5 Things Hawaii: Budget bill, 5 Slides video, Steve Robertson

Welcome to the second half of 2020! I appreciate very much your taking the time to read our stuff, to hear from our guests, and to forward this newsletter to other folks you think might want to subscribe. Our broader ohana in Hawaii, made up of everyone of you that follows our content, that speaks at our events, and who has helped us along over the last four years, has made all of the difference in our ability to continue to help foster discussion and conversation about moving Hawaii’s health system forward.

So, mahalo for all of the wind that you put into our sails. We are honored you give us this opportunity to help inform the work you are doing.





With help from Emily Boerger

1. 5 Slides: How Hawaii’s healthcare community is responding to COVID-19

We recently hosted our “5 Slides: How the Healthcare Community in Hawaii is Responding to COVID-19” virtual convening with Mark Mugiishi, MD, President & CEO at HMSA, Ray Vara, President & CEO at Hawaii Pacific Health, and Mary Boland, DrPH, Dean and Professor of the School of Nursing and Dental Hygiene at the University of Hawaii at Manoa. Through a series of 5 slides, the three leaders described COVID’s impact on Hawaii and touched on numerous issues including the economy and tourism, testing, preparedness, and health equity.

These conversations are free and meant to continue to foster community for those working to reform our system. We have another 5 slides conversation tomorrow morning, focused on COVID-19’s impact on mental health in Washington State. We have another Hawaii-specific event coming up later this month. So, stay tuned.


2. Budget bill on the governor’s desk

The Legislature passed a key budget bill (SB 126) on Friday, amending the state budget and outlining a plan to use $635 million in CARES Act funding. SB 126 relies on the rainy day fund and potentially tapping into the Hawaii Hurricane Relief Fund to help balance the budget.

The bill includes $100 million for housing and rental assistance for eligible households impacted by COVID, $100 million for the purchase and distribution of personal protective equipment, and $90 million to be used for airport screening and health security initiatives. The Department of Business, Economic Development, and Tourism is also slated to get $36 million to be used for workforce development programs. The Legislature is scheduled to consider a series of other bills prior to the July 10 session end date.

3. COVID numbers in context

Hawaii has a relatively small number of positive COVID cases. As of this morning, the state has a confirmed case count of 917 people and 18 total deaths. But according to Rt.live, Hawaii has the ninth highest effective reproductive rate in the country at 1.23. This has been a number we’ve been watching closely, and could signal a future uptick. I featured a similar trend in Texas a month ago, but wasn’t sure an uptick was assured. Today, Texas has a seven-day moving average of over 5,599 new daily cases, a quadrupling over a month ago. At that point, Texas had a per capita case count of 200 cases per 100,000 versus 577 today. Hawaii is now at 64 cases per 100k, or a third of where Texas was a month ago..

But, even a big increase on Hawaii’s small number is still (usually) a small number. That Hawaii’s positivity rate of tests around 1% is a good sign, too. That means Hawaii is likely catching more of the total positive cases than a state like Texas was. I know Hawaii isn’t Texas, but math is math. And, I think the lesson on the mainland is that things can spiral out of control very quickly if one is not careful.

4. Video: Steve Robertson, HPH

Steve Robertson is the Executive Vice President & Chief Information Officer, Revenue Management and IT, at Hawaii Pacific Health. He joins us in this edition of “What They’re Watching” to discuss tech innovations in health care, particularly highlighting voice-enabled technologies, artificial intelligence, and genomics.

“Genetic information is widely available and it’s being adopted more at the consumer level…I personally think that the human genome will be a fundamental part of your electronic medical record. That as soon as it becomes your record, and as medical advances become available, then we can install logic maybe using AI or other kinds of algorithms so that we’re providing you the best possible care based on your genetic makeup.”


5. Leadership Series: Lt. Gov. Josh Green

Last week Lt. Gov. Josh Green, MD, joined me for a one-on-one conversation as part of our new virtual “Leadership Series,” where he shared his thoughts on the progress Hawaii has made in managing the COVID-19 crisis both from a clinical perspective as well as an economic one. During the conversation, Green noted that Hawaii has been successful in limiting the spread of the virus, but that it has come at a big cost.

“We’ve had on the one hand, thank goodness, an extraordinary public health response where very few people have died and very little spread has occurred,” says Green. “But on the other hand, we’ve had incredible economic consequences.” In our conversation, Green lays out the next steps in encouraging tourism, re-opening the economy, and managing the state budget.