• Follow on Facebook

  • Begins Thursday!

    2016 Big Island Film Festival
  • Breaking News

  • World Botanical Garden
  • Dolphin Quest Waikoloa
  • Discount Hawaii Car Rental
  • RSS Mayor Kenoi’s Blog

  • Say When

    May 2016
    S M T W T F S
    « Apr    
    1234567
    891011121314
    15161718192021
    22232425262728
    293031  
  • When

  • RSS Pulpconnection

  • Subscribe to Blog via Email

    Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Use of Video Decision Aids Increases Advance Care Planning in Hilo

Pilot study part of statewide program to improve end-of-life care

A program encouraging physicians and other providers to discuss with patients their preferences regarding end-of-life care significantly increased the documented incidence of such conversations and the number of patients with late-stage disease who were discharged to hospice.

Filling in an advance health care directive

In a Journal of General Internal Medicine paper that has been released online, a team led by Massachusetts General Hospital (MGH) investigators describes the pilot program, which is part of a larger initiative to transform medical care for serious illness in the state of Hawaii. The program included video decision aids in 10 languages and was carried out in the city of Hilo, Hawaii.

“By collaborating with the people of Hawaii and recognizing the diversity of the community, we were able to honor and respect patients’ individual choices when it came to medical care,” says Angelo Volandes, MD, MPH, of the MGH Department of Medicine, lead author of the report. “Doctors are often uncomfortable having end-of-life conversations and have rarely been trained in advance care planning. The videos can be a valuable supplement to, not a replacement for, the doctor-patient relationship.”

Advance care planning – conversations with patients regarding the type of care they would like to receive, or not receive, if they become seriously or terminally ill and cannot speak for themselves – has been the subject of considerable attention in recent years. Earlier this year Medicare began reimbursing clinicians for advance care planning discussions with patients, and the process was mentioned in, but not funded by, the Affordable Care Act. But there have been few studies examining the impact of advance care planning efforts on medical documentation of such conversations, on the care actually delivered or on costs.

A broad coalition of stakeholders, led by Hawaii Medical Service Association (HMSA), an independent Blue Cross/Blue Shield licensee, has been working since 2012 to improve advance care planning rates statewide through innovative collaborations, including implementation of educational videos. Hilo Medical Center, a 276-bed hospital, was the first in the state to make advance care planning the standard of care for patients, and the JGIM paper reports on the first 21 months of the program’s implementation in the city of more than 43,000.

Beginning in early 2013, Hilo Medical Center clinicians, Hospice of Hilo staff and 30 primary care physicians in the city were offered a one- to four-hour training program and access to advance care planning video decision aids in English, Japanese, Cantonese, Vietnamese, Samoan, Korean, Ilocano, Tagalog, Spanish and Marshallese. Less than 10 minutes long, the videos are designed to be accessible to general audiences and include broad questions that patients should consider regarding their individual preferences and how they could affect future medical interventions. How or whether providers used the videos in subsequent advance care planning discussions was neither required nor tracked.

The primary study outcome for Hilo Medical Center was any change in the rate at which advance care planning conversations were documented in medical records of patients with late-stage disease. For outpatient care, any difference between the rates of advance care planning in Hilo and in a control group of similar Hawaii communities was analyzed. The researchers also compared the number of hospice admissions for late-stage patients before and after the program was implemented – compared with the control communities – as well as the rate of in-hospital deaths. Any impact on health costs was determined by analyzing HMSA claims data.

Prior to implementation of the training program, the rate of advance care planning documentation for late-stage patients at Hilo Medical Center was 3.2 percent, but during the 21 months after training was offered, the rate increased to almost 40 percent. Among almost 4,000 HMSA patients over age 75 in Hilo who saw a primary care physician during 2014, the year following primary care physician training, 37 percent received advance care planning, compared with 25.6 percent in the control communities.

The percentage of late-stage Hilo Medical Center patients who were discharged to hospice, which was 5.7 percent before the training, rose to 13.8 percent. Overall Hospice of Hilo admissions increased 28 percent in 2013 and 51 percent in 2014, compared with 2012. While average HMSA reimbursements for care during the last month of life increased from 2012 to 2013 in both Hilo and the control area, the increase for Hilo was only 5.5 percent, compared with more than 22 percent in the control area, reflecting an average per-patient savings of $3,458 for the last month of life.

Although this study was conducted in a relatively small region, the authors note that the diversity of the Hawaiian population may offset that limitation. The program has now expanded to all hospitals in Hawaii, 10 hospices, military facilities and many other providers; and Volandes expresses the hope that this study’s results will renew calls for continuing innovation in advance care planning, including certification and reimbursement for patient decision aids.

“Advance care planning videos and other decision aids offer cost-efficient and broadly applicable methods of placing patients at the center of their care,” he says. “They also allow doctors and other health providers to have critical conversations with patients that were rarely encouraged during their training. Making these decision aids widely available could be a real health care game-changer.”

Planned Parenthood Launches Online Access to Birth Control in Hawaii

Today, Planned Parenthood of the Great Northwest and the Hawaiian Islands (PPGNHI) officially announced the launch of Planned Parenthood Care in Hawaii.

Birth Control ApThe app allows people to talk to a Planned Parenthood provider online and face-to-face through a secure video consultation system, and then receive birth control in the mail. Consultation for urinary tract infections is also available. This mobile app will bring reproductive health care services directly to women and men across the state.

“Planned Parenthood Care provides the same high-quality health care people have trusted Planned Parenthood to provide in Hawaii for 50 years.  What’s new is now our clinicians can literally meet people where they are—wherever they are—to get them the care they need,” said Chris Charbonneau, CEO of PPGNHI. “Telehealth is an incredible tool in expanding access to care. We know that life gets busy and that is why we are proud to lead with this technology that allows us to deliver health care and information to people who need it, regardless of their location.”

PPGNHI launched Planned Parenthood Care in Washington state in 2014 and in both Alaska and Idaho in 2015. Planned Parenthood Care™ builds upon decades of innovative health care and information delivery from Planned Parenthood and its affiliates nationwide. Planned Parenthood’s websites provide accurate, nonjudgmental information about contraception, sex, and reproductive health to 60 million visitors each year. Planned Parenthood’s Chat/Text program, which has served nearly 577,000 users so far, has been successful in reducing worry around sexual health issues by connecting youth to a real person through their computer or phone in real time.

“Hawaii is uniquely positioned to benefit from this service given the geography of this great state and the limited access to local health centers,” said Sonia Blackiston, Hawaii Education Manager at PPGNHI. “This app allows people to consult with a physician in real time via video on their device and determine what makes the most sense for them. It provides convenient access to Planned Parenthood’s trusted, high quality health care.”

The app is available at the iOS app store or from Google Play, but at present health care can only be delivered through Planned Parenthood Care to residents of Hawaii, Alaska, Idaho, Washington, and Minnesota.

New Imported Case of Dengue Fever Reported on the Big Island of Hawaii

This is a Civil Defense Message. This is a dengue information update for Friday, May 20, 2016.

Mosquito BiteThe State Department of Health has identified a single imported case of dengue on Hawaii Island. Vector control crews have treated the person’s residence and adjacent properties today.

Again, this is a single imported case. There is no evidence to indicate a local transmission has occurred. There have been no reported dengue cases attributed to local transmission since March. Imported cases occur from time to time and remind all of us to always be vigilant and fight the bite.

As the summer approaches and more travel is anticipated, the public is reminded that the most effective method to reduce the spread of dengue or other mosquito borne illnesses is for everyone to avoid and prevent mosquito bites. Fight The Bite by wearing clothing that minimizes exposed skin, using mosquito repellent, and avoiding activities in areas of high mosquito concentration during the early morning and late afternoon periods when mosquito activity is greatest. If feeling ill and unsure if you may have dengue, remain indoors to avoid getting bitten and infecting mosquitoes and contact your health care provider.

For information on dengue, visit health.hawaii.gov or call the Department of Health at 974-6001.

Hawaii Department of Health Issues Medical Marijuana Dispensary Licenses – Posts Merit-Based Scores for Licensees

The Hawaii State Department of Health (DOH) began issuing licenses today for Medical Marijuana Dispensaries.

Medical MarijuanaThe eight selected licensees have completed the full payment of licensing fees and were given the option of picking up their license or having it delivered by certified mail.

Licensees were selected based on the scoring of 13 merit criteria. The total scores used in the selection of each licensee are provided below and will be posted today at health.hawaii.gov/medicalmarijuanadispensary/latest-updates-and-news/.

City & County of Honolulu Score
Aloha Green Holdings Inc. 475
Manoa Botanicals LLC 470
TCG Retro Market 1, LLC dba Cure Oahu 470
Hawaii County
Hawaiian Ethos LLC 480
Lau Ola LLC 471.5
Maui County
Maui Wellness Group, LLC 510
Pono Life Sciences Maui, LLC 470
Kauai County
Green Aloha, Ltd. 433

DOH is in the process of notifying in writing all unselected applicants of their total score and ranking for their respective group. After all unselected applicants confirm receipt of their written notification from the department, the total scores of all applicants will be posted on the medical marijuana dispensary website.

For more information and updates from the Medical Marijuana Dispensary Program go to health.hawaii.gov/medicalmarijuanadispensary/ and select “News & Updates.” Questions about the Medical Marijuana Dispensary Programs may be emailed to medmarijuana.dispensary@doh.hawaii.gov.

First Annual Waipi’o Kalo Festival Coming Up

The first annual Waipi‘o Kalo Festival will take place on Saturday, June 4, 2016, 9 a.m.-4 p.m. at Koa‘ekea, near the Waipi‘o Valley Lookout. Presented by the grassroots state-recognized nonprofit, Hā Ola O Waipi‘o Valley, the free event is a tribute to kalo (taro), Waipi’o, and the kupuna and others who live, work, and find inspiration there.

Waipio Valley Taro Festival

The Kalo Festival is designed to be educational as well as entertaining, and will include much that Hawai‘i Island loves: live music and hula, craft vendors, games and great food. In addition, there will be displays and talk story sessions about the region’s rich history, and its significance in Hawaiian culture.

Central to Hawaiian culture, kalo is considered the “older brother” of all Hawaiians. Legend says that a child named Hāloa was born to deities Wakea and Ho‘ohōkūkalani. Hāloa died at birth and was buried in the garden, where soon shoots of kalo plants began to grow. Their next child was named Hāloa in his honor, and to forever acknowledge the familial tie between people and nature.

Waipi‘o was home to many deities and notable ali‘i, and at its peak, the thriving agricultural community may have supported a population as high as 10,000 people. Waipi‘o is also a storied wahi pana, sacred place, site of seven important heiau (temples) including  Pāka‘alana, a pu‘uhonua, “place of refuge.”

The Kalo Festival is designed to be educational as well as entertaining, and will include much that Hawai‘i Island loves: live music and hula, craft vendors, games and great food. In addition, there will be displays and talk story sessions about the region’s rich history, and its significance in Hawaiian culture.

Every aspect of the Kalo Festival is connected to the Valley in some way. Presenters may come from multigenerational kalo farmers on ancestral lands; cultural practitioners appreciate its vast resources; artists and musicians, even chefs, are inspired by Waipi‘o for their creations.

Hands-on ku‘i kalo gives festival-goers a feel for the art of poi pounding, and other cultural activities like lei-making, lau hala and lau niu weaving are available. More competitive attendees can enter the Taro Team Relay, a fun obstacle course with a simulation of a typical taro farmer’s jobs.

On the scholarly side, agricultural exhibits and demonstrations offer a chance to learn about varieties of kalo and how they are cultivated, its preparation as food and nutritional/health benefits. Displays from USDA, DLNR, Natural Resources Conservation Service (NRCS), North Hawaii Education and Research Center (NHERC) and others cover a broad range of related topics, from healthy soils, to agro-forestry, the importance of water, and more.

For the foodies, a Kalo Cookoff offers prizes to home chefs who bring their best kalo pupu, main dish or dessert for a friendly competition with prizes. Any part of the kalo plant may be used in the dish. (To enter, please bring at least five portions for judges to taste. Kalo must be an ingredient.) Kalo Contest Winners will be announced after the Relay, and receive a Makana Basket and a Gift Certificate.

In addition, homestyle Hawaiian plate lunches will be available for sale, with kalua pig, laulau, squid lū‘au, chicken long rice, sweet potatoes, fernshoot salad, haupia, kulolo, poke and of course, poi.

Koa‘ekea (the former Rice property is located at 48-5546 Waipi‘o Valley Road, and event parking will be available at Kukuihaele Park, with free shuttles provided. No parking at the Lookout.

The schedule for the day includes:

  • 9 a.m. Gate opens. Opening Pule and Oli at 9:05 a.m.
  • 9:10 a.m. Hālau Na Lei Punahele, Kumu Hula Punahele Andrade
  • 10 a.m. Larry Miller and Jeff Quinn
  • 10:50 a.m. Hālau Kou Lima Nani E, Kumu Hula Iwalani Kalima
  • 11:50 a.m. Sons of Keawe
  • 1-1:50 p.m. Kalo Team Relay/Kalo Cookoff
  • 2 p.m. Rubbah Slippah Productions, Ryan Hiraoka
  • 2:50 p.m. Masoe ‘Ohana
  • 3:50 p.m. Closing Pule and Hawai‘i Aloha

The Kalo Festival is sponsored by the Office of Hawaiian Affairs, the County of Hawai‘i and other generous supporters. Friends of the Future and Pōhāhā I Ka Lani both serve as the fiscal sponsors for this project. For more information about the Kalo Festival, email HaolaoWaipioValley@gmail.com or follow Hā Ola O Waipio Valley on Facebook.

Joint Task Force Established to Combat Rat Lungworm Disease in Hawaii

The Hawaii State Department of Health (DOH) and the East Hawaii Liaison to the Office of the Governor announced today the establishment of a Joint Task Force to assess the threat of rat lungworm disease (Angiostrongyliasis) in Hawaii. The mission of the task force is to share scientific knowledge in the application of diagnostics, treatment, mitigation and public education activities.

rat lungworm

Rat lungworm disease is caused by a nematode, which is a roundworm parasite called Angiostrongylus cantonensis. The parasitic nematode can be passed from the feces of infected rodents to snails, slugs and certain other animals, which become intermediate hosts for the parasite. Humans can become infected when they consume, either intentionally or otherwise, infected raw or undercooked intermediate hosts.

Although rat lungworm has been found throughout the state, Hawaii Island has a majority of the cases. Some infected people don’t show any symptoms or only have mild symptoms. For others, the symptoms can be much more severe, which can include headaches, stiffness of the neck, tingling or painful feelings in the skin or extremities, low-grade fever, nausea, and vomiting. Sometimes, a temporary paralysis of the face may also be present, as well as light sensitivity. This infection can also cause a rare type of meningitis (eosinophilic meningitis).

“Establishing a joint task force with local experts in the medical field and leaders in government will produce a set of best practices that be used to target rat lungworm disease not only on Hawaii Island, but on a statewide scale as well,” said Wil Okabe, East Hawaii Liaison to the Office of the Governor. “There is no specific treatment yet identified for this disease, so finding the best ways to prevent its spread and educate the public is crucial.”

The members of the task force are as follows:

  • Wil Okabe (Facilitator), East Hawaii Governor’s Liaison Office
  • Robert Cowie, Ph.D., Pacific Biosciences Research Center, University of Hawaii at Manoa
  • Robert Hollingsworth, Ph.D., U.S. Department of Agriculture (USDA)
  • Sue Jarvi, Ph.D., School of Pharmacy, University of Hawaii at Hilo
  • Jerry Kahana, Hawaii State Department of Agriculture
  • Kenton Kramer, Ph.D., Department of Tropical Medicine, John A. Burns School of Medicine (JABSOM)
  • John Martell, M.D., Hilo Medical Center
  • Marian Melish, M.D., Pediatric Infectious Disease, Kapiolani Medical Center
  • Donn Mende, Research and Development, County of Hawaii
  • DeWolfe Miller, Ph.D., Tropical Medicine Microbiology and Pharmacology, JABSOM
  • Peter Oshiro, Sanitation Branch, DOH
  • Sarah Park, M.D., F.A.A.P., State Epidemiologist, DOH
  • Joanna Seto, Save Drinking Water Branch, DOH
  • Aaron Ueno, Hawaii District Health Office, DOH
  • Chris Whelen, Ph.D., State Laboratories Division, DOH
  • Jonnie Yates, M.D., Kaiser Permanente

High Rates of Hepatitis C Found Among Hawaii’s Kupuna

Hawaii’s kupuna — baby boomers between the ages of 51 and 71 — are among those most at risk for hepatitis C, which can lead to liver disease or liver cancer. The Hawaii State Department of Health is partnering with CVS Minute Clinics and Hep Free Hawaii to protect kupuna and others by offering convenient hepatitis C point-of-care testing, on an ongoing basis starting on Thursday, May 19, 2016, which is National Hepatitis Testing Day.

clinic locator

All nine CVS Minute Clinics, located within selected Longs Drugs stores on Oahu, will offer a finger-prick test (instead of a blood draw) to check for hepatitis C in persons at risk, especially baby boomers born between 1945 and 1965. Results from the rapid hepatitis C antibody test are available in 20 minutes. This preventive health service is fully covered by most insurance plans with no out-of-pocket costs for members.

Hepatitis C and Liver Cancer

Hawaii is the state with the highest rate of liver cancer in the U.S., and the majority of liver cancer cases in Hawaii are caused by viral hepatitis types B and C. An estimated 23,000 persons in Hawaii are currently living with chronic hepatitis C, which can lead to liver disease and cancer.

Hepatitis C is spread by blood-to-blood exposure (such as sharing injection equipment), but there are also high rates among baby boomers (born 1945-1965), regardless of any known blood exposure. More than one out of four people in Hawaii are baby boomers and should be tested at least once for hepatitis C infection.

Early Detection is Critical
“Most people with hepatitis C don’t know that they have it,” stated Thaddeus Pham, Viral Hepatitis Prevention Coordinator with the Hawaii State Department of Health.  “If undetected, hepatitis C can lead to liver disease, liver cancer, or even death. Since hepatitis C is manageable and, in some cases, even curable, people can prevent liver cancer through early detection. We encourage all baby boomers, as well as other Hawaii residents at risk for hepatitis C, to get tested right away. Getting tested is the first step in liver cancer prevention.”

CVS Minute Clinics are staffed by nurse practitioners who not only can administer the test, but also offer other services such as immunizations and non-urgent medical care. They are also committed to ensuring the patients get connected back their primary care providers. The CVS Minute Clinics are currently at 9 select locations on Oahu.  See http://www.cvs.com/minuteclinic/clinics/Hawaii for exact locations and times.  Appointments are first come, first serve, although you can hold a place in line using the Minute Clinic location website.

Partnering with Community

“We’re partnering with local CVS Minute Clinics because we recognize the increasing importance of non-traditional healthcare delivery models,” Pham said. “Many of us often go to our local pharmacy or drug store more often than we go to our doctor. It’s important to use every opportunity to increase awareness and screening for our ohana. Ultimately, it doesn’t matter where you go, as long as you get tested to prevent liver disease and cancer.”

For list of participating sites, go to http://www.cvs.com/minuteclinic/clinics/Hawaii or www.hepfreehawaii.org.

Commentary on HB1072: “This Deserves a More Transparent Process”

It is alarming the House chose not to allow this measure HB1072 to come to a vote while there is so much support from Senators, state agencies, mental health consumers and a wide swath of the community. This deserves a more transparent process.

Click to view status of bill

Click to view status of bill

The issue has been thoroughly vetted to address a mental health crisis occurring in our rural communities. We’ve spent almost ten years on this, gathering support that is now overwhelming, from even the Department of Health. The only opposition was the medical community that offered no solutions and has failed to address this for decades. This is a sad day for consumers, indeed.

The level of denial of how bad Hawaii’s mental health gaps are is evidenced when our legislators are influenced by powerful lobbyists while so many of our residents are suffering from mental illness and can’t access care.

Are we being forced to debate for another year whether highly trained psychologists should have the ability to help these patients with medication needs, even though there’s a serious shortage of psychiatrists, and many of those won’t see the neediest patients?

What we saw today is an insult to our legislative institution; elected officials have failed to live up to the standards that are set for public servants, they have allowed the institution to be used by the rich and powerful to the detriment of the hundreds of consumers of mental health services who asked for their help.

The public needs to demand that individuals who occupy seats in the Capitol building, do so with integrity and courage. These were absent today; it is a shameful and cowardly way for legislation to be killed.

Alex Santiago, Hawaii Psychological Association

Big Island of Hawaii 10 Days of Free Health Care – Tropic Care 2016

The Big Island of Hawaii will have 10 days of free health care as a result of Tropic Care 2016.

The Oahu-based 1984th United States Army Hospital will conduct a two-week Innovative Readiness Training mission providing medical care to under served communities of Hawaii.

Screenings will be held in Pahala, Hawaii Ocean View Estates and Keaau.  See flyer below for times and dates.

tropic care 2016

Working closely with the Department of Health, State of Hawaii, and other private corporations, the 1984th USAH, along with other military units, are proud to serve the people in the community.

Thanks to the support of The US military, Hawaii State and county plus many non-profits and volunteers for making Tropic Care 2016 possible.

Hawaii Department of Education to Expand Free Meal Program to 30 Schools on Six Islands

This upcoming school year, the Hawaii State Department of Education (HIDOE) will expand a U.S. Department of Agriculture (USDA) free meal program, called the Community Eligibility Provision (CEP), from seven public schools to 30 across the state. 

School Lunches

The CEP program allows a school district, a group of schools or a single school to serve free meals to all students even if they do not qualify for free or reduced-priced lunch reimbursements.

“We are pleased to be able to expand this program to more schools and include nearly every island with free meals,”stated Superintendent Kathryn Matayoshi. “We’ve heard from parents in this year’s pilot project who say the program was a tremendous help for their families.”

The 23 additional schools being added to the program in school year 2016-17 are:

Kauai:

  • Kekaha Elementary

Hawaii Island:

  • Kau High & Pahala Elementary
  • Keaau Elementary
  • Keaau High
  • Keaau Middle
  • Keonepoko Elementary
  • Naalehu Elementary
  • Pahoa Elementary
  • Pahoa High

Maui:

  • Hana High & Elementary

Lanai:

  • Lanai High & Elementary

Oahu:

  • Leihoku Elementary
  • Maili Elementary
  • Makaha Elementary
  • Nanaikapono Elementary
  • Nanakuli Elementary
  • Nanakuli High & Intermediate
  • Olomana School
  • Pope Elementary
  • Waianae Elementary
  • Waianae High
  • Waianae Middle
  • Waimanalo Elementary & Intermediate

The seven schools in the pilot program will continue participating next year, including:

  • Kaunakakai Elementary School, Molokai
  • Kilohana Elementary School, Molokai
  • Maunaloa Elementary School, Molokai
  • Molokai Middle School, Molokai
  • Molokai High School, Molokai
  • Mountain View Elementary School, Hawaii Island
  • Linapuni Elementary School, Oahu

To qualify for the CEP program, a district, grouping or school must have a minimum of 40 percent or more of its students eligible for free or reduced-price meals through the National School Lunch Program.

Currently HIDOE pays an average of $5.50 a meal (including food costs, labor, utilities, etc.). The USDA reimburses the state $3.85 for students who qualify for a free meal and $0.40 for those paying for a meal. HIDOE charges $2.50 for elementary school meals for a total of $2.90 in recouped cost for the state. 

Under the program all students in the CEP school would qualify for the higher $3.85 reimbursement. While the seven schools will no longer be collecting meal monies and ensuring accounts have sufficient funds, families will be required to provide information for data collection.  

“Last year, we were able to launch this pilot project at seven schools to establish its impacts on finances and staffing,”said Assistant Superintendent Dann Carlson, Office of School Facilities and Support Services. “The response was positive and we are happy that this year we will be able to expand the program to all counties and include several new whole school complexes. This USDA program allows us to feed more students, for free, and do so in a way that does not increase the cost to the state.”

For more information about the USDA CEP program visit: http://1.usa.gov/1iP9FQI.  For details on HIDOE’s CEP pilot program, visit http://bit.ly/1Kh8SL1

HIDOE’s School Food Services Branch has a website that will provide families at schools that are not in the CEP program with the option to submit applications for Free and Reduced-Price Meal Benefits online. For more information visit http://bit.ly/1VX1OID.

Hirono, Ige, Public Health, and Emergency Response Experts Raise Awareness, Call for Funding To Fight Zika

Senator Mazie K. Hirono, Governor David Ige, Hawaii Director of Health Dr. Virginia Pressler, State Administrator of Emergency Management Vern Miyagi, Healthcare Association of Hawaii emergency responders, and Dr. Elliot Parks, CEO of Hawaii Biotech today called for increased public awareness and additional federal resources to prepare for and fight the Zika virus in Hawaii and across the country. Senator Hirono and Governor Ige also got a firsthand look at Hawaii Biotech’s work to develop a Zika vaccine.

Senator Hirono and Governor Ige get a firsthand look at Hawaii Biotech’s work in developing a Zika virus vaccine.

Senator Hirono and Governor Ige get a firsthand look at Hawaii Biotech’s work in developing a Zika virus vaccine.

“As Hawaii continues to recover from the recent dengue fever outbreak, we must act before the Zika virus poses a major threat to Hawaii families,” said Senator Hirono. “Bringing together Governor Ige and Zika experts today underscored that we must ensure first responders, state and county governments, and pioneering scientists like Dr. Parks have the necessary resources to face Zika head on. Stopping a widespread U.S. Zika outbreak requires a comprehensive approach and that’s why I’ll continue to push for action on the President’s emergency funding request to fund vector control, education programs, and vaccine development in Hawaii.”

“We all have a stake in preventing the Zika virus and other mosquito borne illnesses from taking hold in Hawaii. We must continue our collaboration and coordinated statewide fight against these illnesses, and with much needed support from the federal government, we will work to reduce the risks here in Hawaii and across the country,” said Governor David Ige.

“Although Zika is not currently circulating in Hawaii and there have been no locally-acquired cases, the mosquitoes that can transmit Zika – the same species that transmit dengue fever and chikungunya – are found in Hawaii, so the virus could be brought into our state by an infected traveler if precautions are not taken,” said Health Director Dr. Virginia Pressler, Hawaii State Department of Health. “All of the cases identified here have been travel-related and infected while outside of Hawaii, and the risk of imported cases increases as we head into warmer summer months and peak travel season. It is crucial for infected individuals to avoid mosquito exposure for three weeks upon their return home. The Department of Health aggressively investigates all reported cases of Zika to reduce the possibility of the disease spreading in our state.”

“We thank Senator Hirono for highlighting the dangerous potential for a Zika outbreak in Hawaii. The recent fight against Dengue has prepared us for Zika however we must continue our efforts to eliminate the mosquito vector. County, state, and Federal agencies can provide support and guidance, but success can only come as the result of a strong and sustained community effort to eliminate the mosquito vector and its breeding grounds,” said State Administrator of Emergency Management Vern Miyagi.

“It’s important for Hawaii to prepare now in order to prevent or minimize a Zika outbreak,” said Chris Crabtree, Interim Director of Emergency Services, Healthcare Association of Hawaii Emergency Services. “HAH Emergency Services has been supporting the efforts of the state and community partners during the dengue outbreak, and is prepared to do the same for future outbreaks of any infectious disease including Zika. Active preparation can prevent or reduce the health impact of disease outbreaks and increase the safety of our residents and visitors. We support any increase in aid to fight Zika.”

“We strongly support Senator Hirono’s call for the Federal government’s leadership in the battle against the Zika virus. Hawaii Biotech is working diligently to rapidly develop a safe and effective vaccine to protect all of us from this dangerous virus,” said Dr. Elliot Parks, CEO of Hawaii Biotech, Inc.

For nearly three months, Congressional Republicans have failed to respond to the President’s emergency funding request, even though the virus continues to spread from South America. In Hawaii, there are nine confirmed cases of Zika since 2015, which includes a case of an infected infant born with microcephaly, a serious birth defect directly linked to Zika. On Friday, the first U.S. death caused by Zika was reported in Puerto Rico.

Senator Hirono is an original cosponsor of federal legislation that would fund the President’s emergency request to provide resources for education and outreach programs, shore up Hawaii health care workers’ response to Zika, increase Hawaii vector control programs, and support the work of companies like Hawaii Biotech, which is racing to develop a Zika vaccine.

Hawaii County Department of Environmental Management Understaffed and Overworked – Appliances Stack Up

The recent Dengue Fever outbreak on the Big Island of Hawaii has had everyone on edge the last few months and both State and County officials have had their hands full dealing with this outbreak.  Thousands and thousands of tires have been disposed of since the county started accepting tires at the transfer stations.

Folks have been noticing that the Hilo Transfer station in general has had a lot of e-waste and appliances stacking up.

Appliances at the Hilo Landfill on 4/30/2016.

Appliances at the Hilo Landfill on 4/30/2016.

Recently Doug Arnott, from Arnott’s Lodge in Hilo, asked the following question in the Facebook Group Opala in Paradise to Bobby Jean Leithead-Todd, Head of the County of Hawaii’s Department of Environmental Management:

Bobby Jean Leithead Todd can you give us an update on the ever growing pile of refrigerators and stoves at the Hilo Station…it seems that a good economy is causing old units to be dumped faster than they can be removed….or is this related to refrigerant removal or a slowdown in scrap metal buying by China…can we get an update please

Leithead-Todd responded:

We’ve had to pull manpower and equipment away to deal with tires and other dengue related clean ups. Earlier we had it pile up as we had a contract dispute and we could not move them until the contract issue was resolved at the state level. Now we are moving the white goods out but they seem to be coming back in as fast as we dispose of them. We hope to get ahead of it after we stop accepting tires.

Hawaii Lawmakers Provide $100 Million for Cooling Schools and Energy Efficiency

House and Senate conferees today provided $100 million to the Department of Education to install air conditioning and heat abatement equipment to cool 1,000 public school classrooms throughout the state and to establish a sustainable schools initiative.

Capital

In his State of the State address, Governor David Ige proposed borrowing $100 million from the state’s Green Energy Market Securitization (GEMS) program to cool 1,000 public school classrooms.  In response, lawmakers drafted House Bill 2569 and Senate Bill 3126, proposing varying methods of funding, but in essence, working toward the same end.  Both bills were sent to conference with unspecified funding for the conferees to decide.

During negotiations, the conferees agreed to $100 million in general funding to immediately begin carrying out the work of installing cooling and energy efficiency upgrades.  The measure now goes to the full House and Senate on Tuesday, May 3, for approval.

“The faster we can reduce our electric costs, the more money we can put back into helping students and teachers.  If the DOE can make progress reducing electric costs even a couple percent per year, that could still save millions over the long term that could be better spent in our classrooms, rather than going to utility bills,” said Rep. Chris Lee, Conference Committee chair, who took the lead for the House on the pair of bills.

Hawaii Department of Health Announces the Selection of Medical Marijuana Dispensary Licensees

The Hawaii State Department of Health (DOH) has selected eight applicants to receive Medical Marijuana Dispensary Licenses. The Department will award three licenses for the City and County of Honolulu, two licenses each for the Counties of Hawaii and Maui, and one dispensary license for the County of Kauai as allowed in Chapter 329D, Hawaii Revised Statutes (HRS).

Medical Marijuana

While the announcement of the selected applicants is being made today, selected applicants are required to pay a licensing fee of $75,000 to the Department of Health within seven days of receiving their written notice of selection to be awarded a dispensary license. If the application fee is not timely paid by close of business on the seventh day, the selected applicant will be disqualified, and the Department shall select the next highest scoring applicant for the county, pursuant to section 329D-4(c) HRS, and section 11-850-21(b), HAR.

The applicants that have been selected for dispensary licenses are:

City and County of Honolulu

  • Aloha Green Holdings Inc.
  • Manoa Botanicals LLC
  • TCG Retro Market 1, LLC dba Cure Oahu

County of Hawaii

  • Hawaiian Ethos LLC
  • Lau Ola LLC

County of Maui

  • Maui Wellness Group, LLC
  • Pono Life Sciences Maui, LLC

County of Kauai

  • Green Aloha, Ltd.

“Upon the completion of the selection process and the awarding of licenses, the Department of Health will begin working with the selected licensees to ensure the safety of their products, and the safety of patients and the public,” said State Health Director Dr. Virginia Pressler. “We look forward to improving access to marijuana for registered patients who have medical needs, and increasing educational opportunities for healthcare professionals.”

After receiving more than 60 applications in January, the department conducted a rigorous review and selection process. A four-member selection panel reviewed and scored applications based on thirteen merit criteria, some of which include the ability to operate a business, a plan and timeline for operations, proof of financial stability, ability to comply with security requirements, and capacity to meet patient needs.

A dispensary licensed pursuant to Chapter 329D, HRS, may begin dispensing marijuana no sooner than July 15, 2016, with the approval of the Department of Health. Each dispensary licensee may operate up to two production centers and two retail dispensing locations within the county they are licensed to serve. Margaret Leong, Supervisor for the Medical Marijuana Dispensary Licensing Program, explained that, “There are many steps the dispensaries will need to take in order to actually start production and dispensing, so we can’t say exactly when the dispensing will begin. But we are excited to start working with the selected licensees on the next steps.”

Pursuant to section 11-850-20, Hawaii Administrative Rules, the Department is holding unselected applications in reserve to offer a license to the next highest scoring applicant if the selected applicants fail to timely pay the required licensing fee. When all available licenses have been issued, the unselected applications will be removed from the list of reserved applications and the Department will notify all applicants of their status, at which time they will have an opportunity to appeal the denial.

The department will post a list of the total scores received by applicants upon completion of the awarding of licenses, which is anticipated to be completed within the next two weeks. The scores will be posted at http://health.hawaii.gov/medicalmarijuana/.

More information about both the medical marijuana dispensary program and the registry program are located at the website.

Milestone Reached in Hawai‘i Island Dengue Fever Outbreak

With no reports of recent incidences of locally acquired dengue fever in 30 days, the state and County of Hawai‘i announced a significant milestone in the Hawai‘i Island outbreak that began in October. While the outbreak seems to have come to a halt, Gov. David Ige, along with other state and local officials caution the public not to let their guard down in the fight against mosquitoes and the diseases they transmit.

Mosquito Bite

The state and Hawai‘i County are standing down certain emergency response activities related to the dengue fever outbreak after 30 days of no new locally acquired cases. This decision rests on the fact that three periods of the maximum human incubation period of ten days have passed. The final day of the infectious period for the last reported case was March 27. However, as per routine operations, the Hawai‘i State Department of Health (DOH) continues to immediately investigate all travel related cases and conduct mosquito assessments and/or treatment of potential areas of mosquito exposure.

“This milestone could not have been reached without the diligent efforts and teamwork by the Department of Health and the Hawai‘i County Civil Defense Agency,” said Gov. Ige. “While this outbreak seems to be ending, our statewide response to mosquito-borne diseases must continue. We must remain vigilant in our mosquito prevention and abatement practices, be ready to respond to the Zika virus, and continue working together as a state to ‘Fight the Bite.’”

Since Oct. 28, 2015, DOH and the Hawai‘i County Civil Defense Agency (HCCDA) have been actively investigating and responding to locally-acquired cases of dengue fever on Hawai‘i Island. Dengue is not endemic to Hawai‘i, but it is intermittently imported from endemic areas by infected travelers. As of April 27, 2016, 264 cases of locally-acquired dengue fever have been confirmed on Hawai‘i  Island with illnesses occurring as early as Sept. 11, 2015.

“By no means are we out of the clear,” said Darryl Oliveira, administrator of the Hawai‘i County Civil Defense Agency. “Cooperation and collaboration between the state and county have been exemplary but we continue to identify actions and efforts that we can improve on in the future. We appreciate the tremendous initiative shown by the community in assisting with mosquito abatement and encourage everyone to continue taking proactive measures around their homes and neighborhoods to keep our state safe.”

Over the course of the outbreak, DOH’s Vector Control team surveyed a total of 523 private properties and 310 public spaces. Of that count, 220 private properties and 65 public spaces were sprayed and/or treated for mosquitoes. A total of more than 1,900 reported potential cases were evaluated and/or tested by DOH disease investigators and State Laboratories Division staff.

Health Director Dr. Virginia Pressler added, “The fight against mosquitoes is far from over and we must do everything in our power to protect ourselves and our communities from the risk of mosquito borne diseases. We continue to receive and investigate reports of travel-related suspect cases of dengue fever, Zika virus and chikungunya on all islands. As Zika continues to spread rapidly overseas, we must take precautionary measures to prevent any locally acquired cases from taking hold in our state.”

“Knowing the dengue fever outbreak has been halted is welcome news for Hawaii’s tourism industry, especially for the travel partners, employees and residents who rely on its continued success,” said George D. Szigeti, president and CEO of the Hawai‘i Tourism Authority. “Travelers considering a visit to the Hawaiian Islands in the coming months can make their plans with confidence and without the hesitation that dengue may have been causing them.”

On April 11, Gov. Ige signed a supplemental proclamation to extend the state’s emergency period for mosquito borne illnesses. Under the extended emergency proclamation, DOH and the Hawai‘i Emergency Management Agency (HI-EMA), with input from county partners, will continue ongoing efforts to develop a comprehensive response plan detailing appropriate actions and measures dependent on the state’s current risk associated with mosquito borne diseases. A statewide public awareness and education campaign will kick off this year to ensure people understand the risks of mosquito-borne diseases and how to best prevent these illnesses in Hawai‘i.

Pregnant women need to take special precautions against the Zika virus and should avoid travel to areas where Zika is actively circulating. The Centers for Disease Control and Prevention (CDC) has confirmed that Zika can cause microcephaly in newborns, a birth defect where a baby’s head is smaller than expected when compared with other babies of the same sex and age. CDC has also confirmed that Zika can be spread from an infected man to his sexual partners. It is still unknown how long the virus can be spread in this way after the infected male’s symptoms have cleared.

For additional information about Zika virus and precautions, visit DOH’s Disease Outbreak Control Division’s website at http://health.hawaii.gov/docd/dib/disease/zika_virus/. For travel information and advisories, visit CDC’s website at http://wwwnc.cdc.gov/travel/page/zika-travel-information.

Update on Response Activities for Big Island Dengue Fever Outbreak – Health Department Daily Web Site Updates End

The State Health Department is no longer updating their website as of 4/26/2016

The State Health Department is no longer updating their website as of 4/26/2016

What: The State and County will announce the status of the Hawai‘i Island dengue fever outbreak and a new phase of response activities

Who:             

  • Governor David Ige
  • Mayor Billy Kenoi, County of Hawai‘i
  • Darryl Oliveira, Hawai‘i County Civil Defense Administrator
  • Dr. Virginia Pressler, Director of Health
  • Maj. Gen. Arthur “Joe” Logan, State Adjutant General and Director of the Hawai‘i Emergency Management Agency
  • George Szigeti, Hawai‘i Tourism Authority President & CEO

When: Wednesday, April 27, 2016 at 1:00 p.m. 

Where: State Capitol, 5th floor, Governor’s Ceremonial Room

We plan to live stream the event through the governor’s website.

End of Dengue

EPA Cites Honolulu Wood Treating for Producing and Selling Mislabeled Pesticide

The U.S. Environmental Protection Agency announced a settlement with Honolulu Wood Treating of Kapolei, Oahu, which will pay a $33,750 penalty for producing and selling a mislabeled pesticide on five occasions in 2013 and 2014 under the Federal Insecticide, Fungicide and Rodenticide Act.

Honolulu Wood TreatmentThe Hawaii Department of Agriculture conducted inspections for EPA at the company’s facility in 2014 and 2015 and referred this case to EPA for follow-up enforcement. During the inspections, the Department found that Clear-Bor F.T., a product used to protect wood from termites and wood decay fungus, did not meet federal label requirements. Specifically, the first aid information and EPA Establishment number were incorrect. The company has since fully corrected the product label.

“Mislabeled pesticides put people at risk,” said Jared Blumenfeld, EPA’s Regional Administrator for the Pacific Southwest. “Every company must ensure its products are properly labeled to protect the health and safety of those who use them.”

EPA requires companies to revise the first aid statements on their pesticide product labels to include medically up-to-date language. The instructions on the non-compliant containers of Clear-Bor F.T. would  have likely interfered with proper medical treatment, as the label instructed the user to “induce vomiting by touching back of throat with finger” in case of ingestion. Current medical first aid instructions no longer recommend inducing vomiting.

The required EPA Establishment number was also found to be incorrect for the product.  This number is used to identify where the product was last produced. It is crucial to maintaining product integrity, as production includes formulating, packaging, labeling and any alteration of the product prior to sale.

For more information about the Federal Insecticide, Fungicide, and Rodenticide Act, please visit: http://www2.epa.gov/laws-regulations/summary-federal-insecticide-fungicide-and-rodenticide-act

Hawaii House and Senate Budget Conferees Agree on Funding to Increase Vector Control Staffing – Concern for Dengue and Zika Drives Need

House and Senate conferees on the state budget today agreed to provide $1,270,120 to bolster the state Department of Health Vector Control Branch to focus on controlling populations of animals and insects that spread disease.

Mosquito Bite

Hawaii Island’s recent outbreak of dengue fever and the Zika virus outbreak in Brazil, which are spread by mosquitoes, have highlighted the continued importance of vector control, and House and Senate conferees want to ensure that the state is prepared to adequately short circuit, monitor and respond to any future outbreaks.

“This funding will help re-establish the vector control branch, which has been reduced over the past few years by furloughs and budget cuts,” said Sylvia Luke, chairperson of the House Finance Committee.  “In making these appropriations, the department will be able to add 20 new positions to monitor populations of vectors such as mosquitoes and rats, and to respond appropriately when a threat arises.”

Before the dengue fever outbreak in October, 2015, the state had 25 vector control positions, but 8 were vacant. With the added 20 new positions, there will be a total of 45 people in vector control when all positions are filled.

“Infectious disease has been and will continue to be one of our key challenges in a world made smaller and more connected with modern day air travel,” said Jill Tokuda, chairperson of the Senate Ways and Means Committee.  “The state’s recent slow response to the dengue fever outbreak on the Big Island was a wake-up call for all us.  We must be more vigilant in anticipating and responding to such outbreaks spread by mosquitoes and other vectors.”

In addition, the budget items agreed upon today included:

  • $6.9 million for public school transportation services;
  • $5.2 million for utilities for public schools;
  • $2.5 million for new fire trucks, firefighter equipment and fire retardant suits to ensure airport safety;
  • $1.5 million to fund a U.S. geographical survey study on Hawaii streams;
  • $1.4 million for port security and safety boats to reduce impact of natural disasters;
  • $1.25 million for maintenance and replacement of equipment at UH community colleges;
  • $400,000 to support beach restoration and protection projects and studies;
  • $180,000 for hydrologist and project development specialist positions for public land management for the disposition of water rights lease management and oversight; and
  • $162,354 for physician salary increases for better access to medical services for the Department of Public Safety.

The agreements were part of House and Senate conferees continued negotiations on a final version of HB1700, the state budget bill.  Earlier in the session, the House Finance Committee and the Senate Ways and Means Committee crafted their respective versions of the budget.

Lawmakers will continue to meet to iron out differences between the two versions through April 29, the deadline for all fiscal bills to pass out of conference committee.  A final conference draft will then be voted upon by the Legislature and if approved, will be sent to the Governor for his signature.

Budget worksheets detailing agreements and disagreements in the state and judiciary budget bills are available on the Capitol website at http://www.capitol.hawaii.gov/budget/2016budget.aspx

The conference committee is scheduled to reconvene on Friday, April 22, at 2:30 p.m. in room 309.

Big Island Substance Abuse Council Opening Food Trailer

Tomorrow, the Big Island Substance Abuse Council will proudly unveil their food trailer, Big Island Fusion as part of their Poʻokela Vocational Training Program.   The Food trailer will allow individuals to gain marketable skills and experience in food marketing, sales, business, and food preparation.

Bisac Food TruckBISAC has been providing aspects of vocational training for well over four years and has seen firsthand the positive aspects that training does to help individuals reclaim their lives and become positive citizens in the community. “We can already see the benefits this program has provided to our clients” says, BISAC’s CEO Dr. Hannah Preston-Pita. “Connecting the food trailer to our therapeutic garden provides an array of skills and opportunities for our clients to explore their inner strengths while enhancing their recovery.”

BISAC’s food trailer also brings to life the farm to table initiative. The Big Island Fusion’s culinary and vocational trainer, Willie Leong is currently in recovery and brings both the experience and passion for culinary arts.   “With my years of experience I will bring passion, creativity, and love for the food in every plate that is created” says Willie. “I know how it is being in recovery. The struggle is real. This trailer will allow me to give these individuals the chance for success so that they are ready to return to the real world and work on their recovery.”

Since 1964, BISAC has been inspiring individuals and families to reclaim and enrich their lives in the wake of the ravages of substance abuse. They offer a continuum of services that are culturally appropriate and aligned with the ever-changing behavioral health field.

North Hawaii Community Hospital Scholarship Opportunities

North Hawaii Community Hospital has several scholarship opportunities available for students in the field of nursing.

North Hawaii Community HospitalThe Peggy Dineen-Orsini Scholarship offers a $2,000 award to a resident of Hawaii County who is enrolled in or accepted for enrollment in a National League of Nursing accredited program in Hawai‘i or on the mainland. Private donors along with the Medical Staff at North Hawaii Community Hospital fund this scholarship in memory of Peggy Dineen-Orsini, who was a Registered Nurse at North Hawaii Community Hospital from 1996 to 2004, remembered for her compassion for her patients, colleagues and friends.

The second scholarship is funded by the North Hawaii Community Hospital Medical Staff and offers two $1,000 scholarships to residents of Hawaii County who are enrolled in or accepted for enrollment in a National League of Nursing accredited program in Hawai‘i or on the mainland.

Applications are available online by visiting www.nhch.com (see Community/Education Scholarships). Completed applications and required documents must be received or postmarked by May 6, 2016. Please mail completed applications and required documents to North Hawaii Community Hospital, Attention: Development Department, 67-1125 Mamalahoa Hwy, Kamuela, HI 96743.

For more information, contact the Development Department at North Hawaii Community Hospital at 881-4420.