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Hawaii Caregivers Now Eligible for Financial Help of $70 Per Day

Working caregivers who pay for services to support their kupuna may now be eligible for financial help of up to $70 per day to cover the cost of adult day care, chore services, home-delivered meals, homemaker services, personal care, respite, or transportation. The Hawaii Executive Office on Aging (EOA) is launching the state’s Kupuna Caregivers Program which was signed into law earlier this year by Gov. David Ige to help Hawaii’s working caregivers.

“The landmark initiative is a first step in recognizing the significant contributions and sacrifices of Hawaii’s working caregivers as they celebrate and honor their kupuna,” said Gov. David Ige. “Support for our caregivers is critically needed as Hawaii’s population is aging more rapidly than the national average and our seniors live longer than seniors in any other state.”

Under Act 102, qualified caregivers who apply for the program may receive up to $70 per day in services (subject to the availability of funds and paid directly to contracted service providers, not the caregiver). To be eligible, caregivers must be employed at least 30 hours a week by one or more employers and provide direct care to a care recipient who is a citizen of the US or a qualified alien, 60 years of age or older, and not covered by any comparable government or private home and community-based care service, except kupuna care services. The care recipient cannot reside in a long-term care facility and must have impairments of at least two activities of daily living or two instrumental activities of daily living or one activity of daily living and one instrumental activity of daily living or substantive cognitive impairment requiring substantial supervision.

“We are hopeful that this program will provide working caregivers with the opportunity to continue working and with peace of mind knowing that their loved ones are safe and are receiving services and supports that maximize their independence and quality of life,” said Terri Byers, director of the Hawaii Executive Office on Aging. “EOA is looking forward to analyzing the data we collect during this first six-month pilot period to evaluate demand for services, provider capacity, and how effective the program is in helping caregivers retain employment and ease financial burden.”

Interested caregivers should contact the Aging and Disability Resource Center (ADRC) as soon as possible to apply for the program. Program funding is limited to a total of $600,000 available until June 30, 2018 unless a subsequent appropriation is made by the Hawaii State Legislature. Applying for the program includes employment verification, assessment of the care recipient, and a caregiver burden assessment. For further information or to apply, call the ADRC statewide phone number (808) 643-2372, ADRC TTY line (808) 643-0899, or go to http://www.hawaiiadrc.org

Teen Mothers May Have Higher Heart Risks

Women who became first-time mothers as teens were significantly more likely than older mothers to have greater risks for heart and blood vessel disease later in life, according to a new study in the Journal of the American Heart Association. Catherine Pirkle, an assistant professor in the Office of Public Health Studies at the University of Hawaiʻi at Mānoa, served as lead author.

Catherine Pirkle

“If adolescent childbirth increases the risk of cardiovascular disease risk, then our findings reinforce the need to assure that girls and adolescents have sufficient sexual education and access to contraception to avoid adolescent childbearing in the first place,” Pirkle said. “If the association is mediated by lower educational attainment, poorer health behaviors and other factors caused by young motherhood, then our findings also suggest a need to provide more support to young mothers.”

Researchers found that women reporting a first birth before the age of 20 scored significantly higher on the Framingham Risk Score, a measure commonly used to estimate the 10-year cardiovascular risk. In comparison, women whose first births occurred at older ages had lower average risk scores.

The lowest cardiovascular risk, however, was among women who had never given birth.

“Adolescent mothers may need to be more careful about lifestyle factors that increase the risk of cardiovascular disease, including maintaining a healthy body weight and sufficient physical activity,” said Pirkle. “Clinicians may need to pay more careful attention to women’s reproductive characteristics, and more intensive screening of cardiovascular-disease risk may be required of women reporting early childbirths.”

While previous studies found that women who had several pregnancies had higher cardiovascular risks, in the most recent study, the number of lifetimes births did not affect cardiovascular risk.

Pirkle notes that women who had never given birth may have miscarried or terminated pregnancies, but would have experienced dramatically lower average levels of pregnancy-related complications. Therefore, they would have no, or much shorter durations, of pregnancy-related stress on the body, which may explain the lower average risk scores in that group.

Investigators obtained information about age at first birth for 1,047 women participating in the International Mobility in Aging Study in 2012. Study participants were between the ages of 65 and 74 and were from Canada, Albania, Colombia and Brazil.

Read more at the American Heart Association story.

Hawaii Ranks 5th in Funding Programs that Prevent Kids from Smoking

Hawaii ranks 5th nationwide in funding programs that prevent kids from smoking and help smokers quit, according to a report released today by leading public health organizations. Hawaii is spending $6.6 million this year on tobacco prevention and cessation programs, which is 48.1 percent of the $13.7 million recommended by the Centers for Disease Control and Prevention (CDC).

The report challenges states to do more to fight tobacco use – the nation’s leading cause of preventable death – and make the next generation tobacco-free. In Hawaii, 9.7 percent of high school students smoke, and 500 kids become regular smokers each year. Tobacco use claims 1,400 Hawaii lives and costs the state $526 million in health care bills annually.

Other key findings in the report include:

  • Hawaii will collect $163.9 million in revenue this year from the 1998 tobacco settlement and tobacco taxes, but will spend only 4 percent of the money on tobacco prevention programs.
  • Tobacco companies spend $25.5 million each year to market their deadly and addictive products in Hawaii – almost 4 times what the state spends on tobacco prevention. Nationwide, tobacco companies spend $8.9 billion a year on marketing – that’s $1 million every hour.

The report – “Broken Promises to Our Children: A State-by-State Look at the 1998 Tobacco Settlement 19 Years Later” – was released by the Campaign for Tobacco-Free Kids, American Cancer Society Cancer Action Network, American Heart Association, American Lung Association, the Robert Wood Johnson Foundation, Americans for Nonsmokers’ Rights and Truth Initiative.

Hawaii has been a leader in the fight against tobacco. It has a high cigarette tax ($3.20 per pack, 5th among the states), a comprehensive smoke-free law, and in 2015 became the first state to raise the tobacco age to 21. This year Hawaii increased tobacco prevention funding by 25 percent (to $6.6 million), the first increase since 2012. However, total funding is still less than half what the CDC recommends.

Hawaii has made tremendous progress, but needs to continue and increase its investment in preventing kids from smoking and helping smokers quit,” said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. “We can win the fight against tobacco and make the next generation tobacco-free, but Hawaii must keep doing its part to help achieve these goals.”

The U.S. has reduced smoking to record lows – 15.1 percent among adults and 8 percent among high school students. But tobacco use still kills more than 480,000 Americans and costs the nation about $170 billion in health care bills each year.

Today’s report also highlights large disparities in who smokes and who suffers from tobacco-related diseases in the United States. Smoking rates are especially high in a swath of 12 states in the Midwest and South, an area called “Tobacco Nation” in a recent Truth Initiative report. Nationwide, smoking rates are highest among people who live below the poverty level and have less education, American Indians/Alaska Natives, LGBT Americans, those who are uninsured or on Medicaid, and those with mental illness. These differences are in large part due to the tobacco industry’s targeting of vulnerable populations through advertising, price discounting and other marketing strategies.

By funding tobacco prevention and cessation programs at the CDC’s recommended levels, states can reduce tobacco use among all Americans. But most states are falling far short:

  • The states will collect $27.5 billion this year from the tobacco settlement and tobacco taxes, but will spend less than 3 percent of it ($721.6 million) on tobacco prevention programs.
  • The $721.6 million that the states have budgeted for tobacco prevention is a small fraction of the $3.3 billion the CDC recommends. Not a single state funds tobacco prevention programs at CDC-recommended levels, and only two states – California and Alaska – provide more than 90 percent of the recommended funding.
  • States with well-funded, sustained tobacco prevention programs have seen remarkable progress. Florida, with one of the longest-running programs, has reduced its high school smoking rate to 5.2 percent, one of the lowest rates ever reported by any state.

The report and state-specific information can be found at tfk.org/statereport.

Hawaii Second Healthiest State

America’s health is challenged by an increase in premature death and uneven concentration of health care providers, according to key findings in United Health Foundation’s America’s Health Rankings Annual Report.

America’s Health Rankings

America’s Health Rankings Annual Report, now in its 28th year, provides a holistic view of the health of the nation and of each state by analyzing 35 measures of behaviors, community and environment, policy, clinical care and outcomes data.

Disturbing Trends in U.S. Mortality: Increases in Premature Deaths, Drug Deaths and Cardiovascular Deaths
The report finds increases in the rates for three key mortality indicators.

  • The premature death rate increased for the third year in a row. The rate increased by 3 percent from 2015. Premature death is defined as the years of potential life lost before age 75.
  • In the past year, the rate of drug deaths continued an upward trend, increasing by 7 percent to its highest level ever as measured by the America’s Health Rankings Annual Report.
  • Cardiovascular deaths increased for the second consecutive year, with the rate among African Americans significantly higher than the rate among whites, Hispanic- and Asian-Americans, and Native Americans.

Even Healthy States Are Experiencing Increases in Mortality
Increases in key mortality indicators are being felt even in the nation’s healthiest states.

  • In the past five years, some of the healthiest states by overall rank have experienced large increases in drug death rates, including New Hampshire (a 118 percent increase, with an additional 13-plus deaths per 100,000 people), Rhode Island (a 56 percent increase, with an additional 8-plus deaths per 100,000 people) and Massachusetts (a 69 percent increase, with an additional 8-plus deaths per 100,000 people).
  • In the past five years, Utah (ranked as the fourth healthiest state) experienced one of the largest increases in the rate of cardiovascular deaths (10 percent, with additional 21-plus deaths per 100,000 people).

Continued Variation in the Concentration of Health Care Providers
The wide variation in health care providers across the country may contribute to differences in overall health.

  • The state with the highest concentration of mental health care providers, Massachusetts, has six times the number of mental health care providers than the state with the least amount, Alabama, Massachusetts has 547 care providers per 100,000 people vs. Alabama, which has 85 care providers per 100,000 people.
  • There is also a significant variation in primary care physicians, with a nearly two-to-one ratio between the states with the highest and lowest concentrations.  Rhode Island, Massachusetts, New York and Connecticut have more than 200 primary care physicians per 100,000 people, compared to fewer than 100 physicians per 100,000 people in Utah and Idaho.
  • Similarly, the concentration of dentists varies by almost two to one across states. Massachusetts and New Jersey have more than 80 dentists per 100,000 people. Arkansas, Mississippi, Alabama and Delaware have fewer than 45 dentists per 100,000 people.

State Rankings in 2017: Massachusetts Ranks 1st, Mississippi Ranks 50th

  • Massachusetts ranks as the healthiest state in 2017 for the first time, followed by Hawaii (2), Vermont (3), Utah (4) and Connecticut (5).
  • Mississippi is ranked 50th for the second year in a row with Louisiana (49), Arkansas (48), Alabama (47) and West Virginia (46) rounding out the states with greatest opportunities for improvement.

“This report serves as an important tool for health care professionals, policymakers and communities in their collaborative efforts to address these challenges, and help build healthier communities across the nation,” said Rhonda Randall, D.O., senior adviser to United Health Foundation, and chief medical officer, UnitedHealthcare Retiree Solutions. “This is a call to action for each of us to make changes in our own lifestyles that can help improve our overall health and well-being.”

DOE & Partners Aim to Promote Oral Health

The Hawai‘i Dental Association (HDA) and the Hawai‘i State Department of Education (HIDOE) are renewing their commitment to educating kids about the importance of dental hygiene. The agencies have continued their Memorandum of Agreement (MOA) to promote oral health by teaching students proper dental hygiene techniques and providing information about access to free dental health services.

HDA will conduct informational presentations in HIDOE first and second grade classes on O‘ahu, Maui, Kaua‘i and Hawai‘i Island through December 2017 and again from January through February 2018, which is National Children’s Dental Health Month.

“Our goal with establishing healthcare partnerships, like this one with the Hawai‘i Dental Association, is to provide access to health services for our students so they can show up to school healthy, engaged and ready to learn,” said Superintendent Dr. Christina Kishimoto. “Mahalo to everyone involved in this partnership—from the dentists to our teachers—it is an important step to ensuring our students are getting proper oral healthcare.”

These efforts are also part of a national initiative from the American Dental Association to bring preventative education and dental services to underserved children, which includes 92,000 economically disadvantaged public school students in Hawai‘i.

“During the first year of this partnership, we had 10 dentists educate more than 700 students,” added Hawai‘i Public Policy Advocate President Melissa Pavlicek. “We look forward to continuing the success of this partnership and expanding outreach even further this year. We encourage schools and teachers that are interested to contact Danny Cup Choy at (808) 447-1840.”

This partnership highlights the work that has been done by the department to ensure that all students come to school healthy and ready to learn.

Other healthcare partners include the University of Hawai‘i at Mānoa, which launched the “Hawai‘i Keiki” program with the department in 2014 and has increased school-based health services.

Department of Health Conducts TB Testing at Lihikai Elementary School

The Hawaii State Department of Health (DOH) is notifying the parents of students and staff members of Lihikai Elementary School on Maui of possible exposure to tuberculosis (TB) at the school. An informational session for affected families and employees will be held next week. Precautionary TB testing will be offered to roughly 80 individuals who may have had exposure.

“The risk of catching TB from someone at school is very low,” said Dr. Elizabeth MacNeill, chief of the DOH Tuberculosis Branch. “TB is not as contagious as many other illnesses such as colds or the flu. Testing may help us find others with early, noncontagious TB and gives us the opportunity to prevent TB for those who might have been exposed. The school screening is an extra measure of safety, and everyone who may have been exposed is being notified.”

DOH conducted an extensive investigation and evaluation of potential contacts and possible exposure immediately after being notified of the active TB case at the end of October. Information on the individual and their case is confidential and protected by law. DOH will be testing only those persons with regular close contact to the patient, and all student families and school employees are receiving a letter describing the situation and whether testing is recommended.

Informational meetings will be held in the cafeteria at Lihikai Elementary School to give families and employees the opportunity to ask questions and discuss their concerns. Meetings will be held on Tuesday, Nov. 21 at 2:30 p.m. for school employees, and at 6 p.m. for families and the general public. TB screening at the school is scheduled to begin on Monday, Nov. 27.

TB is a disease that is commonly seen in the lungs and can be spread from person-to- person through the air with close, continuous contact. When a person with active TB disease in the lung or throat coughs, sneezes, speaks, or sings, tiny drops containing M. tuberculosis may be spread into the air. If another person inhales these drops, there is a chance that they may become infected with TB. Two forms of TB exist, both of which are treatable and curable:

  1. Latent TB infection – when a person has TB bacteria in their body but the body’s immune system is protecting them and they are not sick. Someone with latent TB infection cannot spread the infection to other people.
  2. Active TB disease – when a person becomes sick with TB because their immune system can no longer protect them from active TB infection. Someone with active TB disease may be able to spread the infection to other people.

For more information on tuberculosis or TB testing, please call the DOH Hawaii Tuberculosis Control Program at 832-5731 or visit http://health.hawaii.gov/tb/.

The Tuberculosis Control Program works to reduce the incidence of TB in the state by providing effective prevention, detection, treatment, and educational services. The program offers diagnosis and treatment of TB; ensures that all cases and suspected cases of TB are identified and appropriate therapy is provided; and provides preventive therapy for patients at high risk of developing TB disease including contacts of active cases, persons who are HIV positive, and those with evidence of untreated TB. Through its clinics located in four counties, the program conducts direct TB services including chest X-ray, sputum smear and culture for mycobacteria, tuberculin skin testing, treatment with anti-tuberculosis therapy, and directly observed therapy.

Ride So They Can Walk – A Biking Event to End Polio Now

The Hawaii Rotary Club is sponsoring statewide bike rides that will be happening from Saturday, Nov. 11 through Saturday, Nov. 18. The purpose of these rides is to help to put an end to polio.

During this week, there will be Rotarians, individual community members, biking groups and clubs riding bikes and those on stationary bikes in health clubs and gyms all riding in the support of eradicating polio. This ride is different in that no roads need be closed as everyone will ride on their own schedule and desired distance.

Each rider will pay a $20.00 registration fee and will also have friends and family sponsor their ride with all those donations going to Rotary’s Polio Plus program. When Rotary started the campaign to eradicate polio in 1988 there were 350,000 cases a year in the world. As of the date of this writing there are 10 cases worldwide – 6 in Afghanistan and 4 in Pakistan. This isn’t good enough – Zero is the magic number. Each rider will receive a commemorative towel with the specially designed logo once they complete their ride and bring in a minimum of $100.00 in sponsor donations. Do even more by challenging another rider to see how many sponsor dollars you can bring in.

Join in the fun by becoming a rider and/or sponsoring a rider to help Rotary End Polio Now.

Register to ride, Sponsor a rider for $20, or Donate now: http://bit.ly/2wSMMi1

Hawaii State Department of Health Leads Oral Health Screening Initiative for Every Head Start and Early Head Start Student

The Hawaii Department of Health (DOH), in collaboration with the Hawaii Children’s Action Network, Head Start Collaboration Office, and Hawaii Head Start and Early Head Start programs, is conducting a statewide oral health screening project, beginning this fall. The project, which focuses on Hawaii keiki who are most at risk for cavities, builds upon the foundation set by the DOH’s Hawaii Smiles statewide third-grade screening project two years ago. The current project will look at younger children and include an oral health screening for every child enrolled in the Head Start and Early Head Start programs.The first screening is scheduled at the Parents and Children Together (PACT) headquarters at The Towers at Kuhio Park on Tuesday, Oct. 17, beginning at 10 am. Altogether, more than 2,970 children at more than 100 Head Start and Early Head Start sites statewide will have a dental screening in this school year. The health department will use this data on the oral health of these young children to inform the U.S. Centers for Disease Control and Prevention (CDC) and develop policies and programs to improve the oral health of children across Hawaii.

The Hawaii Smiles statewide screening team is composed of dentists and dental hygienists from the public and private sectors who will evaluate the extent of cavities in these children, provide oral health educational materials for parents and teachers, and offer recommendations for follow-up dental care.

“This project will allow us to better understand the patterns that surround dental decay in families and communities in our state,” said Dr. Gavin Uchida, DOH dental director. “On a community level, we know we must all do much more to improve the oral health of the residents of our state, and this information is foundational in helping us create the smartest, most effective plans for positive change.”

Previously, DOH issued the 2015/2016 Hawaii Smiles report, which validated that Hawaii’s third grade children have the highest prevalence of tooth decay in the nation. The baseline results were based on data collected from more than 3,000 third grade students in 67 public elementary schools during the 2014-2015 school year.

The findings from the Hawaii Smiles report were disappointing, but not surprising:

  • 71 percent of third graders in Hawaii have tooth decay, which is higher than the national average of 52 percent;
  • 22 percent of third graders have untreated tooth decay, indicating they are not receiving dental care;
  • About 7 percent of third graders are in need of urgent dental care because of pain or infection; and
  • There are significant oral health disparities by income as well as by race/ethnicity among third grade students in Hawaii.

“We are grateful that the HDS Foundation is being proactive and funding early solutions to Hawaii’s oral health problems,” said Deborah Zysman, executive director of the Hawaii Children’s Action Network. “These problems are often preventable when addressed in early childhood through screening, public education and outreach, and public policy. We are excited for the opportunity to make a difference in the health of Hawaii children.”

As part of the outreach efforts, parents and teachers will receive oral health educational materials and classroom supplies to reinforce the importance of good oral health to children.

The Hawaii Smiles report recommended community-based prevention programs that focus on oral health promotion and prevention services in early childhood programs to reach children at a younger age. The Early Head Start and Head Start programs were identified because of their extensive reach to children from birth to five years old.

“While this project is organized by the Department of Health, it actually is a growing coalition of local and national community partners who are taking action,” said Dr. Uchida. “We’re seeing the result of partnerships that start with caring individuals and small community groups, and extends to local businesses and associations, and even to national leadership at the CDC. A lot of people are now coming together to address the oral health problems we’re seeing in Hawaii, and this current project is just the beginning of good things to come.“

“We’re pleased to be able to continue our support for the Hawaii Smiles project,” said

Mark Yamakawa, president and CEO of Hawaii Dental Service (HDS). “Prevention is the key to good oral health especially for our young children, and we appreciate the collaborative effort to tackle this important issue in our state.”

The CDC awarded the DOH a $1.1 million grant to rebuild its oral health program, a portion of which is being used for these oral health screenings for 1,450 children at 50 Head Start and Early Head Start sites throughout the state.

The HDS Foundation gave a $45,000 grant to the Hawaii Children’s Action Network, which is helping to coordinate the logistics of this project, to expand the outreach efforts to an additional 59 sites and to conduct dental screenings for an additional 1,520 infants, toddlers and preschoolers for a total of more than 2,970 children.

Children will be referred to their dentist for follow-up care.  If they do not have a dentist, the DOH and the Head Start and Early Head Start programs will refer families to Community Case Management Corp., which assists Medicaid beneficiaries with finding dentists for treatment.

October Brown Bag Lunch Series – “Conflict Resolution Day: Mediation as a Tool for Peace”

With a focus on “Finding Solutions, Growing Peace,” this monthly lunch-and-learn series features interesting speakers discussing topics related to communication, dispute prevention and resolution, and transforming conflict.

This month’s speaker is Julie Mitchell on “Conflict Resolution Day: Mediation as a Tool for Peace.”

“Conflict Resolution Day is an annual international celebration held every third Thursday in October,” says Julie. “It promotes awareness of peaceful means of resolving disagreements and encourages the use of conflict resolution in schools, families, businesses, communities, government, and the legal system.”

During this talk, professionally trained volunteer mediators will conduct a ‘Live Action Mediation’ to demonstrate how mediators empower people to find their own best solutions.

Ku‘ikahi’s Brown Bag Lunch Series is free and open to the public. Attendees are encouraged to bring their own lunch, enjoy an informal and educational talk-story session, and meet others interested in “Finding Solutions, Growing Peace.”

For more information, contact Ku‘ikahi Mediation Center Program Coordinator Al-Qawi Majidah at (808) 935-7844 x 3 or majidah@hawaiimediation.org. No RSVP needed – walks ins welcome!

Hospice of Hilo to Offer Presentation for Professionals

Hospice of Hilo will be offering a free presentation for community professionals serving those whose lives are affected by loss  “Grief Touches Everyone.” Participants will meet at Hospice of Hilo’s Community Room located at 1011 Waiānuenue Ave in Hilo, on Wednesday, October 25, from 3:00 pm to 4:30 pm.

Facilitated by Hospice of Hilo bereavement counselors, participants will learn about common responses to loss, and how grief can affect adults and children emotionally, cognitively, physically, socially and spiritually. An overview of the organization’s free community Bereavement Services will also be provided.

The workshop is highly recommended for teachers, counselors, case managers, social workers, and caregivers.“ This well organized and informative workshop is a good introduction to grief and the resources that can help,” said a past participant.

To register or for further information contact: Anjali Kala at 961-7306 or email anjalik@hospiceofhilo.org. Please RSVP no later than October 24th.

Hawai‘i Telehealth Summit Moves State Toward Increasing Access to Healthcare Using Innovative Technology

More than 150 healthcare and information technology professionals from throughout the state will gather for the Hawaiʻi Telehealth Summit this week to explore ways to improve access to care for Hawaiʻi residents through telehealth technology.

The two-day Hawaiʻi Telehealth Summit, co-sponsored by the Hawaiʻi Department of Health (DOH) and the University of Hawai‘i at Mānoa, will be held at the John A. Burns School of Medicine and the Dole Cannery Ballrooms on Oct. 12 and 13.

“Today, we have technology capable of improving access to healthcare services for Hawai‘i residents who are homebound or living in rural areas, including the neighbor islands where there is a shortage of specialists,” said Dr. Virginia Pressler, director of the Hawai‘i Department of Health. “The Department of Health has adopted telehealth for adolescent psychiatric counseling and has piloted teledentistry for West Hawai‘i residents, but as a state, we’ve only just begun to scratch the surface.

The event will feature exhibits and hands-on demonstrations of the latest telehealth technologies, equipment, and services.

On the first day, summit attendees will hear a keynote address, “Telepresence Skills: How to build and maintain authentic and effective provider-patient relationships when practicing telemedicine,” by Dr. David Roth of Mind and Body Works.  The second day of the summit will feature keynote addresses from Gov. David Ige and Congressman Brian Schatz. The event will culminate in facilitated discussions to establish a statewide telehealth strategic plan.

Hawai‘i has adopted new payment models to keep pace with advances in telehealth technology. In July 2016, Gov. Ige signed a law that allows healthcare providers to receive the same reimbursements for patient care, whether it is through a telehealth consultation or a face-to-face office visit. These types of changes are expected to further accelerate telehealth’s popularity in Hawai‘i.

“It is exciting that the telehealth law paves the way for tremendous opportunity for providers and communities in Hawaiʻi, but there is still a lot of work to be done,” said Denise Konan, the dean of the UH Mānoa College of Social Sciences. “The university is fully supportive of the summit and committed to bringing people together to keep the momentum going.”

Currently, about 15 percent of Hawaiʻi physicians use electronic communications to deliver health care, according to the Hawaiʻi Physician Workforce Assessment Project’s 2017 report to the state legislature.

“Telehealth is changing the way providers interact with patients,” Dr. Pressler said. “Telehealth is particularly convenient for our island state, where many segments of our population face challenges in accessing quality healthcare due to geographical constraints. Telehealth can be a cost-effective alternative to the more traditional face-to-face way of providing medical care and provides greater access to healthcare.”

For example, the state’s physician shortage often forces neighbor islands residents to fly to Oʻahu for treatment. These patients — or government programs such as Medicaid — must absorb the added cost of travel and patients must endure long wait times. With telehealth, medical specialists on Oʻahu can treat patients at smaller, neighbor island hospitals that lack such specialists.

Pressler added, “We look forward to working with our partners in the community to develop a strategic plan for telehealth and ultimately improve the way we deliver healthcare for Hawaiʻi’s people.”

For additional information on the summit, call the DOH Office of Planning, Policy and Program Development at (808) 586-4188.

Hawai‘i Ranks Third in Nation in U.S. News’ Best States for Aging Ranking

The State of Hawai‘i ranks third in the country when it comes to states that are best at serving their older population. U.S. News and World Report based its rankings on the cost of care, nursing home quality, primary care and life expectancy.The publication says that Hawai‘i’s residents have the longest life expectancy in the U.S., with its 65-and-older population expected to live 20 years longer than in other states. U.S. News has also found that Hawai‘i has the best nursing home quality in the country.

“It’s part of our culture in Hawai‘i to respect and honor our kupuna or elders. Our programs reflect these values and aim to keep our older population active and contributing members of society,” said Gov. David Ige.

Colorado ranked first, with one of the healthiest and most physically active older populations in the country. Maine is second, where a fifth of the population consists of residents 65 and older, a higher percentage than in any other state.

Rounding out the top 10 are: Iowa, South Dakota, Wisconsin, Minnesota, Vermont, New Hampshire and Florida.

In 2016, Americans 65 and older accounted for 15.2 percent of the total population, an increase of 2.8 percent from 2000. Not only are baby boomers aging, but advances in medicine and technology are resulting in a longer life expectancy.

The U.S. Census Bureau predicts that one in five Americans will be 65 years and older by 2030.

Congresswoman Tulsi Gabbard Calls on Congress to Support the POWER Act During Domestic Violence Awareness Month

Congresswoman Tulsi Gabbard (HI-02) today spoke on the House floor urging Congress to support survivors of domestic violence during Domestic Violence Awareness Month, and cosponsor the POWER Act (H.R. 1762).

Congresswoman Tulsi Gabbard said:

“Domestic violence often hides behind closed doors and drawn curtains, but the problem is very staggering. In my home state of Hawai‘i, 575 domestic violence survivors reach out to local organizations seeking help every single day. Their stories are heartbreaking and too often, even if they are temporarily removed from their abusive environment, they often return to that abuser.

“Survivors can seek legal protection from their abusers, but they aren’t likely to do so – or to be successful – unless they have a lawyer. Just 32% of victims successfully obtain a restraining order without legal representation. I call on my colleagues to support the POWER Act, which requires every state’s U.S. attorney to promote and expand pro-bono legal services, specifically for domestic violence survivors.

“We all need to be more conscious of this problem because it’s happening in our communities. As we observe Domestic Violence Awareness Month, let us have the courage to confront the pervasiveness of this crime and take action to help provide survivors with the safety and security that they need.”

Background:

Rep. Tulsi Gabbard has long been an advocate for survivors of domestic violence, including supporting Maui’s Women Helping Women, passing Talia’s Law, praising the Hawai‘i Text-to-911 program, and more.

The Congresswoman is an original cosponsor of H.R. 1762, the POWER Act, which would help connect domestic violence survivors with legal representation. For more information on the economic benefits of providing legal assistance to survivors of domestic violence, view the Institute for Policy Integrity Report, Supporting Survivors, here.

Statement by Hawai‘i Gov. David Ige on Hawai‘i’s Medicaid Expenditures

The State of Hawai‘i has responded to Sen. Ron Johnson’s request for information on Hawai‘i’s Medicaid expenditures for the Medicaid expansion. (Letter attached).

I am setting the record straight. Hawai‘i’s overall Medicaid costs per capita are at or below the national average. We have among the lowest rates in the nation. I am proud of our program and its effectiveness in providing our residents with quality health care they can afford.

Let me be clear. This is not about politics or data. This is about people, their lives and our responsibility to ensure that they receive quality health care.

We must stop wasting our time and energy on politics and blame. I ask our public servants to reach across the aisle and talk to each other so that we can resolve this issue.

For Hawai‘i, it is clear. We have a model Medicaid program and we will continue to be one of the nation’s leaders in quality health care.

Letter to Senator Ron Johnson

Hawai`i Department of Health Approves Fourth Dispensary to Begin Retail Sales of Medical Cannabis

The Hawai‘i State Department of Health (DOH) has issued a formal notice to proceed to Mānoa Botanicals LLC dba Noa Botanicals after the dispensary completed laboratory testing requirements and passed its final onsite inspection. Noa Botanicals is the fourth licensed medical cannabis dispensary in the state (and the second on O‘ahu) to receive approval to begin sales of medical cannabis to registered patients and their caregivers.

The licensed retail center for Noa Botanicals is located at 1308 Young Street in Honolulu, and the dispensary expects to begin sales at the site this month.

“We are continuing to closely work with both the licensed dispensaries and private laboratories in each of the counties to help them meet all of the requirements as efficiently as possible without compromising product or patient safety,” said Keith Ridley, who oversees the medical cannabis dispensary program for the Hawaii State Department of Health.

The rigorous dispensary approval processes to open and begin selling medical cannabis are based on the requirements of Hawai‘i Revised Statutes Chapter 329D and Hawai‘i Administrative Rules Chapter 11-850. Dispensaries are required to comply with all state and county, health, safety, and sanitation regulations, and are subject to unannounced inspections by the Hawaii Department of Health.

The other licensed retail centers are:

  • Maui Grown Therapies, located at 44 Pa‘a Street in Kahului, Maui, which was the first licensed dispensary in Hawai‘i to receive a notice to proceed on Aug. 8, 2017;
  • Aloha Green, in the Interstate Building at 1314 South King Street in Honolulu, received its notice to proceed on Aug. 9, 2017; and
  • Pono Life Sciences Maui LLC, at 415 Dairy Road in Kahului, Maui, was the second Maui dispensary to receive a notice to proceed on Sept. 29, 2017.

Registered patients and their caregivers may purchase up to four ounces of medical cannabis during a 15 consecutive day period and purchase a maximum of eight ounces over a 30 consecutive day period. All use of medical cannabis must be on private property and may not be used in a car while on the road, at work, at the beach, on hiking trails, or in any other public space.

There are eight licensed dispensaries in Hawai‘i. There are three on O‘ahu: Aloha Green Holdings Inc.; Mānoa Botanicals LLC dba Noa Botanicals; and TCG Retro Market 1, LLC dba Cure O‘ahu. There are two in Hawai‘i County: Hawaiian Ethos LLC and Lau Ola LLC. The two Maui dispensaries include Maui Wellness Group, LLC dba Maui Grown Therapies; and Pono Life Sciences Maui, LLC. The one dispensary located on Kaua‘i is Green Aloha, Ltd. Each licensed dispensary is an independent business and operates based on their individual business plans.

More information on the Medical Cannabis Dispensary Program is available at www.health.hawaii.gov/medicalcannabis/.

North Hawai’i Community Hospital Lobby to Close Temporarily

The lobby at North Hawai’i Community Hospital will close for several weeks starting Thursday, October 12.

The closure is required while flooring in the lobby is replaced. This is the last phase of a large-scale flooring replacement project ongoing at the hospital since November 2016.

Patients and visitors are directed to enter the hospital through the emergency room entrance. Signage will be placed throughout the campus to help redirect visitors.

For patient convenience, all parking near the emergency room will be designated for patients and visitors only.

Visitors to the Lucy Henriques building will continue to enter through that building.

The project is expected to be completed by November 3.

Commentary – Were Pahoa High and Intermediate Lunch Times Shortened Because of a Fight?

Yesterday, KHON2 News ran a news story about Pahoa’s lunches being shortened.

…Changes to the lunch program at a Hawaii island school prompted parents to reach out to us, saying their kids are being rushed to eat.

Their kids go to Pahoa High and Intermediate School, which recently started a pilot lunch program.
High school students eat during the normal 30-minute lunch break, but intermediate school students eat during recess, which is just 15 minutes long…

I received the following message on Wednesday indicating that this change in policy may have stemmed from a fight on campus… but didn’t discuss it further with the person sending me the information until tonight:

Aloha Damon, I wanted to bring something to your attention that maybe you could do some investigative reporting. Apparently Pahoa High and Intermediate administration has decided to have Intermediate student only eat lunch during first recess which is 15 minutes while the high school eats during regular lunch which is 30 minutes. When I complained to the principal she stated it was due to decreasing tardys to class during lunch time. An insider told me they did it because of a fight that occurred between a Intermediate kid and a high schooler.

When discussing this with friends on Facebook, one person posted a picture from the Pahoa Cafeteria:

My kids say they don’t even bother eating when this is what they are serving at Pahoa. ~VW

“This was what they call Baja fish taco SMH. This was on Wednesday when we went to school for student of the month luncheon I was In Shock when he came to the table with this…Home lunches from now on!!!” said Valerie Walsh.

Got Baja Fish Taco? I don’t know if I could swallow this in 15 minutes… less yet an hour!!!

Hawai`i Joins Coalition of 18 States Opposing President’s Contraception Coverage Rollback

Attorney General Doug Chin today joined a coalition of 18 attorneys general warning the Trump administration that it should expect legal action over its discriminatory, ill-considered, and dangerous move to effectively end the contraception coverage rule created by the Affordable Care Act. The 18 attorneys general have written Acting Secretary of Health and Human Services Don Wright, Secretary of Labor R. Alexander Acosta, and Secretary of Treasury Steven Mnuchin expressing their strong opposition to the Trump administration’s action that will increase healthcare costs for women, lead to more unplanned pregnancies, and place even more strain on state budgets.

Attorney General Doug Chin

Attorney General Chin said, “We are talking about basic access to health care for women. Contraception provides women the autonomy they deserve. It’s also used to treat a variety of serious conditions having nothing to do with birth control. And the public has had no opportunity to comment.”

For millions of women the contraception coverage rule has reduced their healthcare costs, helped address medical conditions, and allowed them to make their own decisions about when and if to have children. Before the contraception coverage rule, birth control accounted for 30-44% of a woman’s out-of-pocket healthcare costs. Now, 62 million women across the country have access to contraception without a co-pay, saving an average of $255 per year for oral pill contraceptives, and the percentage of women who have a co-pay for contraception has fallen from more than 20% to less than 4%.

“Allowing any employer or insurance company with a religious or ‘moral’ objection to contraception to opt out of this requirement will take away women’s autonomy to make their own reproductive decisions and put those decisions in the hands of their employers,” write the attorneys general. “Subjecting women to the religious and moral beliefs of their employers violates the right to privacy that is so evident in Supreme Court doctrine. Women should have coverage for their critical health care just as men do.”

The attorneys general also informed the relevant cabinet secretaries that “we will closely monitor any legal challenges to this rule that discriminates against women in our states and negatively impacts our state budgets. We stand ready to take action to protect the best interests of our states and constituents.”

In addition to Hawaii, Oregon, and Virginia, joining today’s letter opposing the Trump administration’s rollback of contraceptive coverage are the attorneys general of California, Connecticut, Delaware, District of Columbia, Illinois, Iowa, Maine, Maryland, Massachusetts, New York, North Carolina, Pennsylvania, Rhode Island, Vermont, and Washington.

A copy of the letter is attached.

Harry & Jeanette Weinberg Foundation, Inc. Donates $2.34 Million To Hawaii Island Adult Care Project

Hawaii Island Adult Care Project Slated For February 2018 Completion

The Hilo Adult Day Center, a joint venture between Hawaii Island Adult Care, Inc. (HIAC) and Hawaii Island Community Development Corporation (HICDC), was awarded $2,340,000 by The Harry & Jeanette Weinberg Foundation, Inc.

“Words cannot express our gratitude to the trustees of The Harry & Jeanette Weinberg Foundation for their generous gift,” said Hawaii Island Adult Care Executive Director Paula Uusitalo. “The Weinberg Foundation’s largess will enable completion of the construction project and positively affect senior lives in Hilo for the next 50 plus years.”

The Weinberg Foundation has so far funded $1,775,000 and the final $565,000 payment will be made at the completion of the project.

Hilo Adult Day Center’s new building, located on Mohouli Street and above Komohana Street, will feature large open spaces for art/craft activities and physical fitness geared to elders along with quiet indoor spaces for reading, socializing and relaxing. Project features include a fully certified kitchen to provide hot meals, outdoor gardens and a meandering path. The project is currently under construction by Isemoto Construction Corporation and is roughly 50% complete. Construction is expected to be completed in February 2018.

“We wouldn’t be here without the organization and support of the Hawaii Island Community Development Corporation and its executive director Keith Kato,” added Uusitalo.  “Keith and HICDC’s Development Manager Jeremy McComber contributing their expertise in securing the site, developing the infrastructure, working with HIAC on the building design, and bidding, awarding and overseeing the construction have been invaluable. Our organization worked towards a new Hilo building starting in the year 2000,but the true Capital Campaign project did not launch until Keith Kato and the Hawaii Island Community Development Corporation became involved.”

The Harry & Jeanette Weinberg Adult Day Center will complement Hawaii Island Community Development Corp’s existing and planned senior housing in the Mohouli Senior complex with its 182 units at full build out. The first phase of 60 senior housing units was completed in 2014, the second phase with 30 units is nearing completion this month and funding for the last increment of 92 units has been secured from the State Housing Finance and Development Corporation.

The total budget for the Adult Day Center project is $8,586,000. While the building will be completed early next year, the parent organization, Hawaii Island Adult Care will still require an additional $580,000 to pay for furniture, fixtures and equipment including a commercial kitchen that will provide meals for the seniors.

To date, in addition to The Harry & Jeanette Weinberg Foundation, project donors include community and board members, County of Hawaii, State of Hawaii, Cooke Foundation, HEI Charitable Foundation, LGA Family Foundation, Matson Foundation, KTA Super Stores, Bank of Hawaii and the Atherton Family Foundation.

For information on how to donate to the capital campaign contact the Hawaii Island Adult Care Executive Director Paula Uusitalo at (808) 961-3747, ext. 105 or Keith Kato, Executive Director of the Hawaii Island Community Development Corporation at (808) 319-2422 or visit www.hawaiiislandadultcare.org.

Hawaii Joins in Settling With Mylan Inc – Will Receive Over $700,000

Attorney General Doug Chin announced today that Hawaii has joined the United States, the District of Columbia, and all 49 other states in settling allegations against Mylan Inc. and its wholly-owned subsidiary, Mylan Specialty L.P. (collectively “Mylan”). The settlement resolves allegations that Mylan knowingly underpaid rebates owed to the Medicaid program for the drugs EpiPen and EpiPen Jr. (“EpiPen”) dispensed to Medicaid beneficiaries. Mylan owns the exclusive rights to sell EpiPen in the United States and possesses legal title to the New Drug Codes (“NDCs”) for EpiPen.

Pursuant to a settlement Mylan entered with the United States in August, Mylan was to pay up to $465 million to the United States and the states, depending on the number of states that joined the settlement. As of Friday, September 29th, all fifty states and the District of Columbia had joined the settlement; as a result, the states will share $213,936,000 of the total settlement of $465 million. Hawaii’s share of the settlement is $742,679.02, which will be split between the Med-Quest program at the Department of Human Services as restitution and the Medicaid Fraud Control Unit at the Department of the Attorney General for its continued enforcement efforts.

The Medicaid Drug Rebate Statute was enacted by Congress in 1990 to keep costs down for Medicaid’s payment for outpatient drugs. The law requires participating drug makers and NDC holders such as Mylan to sign a rebate agreement with the Secretary of the U.S. Department of Health and Human Services. That agreement is a precondition to drug makers getting Medicaid coverage for their drugs, and to pay quarterly rebates to state Medicaid programs for drugs dispensed to Medicaid beneficiaries. NDC holders must provide information to the Centers for Medicare and Medicaid Services (“CMS”) concerning their covered drugs. In particular, they must advise CMS regarding the classification of a covered drug as an “innovator” or “noninnovator” drug. This is because the amount of rebates owed varies depending on the drug’s classification. The amount of the rebate also depends on pricing information provided by the manufacturer. For drugs classified as “innovator” drugs, NDC holders must report their “Best Price,” or the lowest price for which it sold a covered drug in a particular quarter.

Specifically, this settlement resolves allegations that from July 29, 2010 to March 31, 2017, Mylan submitted false statements to CMS that incorrectly classified EpiPen as a “noninnovator multiple source” drug, as opposed to a “single source” or “innovator multiple source” drug. Mylan also did not report a Best Price to CMS for EpiPen, which it was required to do for all “single source” and “innovator multiple source” drugs. This meant Mylan submitted false statements to CMS and the States relating to EpiPen for Medicaid rebate purposes, and underpaid its EpiPen rebates to the State Medicaid Programs.