5 Things Hawaii: Brian Baker, HCBS spending proposal, ICU capacity projections


Emily Boerger


We are at a tricky place in America right now vis-a-vis COVID. For the first time since January, more people are pessimistic about the future of the disease than are optimistic, according to new polling from Gallup.

Moreover, 1 in 3 vaccinated individuals are “somewhat” or “very worried” about contracting the virus. Statistically, they have about a 0.1% chance of that happening. So, thanks for hyping this, media. Hope that was worth it.

Of unvaccinated individuals, 20% are “somewhat” or “very worried” about getting the disease. Perhaps 80% of unvaccinated folks are a bit over-confident. But, for the 1 in 5 that are worried about it, getting a vaccine will help alleviate your concerns. If you’re not yet vaccinated, I can tell you this: it does wonders for your mental health. If you’re unvaccinated and worried about it, getting a shot will help.





With help from Emily Boerger

1. Report: Hawaii hospitals expected to face “extreme stress” in the fall

A new report out of the Institute for Health Metrics and Evaluation projects Hawaii’s ICU usage will be under extreme stress (where 60% or more beds are occupied by COVID patients) from September through November. No other state is projected to face extreme stress conditions for as long as Hawaii in the fall.

The report also estimates that come fall, inpatient hospital bed usage will be under extreme stress with 20% or more occupied by COVID patients. Again, Hawaii leads the country in this estimation. Hawaii has seen a 213% increase in COVID cases over the past two weeks, largely driven by a surge in Delta variant cases particularly among those not vaccinated.


2. Video: Brian Baker, Beacon Health Options

Brian Baker is the Vice President of National Client Partnerships at Beacon Health Options. In this video conversation, Baker discusses the importance of having honest conversations about behavioral health in Hawaii and the ways providers can seize this opportunity to make meaningful change.

“We need to take this opportunity to…help providers in the primary care setting feel more comfortable taking care of members with low to moderate acuity behavioral health concerns because we know that there are not enough behavioral health specialists out there in the field right now. So, if we can help extend the reach of behavioral health without further overburdening the behavioral health providers in the community, that’s a win-win for us.”


3. DDD submits HCBS spending proposal

DOH’s Developmental Disabilities Division (DDD) recently submitted a joint HCBS (home and community based services) spending plan with Med-QUEST, taking advantage of ARPA’s 10% FMAP increase. (Sorry about the acronyms… That’s health care for you.) DDD projects the funding attributable to the FMAP increase to be $15 million, but says those funds can be reinvested to make the funding for the proposed initiatives go further. The $30 million proposal focuses on 5 goals: supporting participants and their families, strengthening capacity and system infrastructure, workforce development, system accountability, and improving health and well-being protections.

During an online briefing, DDD Administrator Mary Brogan emphasized the importance of long-term funding. “We have to have an eye on sustainability. Some of these things are projects that can be implemented and completed in the next three years, but depending on the options that we choose, some will need much longer term strategies to be put into place. That has to be part of our planning.”


4. Leaders at odds over who to include in “herd immunity”

As of Tuesday, Hawaii is 60.3% fully vaccinated – about 10 percentage points shy of the 70% rate Gov. Ige says is necessary to remove all pandemic restrictions in the state. During a briefing last month, DOH director Dr. Elizabeth Char told state legislators that decreasing vaccination rates will make it unlikely Hawaii will reach 70% before September.

At the briefing, state leaders questioned if DOH should include individuals previously infected with COVID as parts of its herd immunity calculations. Deputy State Epidemiologist Sarah Kemble says Hawaii’s low number of confirmed COVID cases would be just a “drop in the bucket” compared to the number of vaccinations. Others argue that official COVID counts could be far lower than the true number of infections that took place in the state.

5. Supporting ALICE communities

Representatives from Aloha United Way, the Hawaii Budget and Policy Center, the Council for Native Hawaiian Advancement, and others hosted a discussion Thursday focused on supporting Hawaii’s Asset Limited, Income Constrained, and Employed (ALICE) population. Prior to the pandemic, 42% of families qualified as ALICE – that number jumped to 59% after the pandemic.

During the panel discussion, nonprofits offered an update on the work they’ve done during the pandemic to support job training, wraparound services, and financial planning for ALICE communities. Aloha United Way will host a final panel conversation on August 26 centered on legislative initiatives for ALICE communities.