While the prevalence of Hansen's disease (leprosy) is decreasing in many countries, the countries of Micronesia continue to have the highest rates in the world; FSM had a prevalence rate of 35/10,000 in 1997. A Department of Interior report in 1998 estimated that 6,700 Micronesians, Marshallese, and Palauans were living in Hawaii. Within the last two years, increasing numbers of new Hansen's disease cases have been diagnosed in this population. Active screening of 321 farm workers resulted in the discovery of 16 new patients (5%). Active screening of 183 people attending an ethnic church on Oahu resulted in two new patients. The patients identified were younger and represented an earlier stage of disease than those found through passive surveillance. Finding innovative ways to actively screen high-risk communities will result in early identification and treatment of Hansen's Disease preventing transmission and complications.