For the Southern part of the island there is only one Vet.  Not all Vets take vouchers.  There is a huge problem in Ocean View, but they get very few services from HIHS.  It is hard enough to get people responsible to spay/neuter, but if they have to drive 1.5 hours each way, they are not going to do it.  The animals pay the price.  Clinics need to be performed all over the island.  That is the only way you are going to control the population without killing 15,000 animals a year.  If they go into the communities, they can also do cat sterilization and release programs much easier.  I guess it depends how serious people are about stopping the unnecessary killing of animals.  Change the rules and change the laws.