny noses and urinary tract infections.

“But in fact this same community, as we know, often times suffers from chronic medical conditions that need sustained long-term relationship building and access to medications, healthy foods and safe places to live.”

He said to the extent that the temporary clinic can connect people to ongoing care systems, that would be a positive thing. But the existing clinics would like to be “deeply involved in” the details of how that will work.

Ireland and Green recognized the concern and said Aloha Free Clinic will readily make patient referrals to the neighboring clinics where they may fit.

“The goal will be to fortify their business model and strengthen it, because right now as we saw, there’s loads of people coming into Medicaid,” Green said.

They also plan to have a Med-QUEST enrollment officer to help people determine if patients are eligible for federally subsidized insurance. According to Green, the Hawaii Department of Human Services has identified one or two enrollment officers who would like to volunteer.

“If people call in, and it makes more sense for us to get them immediately into a community health center, we want to facilitate that,” Ireland said. “But we also think it’s important to at least initially minimize the cost for people.”