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Hawaii Department of Health Receives $3.04 Million Federal Grant for Treatment of Adolescent Substance Abuse and Mental Health Disorders

The Hawaii State Department of Health’s Alcohol and Drug Abuse Division (ADAD) has received a $3.04 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services, to provide funding over four years for the treatment of adolescents and transitional aged youth with co-occurring substance abuse and mental health disorders.

The grant is designed to bring together stakeholders who serve Hawaii’s adolescents, enhance and expand treatment services and implement financial mechanisms and other reforms that improve the efficiency of substance use disorder (SUD) treatment efforts.

“We are moving towards our goal of a drug free Hawaii,” said Edward Mersereau, ADAD chief. “This grant will allow us to expand the Hawai‘i Adolescent and Transitional Aged Youth Treatment Implementation project (YT-I) to increase rates of abstinence, enrollment in education, vocational training, employment and social connectedness—along with decreasing criminal and juvenile justice involvement among our youth.”

ADAD’s treatment services are designed to promote a statewide culturally appropriate, comprehensive system of services to meet the treatment and recovery needs of individuals and families. Throughout this project, ADAD will have a coordinated SUD treatment services program with the department’s Child and Adolescent Mental Health Division, Family Guidance Centers, and four drug and alcohol treatment providers.

According to a 2014 DOH report on alcohol and drug abuse treatment services in Hawaii, adolescents comprised more than half (53 percent) of the nearly 4,000 clients who received treatment by ADAD in 2014. At a six-month follow-up that same year, almost all adolescents (99 percent) who received services were attending school and the majority (61 percent) reported not abusing any substances in the 30 days prior to follow up. The vast majority of those adolescents continued to have no arrests, no hospitalizations, and no emergency room visits since discharge.

“The result of this project will be higher cross-professional training in SUD treatment practices, a more proactive approach to preventative healthcare, a concrete referral system that leaves little room for patients to fall through the cracks, and expanded use of health information technology for better informed decision-making at the point of care,” Mersereau said. “Our goal is a statewide system of treatment that is substantially more effective in utilizing existing resources and treatment methods far beyond the life of the YT-I project.”

The Department of Health’s Alcohol and Drug Abuse Division is the primary and often sole source of public funds for substance abuse treatment in Hawaii. ADAD’s treatment efforts are designed to promote a statewide culturally appropriate, comprehensive system of services to meet the treatment and recovery needs of individuals and families. Treatment services have, as a requirement, priority admission for pregnant women and injection drug users. For more information about the division go to: http://health.hawaii.gov/substance-abuse/.

Hawaii Mumps Outbreak Explodes – 16 Additional Oahu Cases

The Hawaii State Department of Health (DOH) has confirmed 16 additional cases of Oahu residents with mumps bringing the total number of cases in 2017 to 81. The recently confirmed cases include children and adults. Most of the cases are linked to previously confirmed illnesses. None of the individuals required hospitalization and all have recovered or are recovering.

The number of cases continues to steadily increase as today’s number represents test results received over the extended holiday weekend. The department expects to see more cases of mumps in Hawaii as the viral disease is highly contagious and circulating on Oahu. Information on case numbers is updated regularly at http://health.hawaii.gov/…/department-of-health-investigat…/.

The DOH is recommending all adults born in or after 1957, without evidence of immunity to mumps, who cannot verify previous MMR vaccination, should receive at least one MMR vaccine dose. Individuals with only one documented MMR dose, are strongly encouraged to consider receiving a second MMR vaccine dose.

MMR vaccine is available at local pharmacies across the state. To locate a vaccinating pharmacy in your community, visit http://health.hawaii.gov/…/vaccines-immun…/vaccine-locators/ or call the Aloha United Way information and referral line at 2-1-1.

Mumps is spread when an infected person coughs or sneezes. The virus is also spread by sharing items such as cups or eating utensils, or by touching contaminated objects or surfaces and then touching the eyes, nose, or mouth.

Prevent the spread of mumps in our community by:

  • Ensuring your family is fully vaccinated with the MMR vaccine. High vaccination coverage helps to limit the spread of mumps. Two doses of the vaccine are 88 percent effective at protecting against mumps and one dose is 78 percent effective. Being fully vaccinated can help protect loved ones, family members, friends, classmates and coworkers.
  • Patients suspected or diagnosed with mumps should self-isolate and avoid going out and exposing others for nine (9) days after onset of parotitis (tender, swollen jaw).
  • People who have been exposed to mumps and are not vaccinated should not attend school, work or travel from day 12 through day 25 after exposure.

Additional information about mumps and the ongoing investigation can be found on the DOH website at http://health.hawaii.gov/…/department-of-health-investigat…/.

Hawaii Department of Health Orders Meadow Gold Dairies to Stop Distribution and Sale of 2% Reduced Fat Milk

The Hawaii State Department of Health (DOH) has ordered Meadow Gold Dairies to stop its distribution and sale of two-percent reduced fat milk. DOH issued a Cease and Desist Order to the company today after laboratory results from routine milk samples exceeded standard limits for Coliform bacteria.

“Milk production is regulated with routine testing both at the farm and after packaging to ensure a safe product,” said Peter Oshiro, program manager of the DOH Sanitation Branch. “Department of Health inspectors will work with Meadow Gold Dairies to investigate the possible source of contamination, approve a plan of correction, and conduct further testing to confirm the company meets the standards to resume two-percent reduced fat milk distribution and sale.”

Samples of two-percent reduced fat milk taken from Meadow Gold Dairies on Jan. 19, Feb. 6 and 22, 2017, revealed excessive Coliform counts of more than 150/ml, 130/ml and more than 150/ml respectively. The maximum allowed Coliform limit for pasteurized milk is 10/ml. Coliform is used an indicator of post-pasteurization contamination.

DOH conducts monthly testing of samples of all Grade A raw and pasteurized milk produced at dairy farms and milk plants in Hawaii. State and Federal regulations require that samples be taken a minimum of four out of every six months, though most jurisdictions in the nation, like Hawaii, conduct sampling every month. DOH may also accelerate routine sampling of a specific product whenever product samples do not meet required standards.

Hawaii Administrative Rules Title 11 Chapter15 states that the DOH may suspend the distribution and sale of a particular milk product produced by a milk plant, whenever the product is in violation three times out of the last five consecutive samples for the first three Critical Control Point (CCP) standards listed below.

Critical Control Point/Critical Limits:

  • Temperature – 45°F or less
  • Bacterial Limits -1 0,000/ml or less
  • Coliform – 10/ml or less
  • Phosphatase – 1mcg/ml or less
  • Antibiotics – No Positive results on drug residue detection

To resume distribution and sale of two-percent reduced fat milk, Meadow Gold Dairies must pass health inspections and undergo additional testing of product samples. All other milk products from Meadow Gold Dairies meet state and federal standards required for distribution and sale.

Hawaii DOH Cautions Travelers Headed to 2016 Summer Olympic Games About Zika Virus

With the 2016 Summer Olympic Games set to begin at the end of this week in Rio de Janeiro, Brazil, the Hawaii State Department of Health (DOH) is cautioning all travelers, especially Hawaii residents, to take preventive measures against being bitten by mosquitoes while there, because of the ongoing Zika outbreak in that country.

2016 OlympicsThe U.S. Centers for Disease Control and Prevention (CDC) currently has posted a Level 2 Travel Alert, advising travelers to the Olympic Games to practice enhanced precautions while in Brazil. CDC is also recommending that women who are pregnant not attend the Olympics because of the risk Zika poses to a developing fetus. Zika has been linked to cases of microcephaly, a serious birth defect that causes a baby to be born with a smaller than normal sized head because of abnormal brain development, which can result in medical problems and impaired development.

“We wish Hawaii residents going to Brazil for the Olympic Games safe travels, and urge them to heed travel warnings by preparing carefully and doing what they can to prevent mosquito bites,” said Health Director Dr. Virginia Pressler. “If people avoid being bitten by mosquitoes, they will substantially reduce their risks of contracting Zika virus and bringing it back to Hawaii. We don’t have locally transmitted Zika here, and we must do whatever we can to keep it that way.”

Travelers returning to Hawaii from areas affected by Zika and other mosquito-borne viruses are advised that if they become ill within two weeks of returning home, they should consult and be assessed by their healthcare provider.

While there have been no cases among persons who have been infected by mosquitoes in Hawaii, our state has been identified as a high risk area for experiencing local Zika spread because of our year-round warm temperatures and consistently high travel rates, both into and out of the state. Florida is also identified as a high-risk state for local Zika transmission, and recently confirmed its first cases of locally-acquired Zika. These cases are the first instances of locally transmitted Zika in the United States.

Local mosquitoes can become infected when they bite an infected human. Active local transmission begins when infected local mosquitoes infect the humans they bite. Zika can also be spread from an infected pregnant woman to her unborn child before or during birth and from an infected person to their sexual partners.

To protect against contracting Zika, especially during travel to Brazil for the Olympics, or other locations with local mosquito-borne transmission, DOH recommends the following precautions:

  • Apply EPA-registered insect repellent containing 20-30 percent DEET, especially if outdoors.
  • Wear protective clothing, such as light-colored long-sleeved shirts, long pants, socks and shoes.
  • Avoid activities outdoors at sunrise and sunset when mosquitoes are most active.
  • Avoid areas with mosquitoes, such as shady, damp locations or standing water.

For travel notices and information related to Zika, visit the CDC’s Zika Travel Information page at http://wwwnc.cdc.gov/travel/page/zika-travel-information. For more information about Zika virus, visit DOH’s Disease Outbreak and Control Division’s website at http://health.hawaii.gov/docd/dib/disease/zika_virus/. Additional resources about DOH’s efforts to raise awareness about mosquito-borne disease prevention in Hawaii can be located at FightTheBiteHawaii.com.

Hawaii Department of Health Awarded $3.7 Million to Support Epidemiological and Laboratory Activities

The Hawaii State Department of Health (DOH) has been awarded $3.7 million from the U.S. Centers for Disease Control and Prevention (CDC) to support infectious diseases epidemiological and laboratory activities in the state. The funding is being provided through the CDC’s Epidemiology and Laboratory Capacity for Infectious Disease Cooperative Agreement (ELC).

Mosquito Bite

In addition to funding vital ongoing infectious disease surveillance and investigation for areas such as foodborne disease, flu, and healthcare-associated infections, the ELC award will provide increased support in the area of arboviral disease (e.g., dengue, Zika, chikungunya) and critical new resources to address growing concerns presented by general antimicrobial resistance and specifically, antibiotic-resistant gonorrhea and chlamydia.

“These new funds will help in many critical areas of disease investigation, including providing support for our current Hepatitis A outbreak,” said Health Director Dr. Virginia Pressler. “We’re grateful for this recognition and generous grant from CDC, and will work to ensure that these new funds translate to sustainable efforts to protect our residents and visitors in Hawaii.”

Of the approximately $3.7 million awarded, ELC funding will focus on areas including:

  • $1,062,000 to support Hawaii’s efforts to protect the state from Zika and other arbovirus diseases such as chikungunya and dengue. ELC funds will be used to augment epidemiologic surveillance and investigation, enhance mosquito monitoring, and provide supplies and support to the State Laboratories Division for arbovirus testing.
  • $2,711,149 to support other ELC efforts, including: building capacity to address antimicrobial resistant gonorrhea and chlamydia concerns, increasing laboratory capacity for antimicrobial resistance detection and response infrastructure, strengthening flu surveillance and foodborne surveillance and response capacity, increasing health information systems capacity, and other ELC activities.

“The funding of this award will greatly boost our efforts to protect our community against the potential introduction of Zika virus and many other infectious diseases,” said State Epidemiologist Dr. Sarah Park. “By building our capacity to find and stop disease outbreaks we increase our ability to help save lives.”

Dr. Chris Whelen, State Laboratories Division administrator added, “We are grateful to the CDC ELC program, and very excited about expanding the role of the State Laboratories in combating drug resistant infectious diseases.”

The Department of Health’s Disease Outbreak Control, Environmental Health Services, Family Health Services, Communicable Diseases and Public Health Nursing, and State Laboratories Divisions are working jointly across the department and with partners throughout the state to assure a comprehensive Zika prevention strategy and response plan. The ELC funding in addition to grants through the Public Health Emergency Preparedness Cooperative Agreement and the Hawaii Birth Defects Surveillance, Intervention, and Follow-up for Zika Virus Grant will further support these efforts to protect public health.

Information on Zika virus can be found at the Department of Health’s Zika webpage at http://health.hawaii.gov/docd/dib/disease/zika_virus/.

For more information on the ELC program, go to http://www.cdc.gov/ncezid/dpei/epidemiology-laboratory-capacity.html.

Statewide Campaign on Mosquito-Borne Diseases and Threats to Hawaii to be Announced

Governor Ige and the Mayors of Honolulu, Maui, Kauai, and Hawaii Counties will announce a new statewide public education campaign to build awareness of mosquito-borne diseases and their threat to Hawaii.

Mosquito Bite

The state and counties will also announce the state’s planning efforts to prevent, prepare, and protect Hawaii from mosquito-borne disease outbreaks this summer and throughout the year. State departments will mention special efforts underway to reach visitors, traveling residents and students with guidance on preventing the spread of Zika.

Why: As a favorite travel destination, Hawaii is identified as one of the nation’s higher risk areas for the potential spread of Zika virus. With the Aedes Aegypti mosquito present in our state, year-long warm climate, and past experience with dengue outbreaks, mosquitos pose a serious threat to our residents and visitors.

When:  Thursday, June 30, 2016 at 1:00 p.m.

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

Who:

  • Governor David Y. Ige
  • Mayor Kirk Caldwell, City & County of Honolulu
  • Mayor Alan Arakawa, County of Maui
  • Mayor Bernard Carvalho, County of Kauai
  • Mayor Billy Kenoi, County of Hawaii
  • Dr. Virginia Pressler, Director, Hawaii Department of Health
    Major General Arthur J. Logan, Adjutant General, Department of Defense
  • George Szigeti, Director, Hawaii Tourism Authority
  • Ross Higashi, Airports Division Deputy Director, Department of Transportation
  • Steven Schatz, Deputy Superintendent, Department of Education

Hawaii Department of Health Delays Announcement of Medical Marijuana Dispensary Licensees to April 29

The Hawaii State Department of Health is reviewing the criminal history records of applicants for the Medical Marijuana Dispensary licenses after announcing last week that applicants were given notice to provide consents and submit fingerprints.

Medical Marijuana“The applicants have been very responsive and a majority of applicants were able to submit their fingerprints and consents by Tuesday,” according to Peggy Leong, Supervisor for the Medical Marijuana Dispensary Licensing Program. “A small number of applicants are traveling abroad and unable to respond as quickly as we had hoped. In addition, it also came to our attention that many business entities, such as limited liability corporations, corporations and trusts failed to submit the consents and fingerprints of the individuals involved in the entities. The department sent an email to all applicants clarifying the requirements of who is subject to a background check.”

“Given the situation, and in order to provide all applicants a fair opportunity to comply with the statutory requirements, we may not be able to obtain and review the remaining information until the last week of April,” Leong added.

Director of Health Dr. Virginia Pressler said, “We have requested that applicants submit the remaining consents and fingerprints no later than April 25 and we will be pushing hard to complete our review and announce the licensees by Friday, April 29. While we regret the delay, we believe the priority is to do this the right way, and that includes being fair to the applicants by providing this additional time.”

Leong said the applicants have all been very cooperative and understanding, despite the challenges of establishing a brand new and complex program, “We really appreciate their patience and willingness to work through this with us.”

More information about the Medical Marijuana Dispensary Program can be found on the website: https://health.hawaii.gov/medicalmarijuanadispensary

Hawaii Department of Health Statement on First Case of Zika This Year

The Hawaii State Department of Health has confirmed the first imported case of Zika in Hawaii this year. The individual had a history of travel in the Pacific and has since recovered and is no longer infectious. The case was confirmed this week by the department’s State Laboratories Division.

Mosquito sucking blood on a human hand

Mosquito sucking blood on a human hand

The department conducted an investigation of the case and has determined there is no health risk to the public.

To protect the privacy of the individual, no other information will be made available about the case.“Because people frequently travel to areas abroad where Zika virus is present, we can expect that we may see more imported cases in the coming months,” said Health Director Dr. Virginia Pressler. “With Zika, and our current dengue outbreak, it’s important for everyone in the state to reduce mosquito breeding areas by getting rid of standing water, and use repellant or protective clothing to prevent mosquito bites.”

The department sent an advisory to healthcare providers statewide on Feb. 17, 2016 updating them on clinical guidance for Zika virus and urging them to be aware of areas abroad where Zika virus is circulating.

In 2015, the Department of Health reported four imported cases of Zika virus in the state.

For travel guidance go to http://wwwnc.cdc.gov/travel/page/zika-travel-information For information on symptoms, diagnosis and treatment go to: http://www.cdc.gov/zika/symptoms/index.html For information on Zika and pregnancy go to: http://www.cdc.gov/zika/pregnancy/index.html

Hawaii Department of Health Takes Critical Role in National Efforts to Control Zika Virus

The Hawaii State Department of Health (DOH) State Laboratories Division is taking an active role in national efforts to control the spread of Zika Virus. Hawaii’s State Laboratories recently provided confirmatory testing for samples from American Samoa and the Marshall Islands to support these U. S. Affiliated Pacific Island Jurisdictions in verifying disease outbreak activity.

A mosquito laying eggs

A mosquito laying eggs

“Hawaii is fortunate to have an experienced and capable public health laboratory that can serve our state with timely and quality testing under emergency conditions,” said Health Director Dr. Virginia Pressler. “That same capability is not available in many other areas of the Pacific, and providing lab support to these areas, when we can, is critical to controlling the spread of diseases and reducing the risk of introduction to Hawaii.”

“With Zika emerging in U.S. island territories of American Samoa, Puerto Rico, and the Virgin Islands, the nation is on alert,” said Dr. Thane Hancock, team leader for the U.S. Centers for Disease Control and Prevention (CDC) American Samoa Zika Response.

The timely response by the Hawaii Department of Health’s State Laboratories staff provided critical support for local disease investigations and for monitoring potentially exposed pregnant women.”

This month, DOH began using the CDC developed real-time reverse transcriptase (rRT) polymerase chain reaction (PCR) test for Zika virus. With this recently developed capability, DOH provided officials in American Samoa and the Republic of the Marshall Islands (Majuro), the first laboratory evidence of Zika transmission in these two U.S. affiliated jurisdictions.

“It’s always a balance to ensure our state needs are met first, but the staff here is more than willing to step up to support national efforts,” said State Laboratories Director Dr. Christian Whelen. “This work helps to better prepare us for potential issues that could arise in our state, and identifying and controlling outbreaks in the Pacific benefits all of us.”

While PCR is the best test during early onset of symptoms, testing for antibody to the viruses is preferred after about a week of illness. CDC is shipping antibody test materials to Hawaii so that the department’s State Laboratories Division can establish these capabilities over the next few weeks.

“The testing is very similar to the methodology our labs use for other RNA viruses such as Chikungunya, dengue, influenza, and measles,” added Whelen. “Our laboratory staff have been thoroughly trained to safely work with high risk specimens.”

DOH continues to work with the healthcare community, state, county, and federal officials to prepare for infectious diseases that threaten Hawaii and the Pacific. The State Laboratories Division administers a statewide laboratories program which conducts and regulates scientific analysis in support of environmental quality, health and safety, and infectious disease monitoring and control activities.

Hawaii Department of Health Meets EPA Interim Targets Ahead of Jan. 29 Deadline – More Funding for Water Quality Projects

The Hawaii State Department of Health Drinking Water State Revolving Fund Program disbursed more than $10.36 million in federal funds in the last half of 2015 to support infrastructure improvements in the public water systems for all four counties. This exceeded the interim target of $7.67 million in disbursements.

Clean Water Act

In addition, as of Jan. 4, the Department of Health made commitments to provide funding totaling over $32.7 million, exceeding the $28.28 million interim target. The commitments for the four Hawaii County Department of Water Supply water system improvement projects include:

  • Over $4.1 million for the Laupahoehoe Reservoir;
  • Almost $12.9 million for the Waimea Water Treatment Plant microfiltration project
  • $823,420 for phase one of the Halaula well development project;
  • $3.2 million for the Ahualoa-Honokaa transmission waterline.

The Honolulu Board of Water Supply commitment involves $11.65 million for multiple water system improvements.

Each year, Congress appropriates funds that are administered by the EPA to provide grants to states to capitalize low-interest loan programs for public water system infrastructure improvements. The funds come with stipulations.

This year, Hawaii had to meet two interim requirements by Jan.29, 2016, and these were met well ahead of schedule by Jan. 4, 2016.

“We must continually demonstrate our stewardship of the federal funds and account for how the funds are being used before we can receive additional funds,” said Joanna Seto, Safe Drinking Water Branch chief. “Our SRF team and County customers were all aware of the pending deadline and what was at stake. There was great teamwork and collaboration to meet the deadline.”

The EPA awarded the Hawaii Department of Health $688,000 on Sept. 28, 2015, and withheld a little over $8 million in federal funds, pending the Department of Health’s ability to meet specific targets by Jan. 29, 2016.

Since it began in 1997, the Drinking Water State Revolving Fund has disbursed more than $201.5 million in low interest loans.

Background

There are two funds for water system infrastructure improvement projects: the Clean Water State Revolving Fund infrastructure loan program, established by the Clean Water Act of 1987, and the Drinking Water State Revolving Fund infrastructure loan program, established by the Safe Drinking Water Act Amendments of 1996.

The Clean Water State Revolving Fund, which is also referred to as Hawaii’s Water Pollution Control Revolving Fund, provides low-interest loans to Hawaii’s four counties to construct high-priority wastewater, storm water, and non-point source water pollution projects.

Since it began in 1991, the Clean Water State Revolving Fund has disbursed more than 705.8 million in low-interest loans, providing significant savings in interest costs to the counties.

Department of Health Issuing Recall on Oysters Imported from Korea

The Hawaii State Department of Health (DOH) is issuing a recall notice for frozen, raw oysters imported from Korea and sold in bulk to distributors and food establishments in Hawaii. The individually quick frozen (IQF) raw oysters on the half shell are packaged under the Dai One Food Company label.

Department of Health

The shellfish harvest dates are Feb. 10, 11, 12, and 13, 2015 and are listed on the required shellfish identification tags for all bulk shellfish cases. “The department has already conducted product trace-backs and embargoed all of the suspect product on Nov. 24 at various local shellfish distributors and restaurants,” said Peter Oshiro, “Although this product is not sold directly to the public, a recall has been issued as an additional safeguard to further notify anyone who may possess the product that it is unsafe and should be destroyed.”

A product embargo prohibits businesses from using a product suspected of causing illness until a determination is made on the safety of the product. The department received reports of sporadic illnesses (11 total) in September, October, and November of this year that appeared to be linked to the consumption of raw oysters.

Samples of the suspect oysters were sent to U.S. Food and Drug Administration Gulf Coast Seafood Laboratory in Alabama for testing, and the samples tested positive for Norovirus. With the positive lab results, DOH has ordered all of the embargoed product held by distributors and restaurants to be destroyed.

Norovirus symptoms include nausea, vomiting, abdominal cramps, diarrhea, fever, and headaches with onset usually within 12-48 hrs after consuming contaminated food. Anyone experiencing these symptoms should consult a physician and if foodborne illness is suspected, report it to the DOH Disease Investigation Branch at (808) 586-4586.

Department of Health food rules effective February 2014 require a consumer advisory at the point of sale for any restaurant or eatery serving raw or undercooked foods.

The advisory states, “Consuming raw or undercooked meats, poultry, seafood, shellfish, or eggs may increase your risk of foodborne illness.” Pregnant or immunocompromised individuals are also advised not to consume any raw or undercooked foods.

For more information on the department’s new restaurant rules and food safety program go to http://health.hawaii.gov/san/

Two Cases of Dengue Fever Confirmed on Big Island of Hawaii – Investigating Others

The Hawaii State Department of Health (DOH) is investigating two confirmed and four probable cases of dengue fever in Hawaii residents and visitors that was locally-acquired on the Big Island of Hawaii.

Mosquito Bite

Further testing and confirmation at the U.S. Centers for Disease Control and Prevention (CDC) is pending. The department sent out a medical advisory to Hawaii County clinicians earlier today to alert them and urge them to report suspect dengue fever cases.

“Although dengue is not endemic to Hawaii, we do have the mosquito species capable of transmitting the disease,” stated State Epidemiologist Dr. Sarah Park. “It’s likely an infected traveler infected the local mosquito population, which led to this cluster, so we want the public to be aware of this mosquito-borne disease and the steps they can take to prevent infection.”

“Our local environmental health assessments have not found significant mosquito activity in the affected area,” added Hawaii District Health Officer Aaron Ueno. “As a precautionary measure the department is conducting mosquito prevention activities such as spraying with consent from property owners.”

Symptoms of dengue fever typically begin within a week after a bite by an infected mosquito and can include fever, joint or muscle pains, headache or pain behind the eyes, and rash. Persons who have the above symptoms should contact their healthcare provider and avoid further exposure to mosquitoes, which is also the best means of prevention.

Dengue virus is most often transmitted through the bite of an infected mosquito. Travelers to areas with infected mosquitoes where dengue fever is endemic are at the highest risk of acquiring the disease. Mosquitoes breed in areas of standing water (such as planters, old tires and pet water bowls). Use mosquito repellents containing 20–30 percent DEET and wear long sleeves and pants in areas where mosquito-borne disease is a concern. For tips on mosquito control, go to http://health.hawaii.gov/san/files/2013/06/Vector-mosquitohandout.pdf.

For more information on dengue fever, visit the DOH website at http://health.hawaii.gov/docd/dib/disease/dengue/.

Department of Health Now in Charge of Medical Marijuana – Rules Change

The Hawaii State Department of Health has completed the transfer of the medical marijuana registration program from the Department of Public Safety. The program officially became part of the Department of Health on Jan. 1, 2015. Hawaii is one of 23 states along with the District of Columbia that allows medical marijuana use.

Possession of a valid medical marijuana registration card issued by the Department of Health and based on the written certification of a physician permits the lawful cultivation, possession, and use of marijuana for medical purposes.

Act 177 was signed into law in June 2013 and authorized the transfer of the 14-year-old program to the Department of Health. As a health initiative, the medical marijuana program is better aligned with the Department of Health’s mission and the department’s experience in working with patients and health programs that involve public outreach, education and safeguarding patient privacy.

Act 178, which was also signed into law in June 2013, amends sections of the existing law. The Department of Health has made the following changes to comply with the law:

  • Law Enforcement 24/7 Online Verification – In accordance with Act 178, the Department of Health will provide 24/7 subject verification to designated law enforcement officers. Although no confidential information will be released, designated law enforcement officers will be able to verify if an individual has a valid medical marijuana registration card should the need arise for official law enforcement purposes. Designated officers are being trained by the department.
  • Registration Fee Increase -The patient medical marijuana registration fee has increased from $25 to $35 effective Jan. 1, 2015. A new, convenient online application and payment system makes the application process easier and faster. A portal administration fee of $3.50 will be charged for the required online services. “We’re working to make the medical marijuana program more accessible to Hawaii residents who may have a qualifying debilitating medical condition and could benefit from medicinal use of marijuana,” said Scottina “Scotty” Malia Ruis, medical marijuana program coordinator with the Department of Health.

The Hawaii Department of Health has also initiated a number of upgrades to the medical marijuana program:

Click to enter site

Click to enter site

  • New Medical Marijuana Website – The Department of Health has established a website with information on the medical marijuana program at www.health.hawaii.gov/medicalmarijuana This is the most complete and up-to-date source of information for patients, physicians, law enforcement officials and the public. The site’s home page features a sign-up box for automatic medical marijuana program updates. This is the best way to keep abreast of all improvements and changes as the Department of Health’s medical marijuana program develops.
  • Phone Information Hotline – The Department of Health has established a phone hotline with recorded messages on different aspects of the medical marijuana program. The phone number is 733-2177. Toll free numbers have also been established for neighbor island residents: Hawaii Island residents may call 974-4000, ext. 32177; Maui residents may call 984-2400, ext. 32177; and Kauai residents may call 274-3141, ext. 32177.
  • New DOH Medical Marijuana Registration Card – This month, the Department of Health began issuing its new medical marijuana registration card, which includes the location of the where the marijuana is grown and the name of the primary care physician. The new card is thin and wallet-sized like an insurance card making it easier for patients and caregivers to keep with them whenever they are in possession of medical marijuana. The new white card with a colored Department of Health logo will replace the long familiar Department of Public Safety “blue card.”
  • Physician Education – Physician outreach and information sharing through planned conference calls has been ongoing to ensure healthcare providers have accurate information about the program. Physicians who are currently certifying patients for the program are emailed information about conference calls and other updates.

Beginning Jan. 28, DOH will hold public hearings for the proposed adoption of Chapter 11-160, Hawaii Administrative Rules for Medical Use of Marijuana. This proposed new chapter will include the process for DOH to consider approval of additional debilitating medical conditions for medical use of marijuana; physician requirements to participate in the program; registration of qualifying patients and primary caregivers; monitoring and corrective action; administrative procedure; and confidentiality of information. The proposed rules are posted at http://co.doh.hawaii.gov/sites/har/admrulechange/default.aspx

Public hearings are scheduled in each county as follows.

  • Jan. 28 (10:30 a.m.-12:30 p.m.) in Hilo, Hawaii at the State Office Building conference rooms A, B and C located at 75 Aupuni St.
  • Feb. 2 (10:30 a.m.-12:30 p.m.) in Honolulu, Oahu at the Diamond Head Health Center room 418 located at 3627 Kilauea Ave.
  • Feb. 3 (10:30 a.m.-12:30 p.m.) in Wailuku, Maui at the State Office Building third floor conference room located at 54 South High St.
  • Feb. 5 (10:30 a.m.-12 noon) in Lihue, Kauai at the State Office Building basement room located at 3060 Eiwa St.

Requests or questions related to the upcoming public hearings may be sent to medicalmarijuana@doh.hawaii.gov

Medical Use of Marijuana Program Transferred to Department of Health

Effective January 1, 2015, Hawaii’s Medical Use of Marijuana Program was transferred from the Department of Public Safety to the Department of Health, according to Act 177.   Act 178  amends sections of HRS 329 Part IX , some notable changes, which became effective January 1, 2015, are:

  • “Adequate supply” changes from “three mature marijuana plants, four immature marijuana plants, and one ounce of usable marijuana” to “seven marijuana plants, whether immature or mature, and four ounces of usable marijuana at any given time.”
  • Notification of changes to information on the application – if the information provided to the department of health for registration changes, the registered program participant MUST report this change to the department of health “within ten working days” of the change. The previous requirement was “within five working days”

To get a complete understanding of ALL changes to the law, please read Act 178.

Medical MarijuanaClick Here to Learn What’s New About the Program

Click Here to Learn What’s Staying the Same

Click Here to Download the General Information FAQ

Other Documents related to Hawaii’s Medical Marijuana Program

Act 228 SLH 2000.  Hawaii’s initial Medical Use of Marijuana law.

Act178 SLH  2013 –  Makes several changes to the current law (such as: “adequate supply” of medical marijuana changes to 7 plants, regardless of maturity; useable marijuana changes to 4 oz; increase in registration fees from $25 to $35; and other changes) please read Act 178 for more information.

HRS-329 Hawaii’s Uniformed Controlled Substances Act (see part IX – Medical Use of Marijuana).

Department of Public Safety Medical Marijunana Program Info

U.S. Department of Justice “Update to Marijuana Enforcement Policy  Aug. 29, 2013.

U.S. Department of Justice “Formal Medical Marijuana Guidelines”  Oct. 9, 2009.

Department of Health Operating Air Monitoring Stations in Response to Lava Flow Activities

The State of Hawaii Department of Health is currently operating three (3) air monitoring stations in the Pahoa and Leilani estates area in response to the current and ongoing eruption and lava flow activities.  These monitors detect the presence of air borne particles that may result from the burning materials (vegetation , grass, brush, and other materials).

air quality guide

The data and information being collected by these monitors can be viewed at the following web site:  http://emdweb.doh.hawaii.gov/air-quality/ , click on “Quick Look” then go to “Puna Special Sites”.

 

Department of Health Reaches Settlement With Central Maui Landfill and Molokai Solid Waste Facility

The Hawaii State Department of Health (DOH) and the County of Maui Department of Environmental Management have reached a settlement on two enforcement cases concerning solid waste violations at the Central Maui Municipal Solid Waste Landfill and the Molokai Integrated Solid Waste Management Facility.

Department of Health

The combined settlement involves a cash penalty payment of $70,000 and a supplemental environmental project that is valued at not less than $70,000.

The proposed supplemental project is a household hazardous waste collection program for the islands of Maui, Molokai and Lanai to be conduct ed during fiscal year 2015 (July 1, 2014 – June 30, 2015). The County of Maui, the remaining county that currently lacks such a program, plans to continue the project beyond the inaugural year.

DOH cited the Central Maui Municipal Solid Waste Landfill with three counts of permit violations from January to April 2011 for failure to maintain leachate compliance levels in the leachate wet well and sump, and failure to monitor and record leachate levels after a storm event. The DOH initially imposed an administrative penalty of $121,900 prior to the settlement. The facility is located off Pulehu Road in Puunene.

DOH cited the Molokai Integrated Solid Waste Management Facility with a two-count violation in April 2011 for failing to minimize liter generation and failure to place daily cover at the facility. An administrative penalty of $20,955 was initially imposed prior to the settlement. The facility is located off Maunaloa Highway in Naiwa.

The County of Maui has completed all corrective actions stemming from the alleged violations.

Department of Health Restricts the Use of Electronic Smoking Devices on DOH Properties

The Hawaii State Department of Health (DOH) has issued a directive containing a policy to restrict the use of unregulated electronic smoking devices on DOH properties.  The directive is the first of its kind among Hawaii state departments.

eCigarette

Beginning Jan. 1, 2014, the use of electronic smoking devices on all DOH properties, as well as premises occupied by DOH, is prohibited any place where smoking of tobacco products is not allowed by law. The policy applies to all DOH employees, visitors, volunteer, students, contract workers, delivery personnel, Department of Accounting and General Services workers, and all others who enter the work setting or environment which includes DOH and those premises occupied by DOH.

The unrestricted use of electronic smoking devices (such as electronic cigarettes, or “e-cigarettes”) is potentially hazardous to health. “Using electronic smoking devices threatens our smoke-free laws designed to protect the public from the harmful effects of tobacco and nicotine,” said Lola Irvin, DOH Tobacco Settlement programs manager. “While electronic smoking devices are touted for being smoke-free, they have not been proven to be safe. These devices release nicotine and other chemicals and carcinogens into the environment, leaving those around them exposed to the potentially harmful vapor just like second-hand smoke.  Electronic smoking devices also confuse the public who expect a smoke-free environment and erode the strong belief in our Hawaii Smoke-Free Workplace and Public Places Law.”

Electronic smoking devices are used by inhaling vaporized liquid nicotine created by heat through an electronic ignition system. This simulates cigarette smoking, thereby reversing the progress that has been made in establishing a social norm that smoking is not permitted in public places and places of employment.

The electronic smoking device policy was one of the last policies signed by the late Director of Health Loretta J. Fuddy, who passed away last Wednesday after the plane she was on was forced to make a water landing after taking off from Kalaupapa, Molokai. “Director Fuddy believed that as the Department of Health, it is our responsibility to set the standard for health for the people of Hawaii,” said Irvin. “Today, we are taking a stand to protect our workers and our public.  We hope to inspire others to take a similar position and join us in carrying out her legacy.”

 

State Department of Health to Hold Public Hearings for New Food Safety Rules

The Hawaii State Department of Health (DOH) will hold public hearings in all counties between Dec. 2 and 6, 2013, to introduce new food safety regulations that will affect all restaurants and food establishments in the state. The last substantial change to these rules was made nearly 17 years ago in 1996.

Department of Health

Highlights of the new food safety rules include: adoption of the 2009 U.S. Food and Drug Administration (FDA) Model Food Code as the basis for the rules; introduction of a highly visible restaurant grading system that will require food establishments to post the results of their last state inspection; move to annual permitting from biennial permitting; and permit fee increases.

“Adoption of the FDA Model Food Code will provide Hawaii with nationally recognized standards based on the most current scientific findings on food safety,” said Peter Oshiro, Sanitation Branch chief. “We look forward to enhancing our current state food regulations with these new and improved rules.”

The new grading system will consist of “PASS” (green), “CONDITIONAL PASS” (yellow), and “CLOSED” (red) placards. A “PASS” green placard will be given to food facilities that have one major violation or less that is corrected prior to completion of the inspection. A “CONDITIONAL PASS” yellow placard will be issued to a facility with two or more major violations during an inspection regardless of whether the violations are corrected on site. Major violations require a follow-up inspection. Follow-up inspections are conducted the next working day after notification from the facility that all major violations have been corrected. A “CLOSED” red placard will be issued if there are imminent health hazards that warrant immediate closure of the facility (lack of water, lack of electricity, sewage overflows in food preparation areas, sick employees, vermin infestation, etc.).

Major health inspection violations at food establishments are conditions that the Centers for Disease Control and Prevention (CDC) and the FDA recognize as the main causes of food illnesses (lack of hand washing, poor temperature controls, and contamination by raw/uncooked foods, etc.)

It is anticipated that the fee increases outlined in the new food safety rules will fund 13 additional full-time inspector positions granted by the state Legislature to be filled in fiscal years 2012-2015. The additional staffing will support an expanded inspection schedule that will include a minimum of three on-site inspections each year for high-risk establishments, two on-site inspections each year for medium risk establishments, and annual visits for all other establishments to meet national program standards and reduce foodborne illness.

“The new food safety rules will mean a huge step forward for our program and will result in overall improvements by expanding food safety testing, pesticide monitoring of local produce, and shellfish monitoring, among many other activities that protect public health every day,” added Oshiro.

To view Hawaii Administrative Rules Chapter 11- 50, titled, “Food Safety Code,” go to http://health.hawaii.gov/san/. Public hearings will be held at the following dates and locations:

Hawaii (Hilo): Monday, Dec. 2, at 1 p.m.

Environmental Health Facility conference room (1582 Kamehameha Ave., Hilo)

Hawaii (Kona): Tuesday, Dec. 3, at 1 p.m.

West Hawaii Civic Center – Liquor Control conference room, 2nd Floor, Bldg. B

(74-5044 Ane Keohokalole Hwy., Kailua-Kona)

Oahu: Wednesday, Dec. 4, at 1 p.m.

Environmental Management Division conference room, 5th Floor (919 Ala Moana Blvd.,

Honolulu)

Maui: Thursday, Dec. 5, at 1 p.m.

UH- Maui College Community Services Building (310 Kaahumanu Ave., Bldg. #205, Kahului)

Kauai: Friday, Dec. 6, at 1 p.m.

Lihue Health Center conference room (3040 Umi St., Lihue)

 

Stop Flu at School Program Begins Today

The Hawaii State Department of Health (DOH) annual Stop Flu at School program begins today and will continue in more than 300 public, private, and charter schools statewide through Nov. 27, 2013. This is the seventh year for the voluntary program, which administers free flu vaccinations to Hawaii students in kindergarten through grade 8.

Flu Shot“Despite cutbacks in spending at all levels of government, we prioritized funding for this important program, which helps protect our children,” said Health Director Loretta Fuddy. “By reducing flu in our keiki, older adults in the household will have less exposure to the virus, so that fewer of them will get it. Ultimately, this cost-effective prevention program saves lives and reduces healthcare costs.”

To vaccinate more than 60,000 students during the six-week program, DOH will orchestrate a team of more than 1,000 clinic staff that include volunteers from the Hawaii Medical Reserve Corps, state Department of Defense, Kaiser Permanente, UH Hilo School of Pharmacy, nursing programs at the University of Hawaii at Manoa, Hawaii Pacific University, Kapiolani Community College, Chaminade University, UH Hilo, Kauai County Community College, and UH Maui College.

The U.S. Centers for Disease Control and Prevention (CDC) recommends an annual flu vaccination for everyone six months and older.

“The Stop Flu at School program not only helps to protect the health of Hawaii students, it is an integral part of maintaining the state’s ability to respond to infectious disease emergencies like pandemic influenza,” said Dr. Sarah Park, state epidemiologist.

“Through this program, we are able to work with our many partners to practice and refine our mass vaccination plans.”

For more information about the Stop Flu at School program, go to http://flu.hawaii.gov/sfas.html or call the Aloha United Way information and referral line at 2-1-1. The Stop Flu at School program is an innovative partnership between the State of Hawaii Departments of Health and Education, the Hawaii Association of Independent Schools, and Hawaii Catholic Schools. The program is endorsed by the Hawaii Chapters of the American Academy of Pediatrics and the American Academy of Family Physicians and is made possible through funding received from the CDC and the Hawaii Association of Health Plans.

Department of Health Requesting Voluntary Removal of OxyElite Pro Pending Investigation of Cases of Liver Failure and Acute Hepatitis

The Hawaii State Department of Health (DOH) is alerting local retailers and requesting the voluntary removal from sale of the product OxyElite Pro pending an ongoing investigation of cases of liver failure and acute hepatitis. DOH Food and Drug Branch today began notifying retailers and distributors to voluntarily suspend sales and remove the product from store shelves until further notice. The public is advised to discontinue use of the product at this time.

OxyElite Pro

DOH is currently investigating 29 cases of acute hepatitis and liver failure that have occurred in the state from May through October 2013 and may be related to the use of diet supplements for weight loss and/or muscle building. The cases under investigation include two individuals that have undergone liver transplants and one death.

“Twenty-four cases reported using OxyElite Pro before their illness,” said Dr. Sarah Park, State Epidemiologist. “No other supplement or medication has been identified in common among more than two patients.”

“The department continues to urge people who use dietary or nutritional supplements for weight loss and/or muscle gain to talk with their doctor or health care provider,” said Health Director Loretta Fuddy. “Anyone who develops symptoms such as abdominal pain or discomfort, fatigue, loss of appetite, nausea and /or vomiting, and yellow skin or eyes, should consult their doctor immediately.”

DOH is working closely with the U.S. Food and Drug Administration and Centers for Disease Control and Prevention throughout the ongoing investigation.