Why GAO did this study. The estimated 328,000 Native Hawaiians living in the state of Hawaii as of 2022 face significant health disparities compared to other populations in the state. The Native Hawaiian Health Care Systems Program, administered by HRSA, aims to improve Native Hawaiians’ access to disease prevention, health promotion, and primary care services in Hawaii. The systems are part of the broader health care infrastructure in Hawaii, which includes other medical service providers from which Native Hawaiians can seek care. House Report 117-96 includes a provision for GAO to review health care services available to Native Hawaiians living in Hawaii. This report describes (1) the provision of services and other characteristics of the Native Hawaiian Health Care Systems; (2) how Native Hawaiian Health Care Systems Program funds are awarded; and (3) how HRSA oversees the program. GAO reviewed reports that the systems submitted to HRSA, which include data on the services provided, patients served, and revenue received in 2022. GAO also reviewed agency documents and program funding data from fiscal years 2018 through 2022 to cover at least one full (3-year) grant cycle and include the most recent fiscal year data available at the time of the review. In addition, GAO interviewed HRSA officials and officials from each of the five systems and Papa Ola Lokahi.
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