Q&A: Representative Della Au Belatti talks the 2021 budget process

Representative Della Au Belatti represents Hawaii’s 24th legislative district, which includes Makiki, Tantalus, Papakōlea, McCully, Pāwa’a and Mānoa. Since assuming office in 2006, she served as the chair of the House Health Committee from 2013 to2017, and in 2017 she was appointed the Hawaii House majority leader. As a member of the House Select Committee on COVID-19 Economic and Financial Preparedness, she is uniquely positioned to talk about how Hawaii plans to recover from the pandemic.

In this Q&A, Belatti discusses how the Legislature planned to tackle a budget deficit, and how they were able to save critical social services from the chopping block.

 

 

Sydney Kurle: What were your priorities going into the session? And how did those change as the session progressed and the pandemic continued?

Rep. Della Au Bellatti: “From the House majority perspective, we really wanted to focus the session, like so many other states, on the budget and stabilizing the state budget, because without doing that first you couldn’t do anything else. Because for Hawaii, the dropping of revenues was just so extreme. So we really needed to stabilize the budget first. 

Second, it was addressing the needs created by the pandemic, because if we didn’t get control and make sure that we have all of those needs addressed, then we really couldn’t move to the third priority, which was, ‘How do we start to restructure and reform government in order to position Hawaii for economic recovery?’

The way those priorities changed over time was the infusion of federal funds, which really helped to address that very first issue, stabilizing the budget. Then it allowed us to be able to address all those other things. I think one caveat would be that even though we have this one time federal infusion, I think that concerns continue to persist. Because again, we’re still in the global pandemic, I cannot keep emphasizing that enough, and we have to make sure that our tax revenues come in. And I think this is important, because it goes to your second question. What I hope is the second question. Now, what do we actually do in the budget, as in, how did we stabilize the budget. 

There were so many dramatic cuts, particularly to Health and Human Services. So what we did as the Hawaii State Legislature is that over $80 million dollars, as a combination of ARPA [American Rescue Plan Act], federal funds, as well as general funds were used to plug the holes for critical services like sexual assault services, domestic violence, perinatal services, general assistance in the Medicaid, the welfare budget and that human services budget. So funding those critical social safety net services, I cannot tell you how important that was for just the general health and well being of the community.”

SK: I wanted to touch on that portion of the budget because going in the session, it looked like there was going to be a deficit. And obviously, it’s very much like a what if sort of question, but before you knew that there was going to be this infusion of federal funds. What were some of the strategies you were considering to save these critical programs?

DAB: “The governor in his original budget had plugged in potential teacher and government worker furloughs. And I think for us, that was a priority not to do, because government workers were so critical going through the pandemic. If you think about all the public health nurses, the teachers who are running virtual learning from their homes, service providers, prison guards, the people at the airports, and all of these critical government services never stopped. So for us, it was important to try to figure out a way to do this without teacher and government worker furloughs. 

So one of the strategies we were looking at were things like looking at special funds and sweeping the money that we knew were sitting in special funds. It was looking at targeted cuts. And we didn’t get out of this budget cycle without some targeted cuts and reform and restructuring. And then I would also say that there was a look at targeted tax increases. Now, what we were looking at, before the federal funds came in was pretty dramatic. And I think what we were able to do with a combination of federal funds, sweeping of special funds, and the targeted tax increases, was that we didn’t balance the budget on the backs of taxpayers. We did have some targeted tax increases for our convenience tax, and some of our higher earners, but we were able to escape without having to make huge tax revenues at this time.”

SK: Can you highlight some important funding in the budget?

DAB: “For social services. I already mentioned the $14.3 million for homeless services. We also put in $5.4 million for general assistance welfare payments, $2.3 million to sex assault treatment services that were initially cut from the governor’s budget, I think by like 63%. We restored services so that there could be 24-hour, seven days a week stabilization services for sexual assault victims, because we were looking at cuts that would have required sex assault victims to come back on a Monday. They were going to just shut down on a weekend. So it’s those kinds of funding. We funded family health services $2.3 million, senior centers $1.5 million. There is just a laundry list, HIV services, TB [tuberculosis] services, all of these things we funded. When you look at all the social services that would have experienced cuts, and we allocated over $80 million to make sure all of those safety net services were restored and maintained.”

SK: Looking into the future, obviously, COVID has had an immense financial impact on just the world in general, but especially Hawaii, which relies so much on tourism. How is Hawaii going to be feeling the financial impacts of COVID for years to come?

DAB: “We spent quite a bit of time during the session looking at structural and regulatory reform to help us get beyond the pandemic. I would say there were probably four areas. I think a critical series of bills that we looked at [asked],‘How do we better manage tourism, since we are so reliant on tourism?’ And also with that, ‘How do we manage tourism and protect our natural resources?’ So there’s a series of bills that really focused on stewardship of our natural resources, created and consolidated different government agencies into an Office of Planning and Sustainable Development. One of the things I’m super excited about is we provided our Department of Land and Natural Resources with those [dynamic pricing] to better manage natural resources, because before COVID, frankly, we had a problem of over-tourism. And then we have another bill that restructured the Hawaii Tourism Authority that provides the counties with the ability to impose their own transit accommodation tax, to better deal with the problems of over-tourism on their specific Island. So that’s one series of bills. 

A second series of bills that we have related to the pandemic and was really revealed by the pandemic was that we need to have more broadband connectivity throughout the state. For lots of reasons, because of telehealth, which became very clear that we needed and we already had policy pieces in places to do telehealth. But we really feel like we need a broadband infrastructure to do telework and to do distance learning. So House Bill 1191 is a bill that really starts to lay the foundation for broadband infrastructure. 

The third area of bills that we really worked on relates to clean transportation, and ground transportation goals. This is related to things like making sure that we have an infrastructure that’s going to be able to electrify our system so that we can have more electric vehicles. And what it means is we need charging systems throughout the state. So we have goals set to make sure that our state fleet is moving towards electrification of vehicles. And that has a dual effect,  clean energy, as well as addressing climate change and greenhouse gas reductions. So that’s really important. 

The final area of bills that I think is critically important is health care. And so one of the things that we did was a lot of structural and regulatory reform in healthcare. This reform will address behavioral health needs in the community going forward. Those three bills are SB 628, which takes our public hospitals and kind of returns them back into the Department of Health to better coordinate universal health services, long-term beds and substance use beds. HB 1281, we have an emergency management system that is funded statewide, but operated by the counties. This bill begins the transition of giving back the EMS services to the City and County of Honolulu as a pilot project. And that’s critically important because they can do more innovative things like community paramedicine, which can address behavioral health needs, taking people that we know are high utilizers of emergency departments and directing them where they really need to go, which is a more clinical setting. This EMF transfer bill is a huge foundation for setting up for better services into the future. And the third bill in the series of bills is HB 541, which really begins to look at the working group in the Department of Health. And it’s clarifies that groups role to look at the gaps in services for behavioral health, and begin to weave together, all of those beds and services we know are out there in the community. So we know where the gaps are that we need to fill. So that group is going to be doing the work to ensure that there’s a continuum of services in the community. 

Those three bills together are critical for long-term care service, behavioral health needs and substance use in the community. People don’t really talk about it because those are not sexy or they’re too hard to understand. But those are the bills that are foundational in my mind.”

SK: Would you say going forward for Hawaii that there’s going to need to be continual investments in, not only the public health infrastructure, but also behavioral health services and getting people into the treatment that they need, not just accessing emergency rooms.

DAB: “That’s exactly what we’re gonna be working on moving into the future. You know, we showed up to make sure that our Medicaid services are going to be funded. And that those are going to be available, we put in $14.3 million of federal funds into homeless services, including housing first programs, rapid rehousing, family assessment centers, homeless outreach, and civil legal services. Those are important, because we know so many of those people who are in those programs are Medicaid recipients, and they may be high utilizers of our emergency department rooms, or they have serious mental illness or behavioral health problems that need to be addressed. So the investment of those federal funds into those homeless outreach programs and services, those are addressing the social determinants of health, all of those other external health factors that we have to make sure that are taken care of. So we did that. 

And now I think the work again begins to move ahead where we have to keep looking at our services and our systems, and our funding mechanisms and our payment procedures. And that takes a lot of rolling up the sleeves and doing the work between government payers, as well as insurance companies that are funding all of these things, all these big programs like Medicaid and Medicare. So this is all conversations that we’re having with our state and federal agencies. 

And one last thing I will say, in the area of Medicaid, prior to COVID, our Medicaid, our Med-QUEST department has put out an RFP and had also applied for a waiver that would have looked at how we integrate homeless support services into our Medicaid program. I think the last I checked with the Medicaid department is that they are still in the process of, if they haven’t already, they’re going to reapply for that waiver as well as reissue our RFP. And that’s going to be critically important. So that was pre-COVID work that got paused because of COVID. But to set us up for the future, we have to continue to pursue those policies. Those policies were good, pre-COVID. And we have to keep following them post-COVID.”

This interview has been edited for clarity and length.