5 Things Hawaii: Tulsi Gabbard, Housing waiver approved, Topical Agenda

Good Monday morning!  We are five weeks out from our 2019 Hawaii State of Reform Health Policy Conference coming up on January 15th.  We’ll release our full list of speakers next week, a list that continues to develop and evolve based on input from our Convening Panel – and you!  If you have suggestions for speakers to address the sessions on our Topical Agenda, drop me a note. I’d appreciate hearing them.

DJ 5 Things Signature With help from Emily Boerger
and Marjie High


1.  ICYMI: Our Topical Agenda is now out!

In case you missed it, we recently released our Topical Agenda for the 2019 Hawaii State of Reform Policy Conference. This year’s conference is coming up on January 15th. With over 300 attendees and some of the most influential healthcare leaders in the state, this is an event we’d love to have you make!

As you may know, our agenda is built with the input from stakeholders across all silos in the Hawaii healthcare system. We’ll be exploring policy and politics in healthcare, assessing opportunities for reform, and diving deep into costs, disruptions, and care delivery. As always, if you have any comments or suggestions on we should include, you can send those my way. And if you haven’t already registered, we’d be honored to have you join us!

2. Changes in HI health policy leadership

The 2018 midterm election brought forth a rise in prominence for some health care leaders as well as changes to health policy leadership in the Hawaii State Legislature. Newly-elected Lt. Governor Josh Green has indicated that many of his priorities in office will revolve around health care, and he recently appointed several health care leaders to his staff.

Health and human services leadership in the state legislature is also changing – bringing additional leadership from neighboring islands. In 2019, Rep. John Mizuno will continue to Chair the House Health Committee, and Representative Joy A. San Buenaventura will Chair the new House Human Services and Homelessness Committee. In the Senate, Senator Roz Baker will again Chair the Senate Committee on Commerce, Consumer Protection, and Health, and taking over for Lt. Governor Green as Chair of the Senate Human Services Committee is Senator Russell Ruderman. Our run down of these leadership changes can be found here.

3.  Audit report: flaws with licensing process for adult care homes

A report from the State Auditor’s Office found significant issues within the Office of Health Care Assurance (OHCA), which governs the quality of care and re-licensing of Hawaii’s adult residential care homes. According to the audit, about half of the 214 examined care homes were operating with either an expired license or a license issued before all re-licensing requirements were met. The report also details OHCA’s lack of guidelines or rules of enforcement in instances where facilities do not meet quality of care requirements.

In response, the Department of Health issued a statement pointing to the improvements that are already underway at OHCA. “It is important to underscore that any risks to the safety, health and well-being of those in adult residential care home are immediately investigated and appropriate action is taken,” said DOH Director Dr. Bruce Anderson. “Further, significant improvements in operations have been made during and since the audit period.”


4.  Five things to know about Tulsi’s campaign for President

While it does seem a bit of a stretch for any member of the US House of Representatives to win the Democratic nomination for President, it seems particularly the case for Tulsi Gabbard’s campaign.  Conventional wisdom suggests the distance alone makes things tough.

Under the old DNC rules for nomination, that might have been the case.  But those old rules are now gone.  And, new rules make a pathway to national prominence for Tulsi much more possible – still narrow, but improved.  In this article, I outline five things you should know about why her chances have increased so much ahead of 2020.


5. CMS approves 1115 waiver housing services amendment

CMS recently approved Hawaii’s 1115 waiver amendment request that was submitted in August to use Medicaid funding to assist those experiencing chronic homelessness and mental health issues with finding housing. Services that will be covered by Medicaid dollars include assistance with housing searches, job skills training, moving assistance, and education and training on tenant responsibilities.

As of Jan 2018, there are 3,475 unsheltered homeless people living in Hawaii, and 3,055 sheltered homeless people – about 1,700 are considered chronically homeless. The expectation is that health care costs will decrease for eligible individuals through the delivery of housing services and other social determinants of health. With this approval, Hawaii becomes one of the few states approved to use CMS funds for these kinds of supportive housing services.