5 Things Hawaii: Med-QUEST amendments, Early Bird Registration, Q&A w/ Heather Lusk


Emily Boerger


I’m keeping my fingers crossed that we will be in person at our 2022 Hawaii State of Reform Health Policy Conference this year. I think things are moving in the right direction and once kiddos can get vaccinated, I know a number of folks will be even more comfortable. Vaccinations will be required.

On a different note, this will be the last 5 Things We’re Watching email with my name on it. Emily Boerger, our managing editor, will take the reins moving forward. She is smart, thoughtful, and has been super important to my efforts here for some time now.

So, you may not see my byline here much in the months ahead, but we will hopefully be able to see one another face to face, in person, come January!





With help from Emily Boerger

1. Q&A: Heather Lusk, HHHRC

Heather Lusk is the executive director of the Hawai‘i Health and Harm Reduction Center, which serves communities impacted by homelessness, chronic disease, behavioral health, and poverty. In this Q&A with State of Reform Reporter Nicole Pasia, Lusk discusses worker burnout, compassion fatigue, and her organization’s work during the pandemic.

Lusk says throughout the pandemic it has been particularly important to be able to bring services directly to people. Their medical mobile unit allows outreach workers, counselors, and medical assistants to work on the street, but she says she’d like to see policy changes to make this service sustainable. “One policy issue is that street medicine is not reimbursable in the United States, let alone in Hawaii,” says Lusk. “So, I can’t pay for all of the mobile street medicine I do until that gets changed.”


2. Early Bird Registration open

In case you missed it, Early Bird Registration is now open for the 2022 Hawaii State of Reform Health Policy Conference coming up on January 12. I’m hopeful that this year’s conference can take place in person at the Hilton Hawaiian Village. We are also planning to offer a virtual component for those who wish to join us from their home or office.

Our Convening Panel will meet in the coming weeks to talk through the issues and topics that will be teed up for discussion at the event. So, if you have any topics, speakers, or content ideas, we would love to hear them. And, if you already know that you want to join us in January, be sure to take advantage of the discounted price and register today!

3. Med-QUEST plan amendments accepting public comments

Med-QUEST is currently accepting public comments on new amendments to the state’s Medicaid plan. At a recent advisory committee meeting, Administrator Judy Mohr Peterson offered details on the amendments which include language clarification for pharmacy services and updated language related to payment for hospice services. She also discussed a recently posted public notice addendum which delayed implementation of a new payment methodology for inpatient acute services.

The amendments were posted on Sept. 10 and comments should be submitted within 30 days after posting. Another amendment discussed at the meeting aims to ensure more equitable distribution of Disproportionate Share Hospital (DSH) funds, though the 30-day timeline for comments has passed. Full Med-QUEST amendments and information on submitting comments are located here, under the “Hawai‘i Medicaid State Plan/Amendments” tab.


4. Hawaii’s underfunded meth epidemic

Discussions about the rise in opioid abuse during the pandemic are common, but State of Reform spoke with one Oahu doctor who says the same focus should be spent on Hawaii’s methamphetamine epidemic. Data from the Pacific Health Analytics Collaborative shows from 2015-2018, 1.5% of Hawaii residents (roughly 17,000 people) used meth annually. This was more than double the national percentage of 0.6%.

Dr. Mark Baker at the Pali Momi Medical Center says stigma associated with meth use is a significant barrier to care, but the use of Hawaii Certified Peer Specialists can help during the recovery process. He notes, however, that funding is scarce and average salaries for these occupations range between $33,000 and $36,000 – a third of the average cost of living in Hawaii. Baker would like to see additional funding to address methamphetamine use come from the state’s opioid response funds.


5. Uncertain outlook for Build Back Better Act

“Nothing about the Biden spending plan is certain, including its health provisions.” That’s according to State of Reform columnist Jim Capretta, who in his latest piece dives into the weeds of the health provisions up for discussion in the $3.5 trillion Build Back Better Act in Congress.

Capretta outlines the state of play for some of the most expensive items being hashed out by lawmakers including the national ACA reinsurance program, Biden’s proposed $400 billion ten-year expansion of Medicaid HCBS, and dental, vision, and hearing coverage for Medicare. Capretta says the fate of the bill is highly uncertain and could be decided in a few weeks. Or, he reasons, conversations may continue through the end of the year and potentially into 2022.