Hawaii’s legislative session kicked off in January, and political insiders met at the 2024 Hawaii State of Reform Health Policy Conference to highlight last year’s successes and goals for the new session, including strengthening the state’s healthcare workforce.
Beth England, MD, chair of the Hawaii Medical Association Public Policy Committee, said the goal of the committee is to prioritize the reduction of disease and improve public health through education and advocacy. She said she is excited Hawaii is continuing to protect the reproductive choices of patients, including abortion care.
“One thing we’re excited to see is that it protects patients and providers caring for patients out of state coming to Hawaii to seek those services that may not be available in their own state, and we really, really value the importance of protecting that patient-provider relationship.”
— England
England highlighted last year’s taxation of electronic smoking devices and liquids as a great example of Hawaii following evidence-based public health measures. A 10 percent increase in the price of cigarettes, for example, led to a seven percent reduction in tobacco use.
Hawaii also joined the Interstate Medical Licensure Compact in 2023, which creates expedited pathways for physicians licensed in one state to become licensed in other states. England said this will help the state address workforce shortages and incorporate more telehealth providers from other states.
“Through our public policy committee, we’ve been working to expand our legislative involvement, and are very dedicated to advocating on behalf of our patients, communities, and fellow physicians,” England said.
To continue the state’s successes, England said there needs to be effective collaboration with the legislature. From volunteering and witnessing the legislative process in action last year, England learned how vast the responsibilities of any given legislator are, including hearing hundreds of bills on a variety of healthcare topics. She said effective legislation needs to rely on outside expertise.
“I think learning how to become that effective resource for your legislators is a way to become a more successful advocate,” England said.
The committee’s 2024 goals include improving access to healthcare, recruiting and retaining physicians by removing barriers, and being aware of healthcare bills related to the expansion of behavioral health treatment.
“A lot of what we focused on last year was to support our providers,” said Paige Heckathorn Choy, associate vice president of government affairs at the Healthcare Association of Hawaii.
Supporting the workforce will increase access to care and will reduce the wait times patients face to get an appointment, Heckathorn Choy said. The healthcare industry is a great environment for youths and individuals looking to change careers, and can help them do something meaningful while earning a living wage, she said.
“These are good jobs that we want to support in this community,” Heckathorn Choy said.
The Healthcare Education Loan Repayment Program (HELP) was also a major positive for the state, Heckathorn Choy said. HELP provides an unprecedented $30 million in educational loan debt repayment to health professionals licensed or otherwise certified to practice in and provide care to patients in Hawaii.
Workforce is the top focus for Heckathorn Choy this year, although the association won’t be bringing forth large funding requests this year. There are existing workforce program initiatives that target youths in high schools, and help them get through application and interview processes, while reducing all barriers, she said. Cost of living is a common barrier for the Hawaii healthcare workforce, based on what Heckathorn Choye’s been hearing from providers. And she is brainstorming how to manage the cost of living from a housing aspect.
“I don’t know where it’s always been the case where hospitals, physicians, and health plans have as much in common as we do today in Hawaii,” said Jennifer Diesman, president of the Hawaii Association of Health Plans (HAHP) and senior vice president of the Hawaii Medical Service Association.
HAHP encompasses nine health plans, and Diesman said there has been greater alignment among all of them than ever before.
“Not every issue touches every health plan the same way,” Diesman said. “Unanimity is important because it creates trust among the health plans, so even if an issue itself doesn’t affect everyone equally, there’s bridging the divide between the different programs, and everyone has an awareness that we’re trying to impact the overall health of the community.”
Diesman said the devastation from the wildfires in Maui and Lahaina brought to light some health issues like housing and workforce shortages, and rural access to care.
“At the end of the day, I think the primary focus is going to be on Maui,” Diesman said.