5 Things Hawaii: Maternal health, Healthy Hawai’i Strategic Plan, Workforce shortages

While DJ is out trying to get in a well-deserved vacation, I’ll be bringing you this edition of 5 Things We’re Watching. I’m the managing editor here at State of Reform where I have my eye on health care and health policy in Hawaii and a number of other states.

Feel free to email me any feedback or tips on what you think we should be covering!


Emily Boerger
State of Reform

1. The future of maternal health initiatives

Providing health insurance for mothers does not always ensure a healthy outcome, says Sunny Chen, executive director for Healthy Mothers Healthy Babies (HMHB). “Having insurance is not a problem – we have one of the highest rates [in the country]. But we have bad health outcomes. So, it tells me we have health equity, racism, and so many other things at play that have an effect on our women’s health and our infants’ health.”

In this interview with State of Reform Reporter Nicole Pasia, Chen describes the future of maternal health in Hawaii and the efforts HMHB is pursuing to drive improvements. Efforts include support for better data collection, targeted education and services for vulnerable communities, and support for expanded forms of care such as health plan coverage for doula services.


2. Lisa Rantz discusses workforce challenges

A 2021 study lists three of Hawaii’s counties – Kauai, Maui, and Hawaii – among the top 15 counties in the nation with the largest primary care provider shortages. Lisa Rantz, executive director of the Hilo Medical Center Foundation, says increasing Medicare reimbursement and exempting medical services from the GET tax are both important solutions to address these shortages.

She says there is a delicate balance between solving immediate needs and creating a sustainable workforce pipeline. “[You want to] help to create systems that are sustainable, that have an impact, that can help get folks connected, that can help lessen disparities, and help build health equity.”


3. Healthy Hawai’i Strategic Plan

The Dept. of Health recently released its Healthy Hawai‘i Strategic Plan 2030 (HHSP) – offering a comprehensive roadmap aimed at preventing and reducing chronic disease in the state. Health Director Dr. Elizabeth Char says close to two-thirds of Hawaii residents live with at least one chronic condition such as heart disease or diabetes.

Under the plan’s health care sector section, goals include convening a Health Information Technology workgroup to enhance population health, establishing Medicaid coverage for services like Medication Therapy Management and Asthma Self-Management Education, and supporting team-based care. DOH says the initiatives outlined in the 10-year plan will shape policies, systems, and environments statewide.


4. Progress on telehealth and broadband

US Sen. Brian Schatz is leading a bipartisan effort in Congress to expand telehealth services through Medicare and make flexibilities adopted during the pandemic permanent. The CONNECT for Health Act of 2021 would remove geographic restrictions on telehealth services, provide the HHS secretary the permanent authority to waive telehealth restrictions, and require a study to learn how telehealth was used during the pandemic.

On a local level, the Department of Business, Economic Development and Tourism (DBEDT) Hawai’i Broadband Initiative issued an RFI last month seeking fixed broadband service providers for the Broadband Infrastructure Program. The federal program offers grant funding aimed at improving broadband infrastructure in rural areas.

5. Three lessons from Vox’s story on physician mental health

In a 4,700-word piece titled “The doctors are not all right,” Vox explores the structural barriers in place that make it difficult for doctors to access mental health care. The article highlights stories of physicians who have died by suicide, COVID-19’s impacts on physician mental health, and efforts to make it easier for doctors to access care. Here are our three lessons learned from the piece.

Vox Correspondent Julia Belluz describes suicide as an “occupational hazard” in the medical field. “The problems emerge in the high-stress years of medical school, and by the start of residency — when doctors’ DNA was found to age six times faster than that of their non-physician peers — rates of depression increase fourfold in the first four months. Across all residency programs, an average of one-third of doctors meet the diagnostic criteria for major depression.”