Neighbors being neighborly to neighbors.
GROWING HEALTH IN KALIHI VALLEY
1972 — 2015
CONTENTS A Message from the Executive Director Our Mission Our Patients 2014 Program Accomplishments Financial Summary Board of Directors Services We Provide How You Can Help
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GROWING HEALTH IN KALIHI VALLEY
Kōkua Kalihi Valley Comprehensive Family Services
Awards & Recognitions
Aloha Kākou,
Looking back on our work spanning over four decades, we at Kōkua Kalihi Valley (KKV) are most proud of the incredible efforts of our staff and our community to persevere, despite enormous challenges, to build a healthier Kalihi together. These efforts have produced remarkable results in the lives of those we serve. We are happy to share some of the accomplishments made possible by the kōkua of many hearts and hands — our dedicated staff and board, ever-ready volunteers, fellow service providers, our funding partners, and individual donors who share our commitment and vision. Last year, KKV significantly expanded the scope and reach of our services. We integrated our primary care, behavioral health and social services, and strengthened our collaborative model of care with the University of Hawaiʻi, government agencies, and other community health partners. We also extended the hours of service during which primary care is provided at KKV’s Gulick Elder Center and Ke Ola Hou satellite clinic located at Kūhio Park public housing development. As a result, more services are being provided to more patients in more locations, increasing access to services for families living in our community.
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At KKV, we believe that health is wholeness, and our work continually evolves around this premise. Within the field of public health, our belief finds validation in a growing recognition that socioeconomic factors such as housing, neighborhoods, education and employment all impact individual and community health. We strive to respond to the needs and daily realities faced by Kalihi families through programs that honor the rich cultures of those we serve. We see that in culture and community patients find powerful pathways to reclaim their health. At its core, our work is generational, and even after 43 years of serving our community, it has only just begun. We celebrate the fact that as a center for community health, we can and do help create the conditions where residents can connect with their cultures, with one another, with their land. We are honored to serve in a place where neighbors can share our struggles, our stories, and help one another...where our community can thrive.
• KKV was recognized as a health quality leader by the U.S. Department of Health and Human Services for our “high quality, comprehensive primary and preventive health care provided to patients who need it most.” • The City & County of Honolulu presented KKV’s Elder Care Program with an Honorary Certificate for “outstanding efforts in maintaining healthy, happy and active kūpuna.” • Nā Lima Kōkua Award - The Hawaiʻi Pacific Gerontological Society honored Elder Care Director Merlita Compton for her outstanding contributions benefiting minority older adults and promoting healthy aging in our multicultural community. • Weinberg AIM for Excellence Award – The Harry & Jeanette Weinberg Foundation recognized KKV’s efforts in developing opportunities uplifting the lives of Kalihi women through sewing.
Mahalo for your support!
• 2014 Medical Legal Partnership Award – Our collaboration with the University of Hawai‘i William S. Richardson School of Law was one of two sites selected among 230 sites across 34 states.
David Derauf, MD, MPH Executive Director
• 2014 Psychologically Healthy Workplace Award – KKV’s commitment to fostering psychological health in the workplace was recognized by the Hawai‘i Psychological Association.
our mission
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OUR ROOTS
Together we work toward healing, reconciliation, and the alleviation of suffering in Kalihi Valley by serving communities, families and individuals through strong relationships that honor culture and foster health and harmony.
KKV WAS FOUNDED by community leaders in 1972, in response to the absence of accessible and appropriate health care services for Kalihi Valley, a predominantly low-income, Asian and Pacific Islander immigrant community. KKV’s original staff consisted of one coordinator and four outreach workers who combed the valley connecting residents in need with needed services, following our motto, “Neighbors being neighborly to neighbors.” Services were first provided out of two renovated military trailers in the back parking lot of Kalihi Baptist Church. Today, KKV provides Kalihi residents with comprehensive primary medical care, dental, behavioral health care services, legal advice, disease reduction programs, elderly exercise programs, youth programs, community advocacy and many other social services. Our 180 culturally diverse staff serve residents out of nine locations throughout the valley — including two of the largest public housing communities in the State of Hawai‘i, two health clinics, a Wellness Center, an Elder Center, and 100 acres of leased State land at the back of Kalihi Valley.
THE COMMUNITY WE SERVE
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our patients
KALIHI VALLEY is a densely populated community that is rich with cultural wisdom, but rife with socioeconomic inequity. As the first home to many newly arriving in Hawaiʻi, Kalihi Valley has the largest number of new immigrants, migrants and public housing residents in Hawaiʻi. Four public housing developments are located here, including the state’s largest. Nearly 40% of Kalihi Valley’s 35,000 residents come from countries outside of Hawaiʻi, bringing with them rich cultural heritage and traditions. Honoring these roots, about half of our staff are bilingual and trained to interpret in more than 20 languages. The patients we serve struggle with a wide array of socioeconomic disadvantages including poverty, cultural and language barriers navigating a foreign social system, lack of access to health insurance and/or lack of money to pay for out of pocket costs, unemployment and discrimination.
KKV Patient Profile Among 10,084 patients served in 2014:
70%
96% were Asian/Pacific Islander
50%
91% lived at 0-100% POVERTY
40%
18%
Private Insurance
17%
5% ica re
e te iva Pr
ed M
ica ed M
In
id
su r
/Q u
an c
es
t
d
0% re
11% are SENIORS (65+)
10%
su
42% are CHILDREN and YOUTH (0-19)
Medicaid/Quest
20%
in
59% were WOMEN
Uninsured
60%
30%
Un
31% lived in PUBLIC HOUSING
Coverage
60%
Medicare
our accomplishments
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OUR ACCOMPLISHMENTS
Our founding motto that we strive to live up to every day is “Neighbors being neighborly to neighbors.”
At KKV, we understand health as wholeness. KKV supports not only medical definitions of health but social, spiritual and indigenous expressions of a healthy, interdependent and just community. Our work goes beyond the exam room to address the root causes of health inequity. Our staff and programs strive to foster health in the broadest sense — physical, mental, emotional, economic and spiritual. We value joy, culture, respect and coming together as a community. While KKV has grown over the years, we remain closely connected to our diverse and vibrant communty. Hiring practices that value language and culture skills, as well as residency in the community contribute to our success in effectively serving our patients. With 46% of our patients
best served in a language other than English, KKV provides interpreter, transportation and legal services to help to bridge barriers of culture, language, poverty and transportation, enabling residents to access the health care they need. Caring for our community means providing high quality health care services that meet residents’ needs across the whole lifespan, from before conception to elderhood. In 2014, KKV significantly expanded the primary care services provided to our community. KKV also provides students pursuing diverse fields — medical, nursing, dental, social work, aging, law — with valuable grounding in public health and community health perspectives, to instill these future professionals with a passion for working in underserved communities.
PRIMARY CARE
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Last year, KKV:
To meet Kalihi Valley’s growing need for dental services, KKV’s 13-year partnership with the Lutheran Medical Center provides advanced training to general and pediatric dentistry students. This program greatly expands KKV’s capacity to provide dental care to our community while also addressing the shortage of dentists working with low-income populations in Hawaiʻi. The KKV-based pediatric program has increased the dental services available to high-risk Asian/ Pacific Islander populations, as well as to developmentallydisabled populations in Kalihi and across the State. One of our vans was converted to become O‘ahu’s first “dental clinic on wheels,” increasing our capacity to provide Kalihi students with preventive care, such as dental exams and cleaning, fluoride treatment, dental sealants, oral hygiene education and referrals.
•
Served 10,084 patients in 22 languages.
•
Provided free transportation to patients coming to KKV clinics, or to attend outside specialist doctor appointments.
•
Expanded the hours and scope of services provided at Gulick Elder Center and Ke Ola Hou clinic at Kūhio Park public housing.
•
Integrated Behavioral Health services within primary care services provided to patients.
•
Trained 5 general and pediatric dentistry residents in community-based dental care.
•
Trained 3 obstetrics and gynecology (OB-GYN) and 4 pediatric residents.
•
Provided dental services to 5,527 patients, including 3,000 children.
•
Launched Oahu’s first mobile dental clinic, providing preventive oral care on campus at 8 Kalihi schools.
strengthening families
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MATERNAL AND CHILD HEALTH
KKV believes that a healthy community requires healthy, strong and empowered women and families. Our holistic and culturally-based Maternal and Child Health program made KKV one of seven National Community Centers of Excellence in Women’s Health in the U.S. from 2002-2005. KKV integrates family planning, perinatal, parenting and nutrition programs with pediatric clinic services to allow women to address a full range of needs during any one visit or contact. KKV seeks to strengthen families and prevent child abuse by integrating parenting support into clinical services and offering activities that promote nurturing and attachment, while building parental skills and confidence: Cross-Cultural Childbirth classes, parent support groups, ‘Ohana Play & Learn activities that engage young children and their parents while waiting for appointments, and group medical visits for prenatal and pediatric care. Nearly all MCH patients live under 100% of the poverty level. Housing, job, food insecurity, chronic health issues and other problems pose stressful burdens that greatly affect families’ health and well-being.
LEGAL ADVOCACY / SELF-SUFFICIENCY
Families are able to access immediate help for medical care and legal care in a “one-stop” setting. By engaging in “preventive law” alongside “preventive medicine,” MLPC attorneys and law students engage in basic legal advocacy before an issue becomes a more serious problem. After resolving a rent dispute in public housing, one father told MLPC, “Without you, my family would be homeless.” Believing that economic development and self-sufficiency are vital factors in both personal and community health, KKV established the Women’s Sewing Program in 2008. Providing introductory and advanced training in sewing, “Seams Wonderful” has increased vocational opportunities while also promoting a sense of belonging, community and self-empowerment for over Kalihi’s low-income women. Looking ahead, KKV hopes to support the Seams Wonderful women in developing and marketing their own product line.
Provided perinatal care to 251 women, family planning services to 849 women,and over 2,600 parenting program encounters.
•
Provided 1,500 women with food nutrition coupons and information.
•
Provided reproductive health education in schools, public housing and community settings.
– Olivia Kovac
Peer Instructor with Seams Wonderful microenterprise project.
Chuukese women engaged in KKV diabetes prevention program.
Last year, KKV: •
“I learned a lot of new skills, how to sew bags, shirts, shorts and pants. I want to learn more because my hope is to start my own business. Also, I want to help other Chuukese women to learn, to show what Chuukese women can do here in Hawai’i.”
. . . uplifting lives
Through the Medical-Legal Partnership for Children in Hawai’i (MLPC), an innovative collaboration between the William S. Richardson School of Law (University of Hawai’i) and KKV, doctors and lawyers work together to address factors that impact child and family well-being.
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•
Provided English language and sewing classes that helped over 130 women to reach for self-sufficiency.
•
Established a sewing machine revolving loan program; 8 machines distributed were paid for and are being used.
•
Provided legal advocacy services for families, in over 275 client encounters at KKV and Kūhio Park public housing.
caring for the ‘āina
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LAND-BASED PROGRAMS
KKV recognizes and respects the ‘āina, the land that feeds us, as a community member. In 2004, KKV secured a 20-year lease to State conservation land deep in Kalihi Valley. Since then, KKV has been stewarding and sustainably developing these 100 acres as a welcoming refuge in the densely populated urban neighborhood. Dedicated to cultural education and community transformation, this land was named Ho‘oulu ‘Āina, meaning “to grow the land” and “to grow because of the land.” Ho‘oulu ‘Āina fosters the reciprocal healing of people and the land. Residents and visitors alike join in year-round opportunities for native reforestation, organic gardening, “green job” training, environmental education and the preservation of cultural knowledge and practices. While working to care for the land, the land in turn nurtures them, as the health of the land and the people are one. Kalihi Valley’s Native Hawaiian and Pacific Islander residents face numerous barriers to good health, resulting in significant health disparities, including high rates of overweight and obesity (90%) and diabetes (19%) among our patients. Nearly one third of Kalihi households struggle with food insecurity. KKV’s Returning to Our Roots program is an ʻāina-to-table initiative that aims to improve residents’ health through the growing, preparing and sharing of nutritious, culturally relevant food. Roots is working with residents to revitalize Kalihi’s food system network and expand access to healthy food—organizing farmer’s markets and planting gardens at KKV program sites, public housing, schools, back yards and patios—to increase residents’ food security, healthy food production and consumption, and strengthen community. KKV’s innovative programs seek to improve overall neighborhood health and promote “health selfdetermination” to balance the medical model where doctors are the experts and patients just listen.
HO‘OULU ‘ĀINA / ROOTS
– Reychelle Ayau-Odom, Ehuola ‘Ohana Health Project participant.
Last year, KKV: •
Trained 8 youth interns in natural resource management and cultural stewardship, and brought together over 10,000 volunteers of all ages together to restore health to the land and build community.
•
Grew 12,000 pounds of organic produce, sending bags of fresh vegetables home with over 100 community members each month.
•
Supported expansion of Kalihi’s healthy food system, planting organic gardens at two schools and three community centers.
•
Established a new “Crop Shop” Farmers Market and Community Garden at Kūhio Park Terrace, bringing local produce to this food-barren community.
•
Launched a successful EBT “double bucks” incentive program at Kalihi farmers markets, increasing monthly consumption of fresh produce by 30%.
•
Established our commercial kitchen and Roots Cafe as a gathering space linking ‘āina to table and residents to one another.
grow, prepare & share
“As parents, we were overjoyed to be so blessed in having three generations, with kūpuna from both sides of the ‘ohana, eat, learn, and nanea (enjoy our time) together... If we all eat healthy and remain active, it will help us be able to enjoy longer, happier lives together.”
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YOUTH SERVICES
empowering youth
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“I used to make trouble at school and now I came more better ‘cause I wanted to make my life more better—instead of making bad choices.” – 14-year old boy active in KVIBE program. KVIBE youth were the driving force behind making a main Kalihi thoroughfare a Complete Street safer for everyone — for pedestrians, bicyclists and motorists alike (above right).
For over two decades, KKV has supported Kalihi youth in attaining better health and realizing their full potential. Working to build a resilient sense of identity and essential core skills among Kalihi children, our Youth Services offer positive alternatives to gang involvement, substance abuse and other high-risk behaviors in a safe yet challenging environment. Our youth programs include the Kalihi Valley Instructional Bicycling Exchange (KVIBE), Tennis Team, and Pacific Voices, a cultural arts and sports program based at
EMPOWERING YOUTH
Kūhio Park public housing community. With rates of unemployment as high as 23% and one in five adults living in public housing having less than a 9th grade education, youth growing up in this community have few examples to help them dream of a different future. Through tennis, bicycling, dancing, and gardening, KKV provides safe spaces and opportunities for children and youth (ages 8-18), who as a whole have few options for positive engagement during after-school hours. Caring KKV staff mentor and guide youth in building their skills, experience and self-esteem, and setting goals for life success. Since 1991, Vailima Watson, an extraordinary coach and mentor (at right), has used the sport of tennis to impact the lives of thousands of Kalihi Valley youth. Approximately 85% of team members are girls and young women navigating the difficult journey of finding their place and emerging as leaders. KKV teams compete in USTA league matches each Spring and Fall—and do well, several times qualifying for regional championships. Since 2007, over 90% of tennis program graduates have gone on to college. Youth are engaged in activities promoting healthy lifestyle choices, leadership, life skills, nutrition, and health education throughout the year, complementing physical activities. Finally, youth are instilled with a strong sense of belonging through community service.
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Last year, KKV: •
Engaged over 3,000 Kalihi youth in positive youth development activities.
•
Celebrated the graduation of 15 high school senior participants of KKV’s Tennis Program.
•
Launched a summer camp at Ho‘oulu ‘Āina and the Pacific Voices program.
•
Piloted financial literacy training and career planning for KVIBE youth.
•
Recycled over 3 tons of metal and restored hundreds of used bikes through our KVIBE earn-a-bike program.
•
Provided hula classes and homework tutoring for young children at KKV’s after-school drop-in center.
•
Supported youth advocacy resulting in Kamehameha IV Road being designated a shared-use Complete Street.
ELDER CARE
caring for our kūpuna
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“Without this program, I’d be
gone to heaven by now for sure. Coming to KKV is my medicine. When I don’t come I don’t feel good. As soon as I walk into the room, I feel full of life again!” — Perpetua Amian Elder Care participant since 2002.
CARING FOR OUR KUPUNA
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KKV supports and empowers Kalihi Valley’s kūpuna (elders) in leading healthy, independent, and meaningful lives. Kalihi Valley elders hold ancestral wisdom that lives within their native languages and cultures. They also have the ability to raise our spirits, and the power to advocate for our community. Their sharing of these gifts and active engagement in the life of their community, in turn, raises their spirits. Our doctors see blood pressures fall and smiles widen. KKV’s Elder Care program provides Kalihi Valley elders with opportunities for physical exercise, socialization and nutritious meals—the top needs identified for elders in a 1999 community-wide assessment. The program’s prevention-focused activities support elders in staying fit and vibrant, and able to age safely in their homes. Working out of two locations — the Gulick Elder Center and the Kūhio Park public housing community— KKV served over 600 elders in 2014. Core services included low-impact exercise; hands-on games and activities; dancing; congregate dining; health education; evidencebased fitness and chronic-disease management classes; health screenings; and case management. In 2014, KKV also offered elders and their families in-home personal care, caregiver respite and caregiver support services, to support families in managing stress and easing the burden of care. Elder Care improves the lives of Kalihi’s seniors and their families by improving elders’ physical fitness and functional abilities, which stabilize health conditions from worsening into debilitating medical problems; decrease the burden of symptoms, hospitalizations and cost of care; and enable seniors to continue living independently in the community. 101 Years Young - In 2014, Nana Perpetua celebrated her 101st birthday with all her Elder Care ‘ohana, including Director Merlita Compton. Today, the Kalihi elder is still smiling, singing and still going strong!
Last year, KKV: •
Provided over 700 community elders with a safe space to gather 5 days a week to dance, exercise, eat, socialize and laugh together.
•
Enabled 98% of elders served to safely age in place with zero falls and 85% fewer unhealthy days.
•
Provided free in-home personal care, homemaker, caregiver respite, chronic disease management and other services to support lowincome elders and caregivers.
•
Provided free transportation to elders and caregivers so that they could participate in exercise programs held weekdays in two locations.
financial summary
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FINANCIAL SUMMARY
REVENUE STATEMENT SOURCES AND USES
STATEMENT OF FINANCIAL POSITION
Revenue Patient Services Revenue 26% 46%
0% 3%
Government Grants & Contracts Contributions In-Kind
25%
Contributed Rent
Assets Current Assets: Cash & Cash Equivalents Certificates of Deposit Accounts Receivable - Net Grants & Contracts Patient Services Revenue Prepaid Expenses & Other Current Assets Total Current Assets Property & Equipment - Net Certificates of Deposit Capitalized Leasehold Interest - Net of Accumulated Amortization Total Assets Liabilities & Net Assets Current Liabilities: Line of Credit Accounts Payable & Accrued Liabilities Accrued Compensation Total Current Liabilities Net Assets: Unrestricted Net Assets: Unrestricted - undesignated Unrestricted - invested in property & equipment Total Unrestricted Net Assets Temporarily Restricted Net Assets Total Net Assets Total Liabilities & Net Assets
STATEMENTS OF ACTIVITIES & FINANCIAL POSITION
*
STATEMENT OF ACTIVITIES *
2014
2013
854,553 323,394
965,713 322,865
842,041 733,295 7,636
723,456 1,058,729 85,292
2,760,919
3,156,055
12,425,969
12,914,890
132,206
131,487
2,250,238
2,342,715
17,569,332
18,545,147
150,000 303,707 612,727 916,434
328,134 599,906 1,078,040
1,261,428
1,300,375
12,425,969 13,687,397 2,965,501 16,652,898
12,914,890 14,215,265 3,251,842 17,467,107
17,569,332
18,545,147
Revenue & Support Patient Services Revenue Government Grants & Contracts Contributions In-Kind Contributed Rent Other Revenue and Support Net Assets Released From Restrictions for Programs Total Revenues and Support: Expenses Program Services: Medical Services Dental Services Social Services Enabling Services Maternal and Child Health Total Program Services Supporting Services: Management & General Fundraising Total Supporting Services Total Expenses Net Assets, Beginning of Year Net Assets, End of Year
2014 5,049,443 2,802,106 349,899 13,248 2,838,981 $(2,124,220)
2013 4,349,962 4,349,962 299,350 13,248 2,119,671 $(1,798,532)
11,053,677
11,132,193
3,921,343 1,690,297 1,515,762 1,022,073 849,074
3,155,715 1,836,957 1,200,574 1,037,467 809,596
8,998,549
8,040,309
2,778,278 91,059 2,869,337
2,670,378 122,340 2,792,718
11,867,886
10,833,027
17,467,107 16,652,898
17,042,558 17,467,107
* KKV undergoes annual single audits by an independent accounting firm. All such audits have resulted in earning KKV the distinction as a low-risk auditee.
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our board and services
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KKV BOARD AND SERVICES WE PROVIDE
“We have innovative programs and the work we’re doing is profound and powerful. At KKV, health means wholeness. Our hearts are in the right place and we work together to bring healing and reconciliation to our community.”
Board of Directors
Services We Provide
President Pua Auyong
• • • • • •
Vice President David Nakamoto Secretary Karen Fox Treasurer Thomas Kusatsu
— Bradley Chun, MD KKV Assistant Clinical Director (and Kalihi-born community member)
Jeffrey Acido Shigeko Bualuay Grace Cobb Edward Kemper Ryan Leong Rickey Murashige Geoffrey Pang
Executive Director
David Derauf, MD, MPH
• • • • • • • • •
Primary Medical Care Dental Services Behavioral Health / Substance Abuse Elder Care Enabling Services Legal Advocacy (Medical-Legal Partnership for Children Hawai‘i) Lei Hipu‘u o Kalihi / Kalihi Calls Maternal and Child Health Nutrition Preventive Health Care Public Housing Ho‘oulu ‘Āina (Kalihi Valley Nature Preserve) Returning to Our Roots Women’s Sewing Program Youth Services
Photo, facing page (inset): “Super Aunty” Merina Sapolu is one of our treasured legacy staff who has served her community for over 40 years. As an outreach worker, she knocked on doors asking residents if they needed assistance. Today, Merina continues to reach out to families, linking them to vital services and resources.
Photo credits: Mahalo to Bren Chun, Leah Friel/Midweek, Ka‘ohua Lucas, Naomi Sodetani, Adam Stoltman, Noe Tanigawa/Hawai‘i Public Radio, and KKV staff.
Kōkua Kalihi Valley • www.kkv.net
Help KKV continue to grow! • Send us a note or story about how your involvement with KKV has touched your life.
• Volunteer your time or skills or make an in-kind contribution.
• Consider a first-time financial gift or an increase in your giving this year.
• Tell one new person about KKV this year and share our stories.
• Donate to KKV’s Endowment Fund or consider a planned gift to sustain KKV into the future.
• Visit a program or kkv.net to learn more about our work.
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GROWING HEALTH IN KALIHI VALLEY
2239 North School Street Honolulu, HI 96819 p. 808.791.9400 • f. 808.848.0979 www.kkv.net KKV is a Hawai‘i-based 501(c)(3) nonprofit and donations are tax deductible.