5 Things Hawaii: Health in the budget, Kōkua services RFP, Public health emergency


Emily Boerger


The final day of the 2022 legislative session is now less than a month away. With that in mind, this edition of “5 Things We’re Watching” features details on health policy on the move and the latest budget conversations taking place in the capitol.

Thanks for reading!

Emily Boerger
State of Reform


1. Senate committee to vote on budget

The Senate Committee on Ways and Means is set to vote later this week on the $16 billion state operating budget. The House unanimously passed the budget last month, slating funding for health initiatives such as the Kupuna Care Program, new positions for the Office of Long-Term Care Ombudsman, and Early Intervention Services.

During a hearing on March 22nd, senators reviewed agency budget requests and posed their concerns, including the delayed opening of the new Hawaii State Hospital psychiatric facility. DOH currently has a $5.3 million request for a hospital fire suppression system. Facility improvements, such as installations of safer door fixtures and showers, were part of the delay, said State Comptroller Curt Otaguro during the hearing. He noted, however, that the department’s construction contractor is working to address these fixes without additional costs to the state.


2. Oahu Region transition update

Financial decisions are delaying the transition of the Oahu Regional Health Care System to the Department of Health, which was originally slated for the end of this year. On Tuesday morning, the Senate Committee on Ways and Means voted favorably on House Bill 1579, which would extend the deadline of the transition and require a report to the legislature prior to the 2025 session.

One workgroup estimate found the transition would cost $10.3 million with an annual post-transition cost of $5 million, which lead DOH to testify in opposition of the transition. “We don’t think that for $10.3 million, we would be able to get anything more than what we’re achieving right now,” said Department of Health Deputy Director Marian Tsuji at the hearing, but clarified DOH would continue to work collaboratively with the Oahu Region regardless of the legislature’s decision.


3. Bills on the move

State lawmakers are working to pass dozens of health bills in preparation for Friday’s second decking deadline. Recent bill movement in the legislature includes policies that address telehealth, substance use, and the rural health workforce.

House Concurrent Resolution 89, which urges the DOH to diversify its workforce by hiring Native Hawaiians and Pacific Islanders, passed unanimously out of the House Committee on Health, Human Services, and Homelessness last week. In the Senate, the Committee on Ways & Means recommended a bill that would establish the Rural Health Task Force within the DOH. Yesterday, the Ways & Means Committee passed Senate Resolution 206, which requests restored funding for certain substance use disorder treatment organizations.

4. DHS issues RFP for Kōkua services

DHS issued an RFP last week in search of organizations to provide outreach, health insurance enrollment assistance, and other Kōkua services for Hawaii’s underserved populations through the Med-QUEST program. The contract will award a total of $1.45 million per year to multiple awardees from July 1, 2022, through June 30, 2024.

The department is specifically looking for support for populations that face challenges with insurance application and enrollment processes “due to language, cultural or other socio-economic factors.” The RFP comes as states continue to prepare for the Medicaid redetermination process, which will kick into high gear at the end of the federal public health emergency. Medicaid enrollment in Hawaii has increased by 35% since the start of the pandemic.


5. Details on Biden’s budget and the future of the PHE

State of Reform Columnist Jim Capretta’s recent columns cover topics that are particularly timely and relevant to ongoing state and federal health policy conversations. In this column, he reviews the status of public health emergency declarations and the various flexibilities put in place during the COVID-19 pandemic.

In his column released last week, Capretta dives into details of the “most significant recommendations” related to health care included in the Biden administration’s updated budget plan. He highlights the funding outlook for pandemic preparedness, the Build Back Better plan, mental health services, and ARPA-H.