By Jim Epstein - Before the Apple Watch was revealed on September 9, it was rumored to include several biometric sensors that could track the vital signs of the person wearing it. The first iteration of the device turned out to be disappointing in this regard: It has only a heart rate monitor. But future iterations of the watch will likely track our body temperature, glucose levels, tremors, oxygen, and hydration, helping patients stay out of the doctor's waiting room.
This is just one of many promising ways in which Silicon Valley is poised to remake the monstrously inefficient health care industry. But can the tech industry stop the government from strangling its emerging ventures?
Take the Palo-Alto based company Theranos, founded in 2003 by Stanford University sophomore Elizabeth Holmes. It's developed a new approach to phlebotomy that involves a simple finger prick. The company uses software to test a single drop of blood on the spot at prices that read like they’re written on the menu board above a deli counter: Checking cholesterol levels costs $2.99. A glucose-tolerance test runs $8.85. Looking for the presence of a cancer antigen sets customers back $14.31. Holmes, now 30, tells the story of a diabetic who recently had several tests performed by Theranos for $34 that otherwise would have cost the insurance company $876.
Clinical labs like Quest Diagnostics, which booked $7.1 billion in revenues last year, aren't the only firms that need to watch out for Theranos. Patients don’t need to bother with insurance companies when a test costs just $2.99. Holmes, whose board of directors is packed with former high-profile government officials, is passionate about changing federal health laws to empower consumers. In February, Theranos scored a victory when the Department of Health and Human Services issued a new rule allowing patients in all 50 states to view their lab results without involving a doctor.
Other ventures aim to help patients make use of all this health data. Curious, a health technology firm cofounded by Linda Avey (who also helped start thepersonal genetics firm 23andme), will start beta testing a new platform in November that synethesizes genetic information (collected by 23andme), microbiomic profiles (collected by a startup called uBiome), personal traumas and life events that users will enter manually (such as a fight with a spouse), and (eventually) biometrics collected by wearables such as the Apple Watch. It will then analyze the information in a way that helps users determine what’s helping, causing, or exacerbating various ailments and conditions.
The company's cofounder and Chief Technology Officer, Mitsu Hadeishi, compares Curious to other peer-to-peer tech companies like Airbnb and Uber because customers will "anecdotally share things" with each other and the software will utilize its network to “look at patterns on a larger scale.” As an example, Hadeishi cites reports that eating the root black cohosh helps mitigate hot flashes. Through Curious, users could track the treatment's effectiveness and share their experiences with other users. If black cohosh helps some participants and not others, the software would look at other aspects of their health profiles that might explain the difference. "It’s not just people randomly saying things on message boards," says Hadeishi.
Ultimately, clinical studies will be necessary to establish links between treatments and outcomes, and Hadeishi sees Curious’ software in part as a "hypothesis generation source." In the past, clinicians could come up with broad theories about what works simply by observing their patients, but in the future doctors need to develop treatments tailored to subsets of patients based on their unique physiologies, so patterns are harder to detect. Tools like Curious’ software could help scientists develop testable ideas.
Medicine is in part about solving mysteries, and eventually Curious’ software (or similar products by other tech firms) could be much more effective at diagnosing problems than high-priced specialists. Yet Curious, like any company seeking to enter this space, has to look out for the Food and Drug Administration (FDA). Companies don't need the agency's approval to market products that track and share raw information on patients, but they get into trouble with the FDA when they try and make "predictive claims," says Paul Howard, the director of the Manhattan Institute’s Center for Medical Progress. Last November, the agency forced 23andme to pull its $99 personal genome test off the market for giving customers too much information about the implications of their test results.
Curious is walking a fine line in this regard, and the FDA could force the company to submit to an expensive approval process that would likely put it out of business. (Curious has raised about $900,000 in seed funding to date.) But Hadeishi says he's fairly confident that his product won’t require FDA approval, and he’s been in touch with staffers in the office of the U.S. Chief Technology Officer—a position created by President Obama to cut red tape—who are "aware of the types of things we want to do” and "want to find a way to accommodate innovation.”
Another way for patients to make use of all the health data available to them while avoiding costly and time-consuming office visits is through the burgeoning field of telemedicine.Doctors on Demand, which the Mercatus Center’s Robert Graboyes wrote about recently in Reason, offers users 15-minute online video chats with physicians for a flat fee of $40—or about the price of a co-pay to visit a doctor’s office under many insurance plans.
The Palo-Alto based HealthTap offers a similar service, with unlimited calls for $99 a month (plus $10 additional per family member), and participating physicians will call in prescriptions and examine physical symptoms photographed with a smartphone. A current limitation is that providers can’t check a patient’s pulse or temperature through a video call—but biometric data-gathering devices could change this, making telemedicine considerably more useful. A less surmountable limitation are state laws dictating that a physician licensed in one state can't treat a patient in another.
In its efforts to Uber-ize health care, Silicon Valley’s biggest challenge will be convincing states to repeal competition-killing licensing laws and working with the FDA to let software eat its way through our antiquated, expensive, and labor-intensive approach to patient care. There’s reason for optimism: In recent years, the tech industry has become far more adept at navigating the regulatory terrain in Washington. The next big political idea to fix our nation’s health care system should be to get out of the way.
Jim Epstein is a producer at Reason TV.
HONOLULU – Calling it a classic case of elderly neglect, Acting Attorney General Diane Taira announced today that a Waipahu caregiver has pleaded guilty to Manslaughter in a Honolulu Circuit Court. 36-year old Jennifer Polintan recklessly caused the death of 88-year old Nona Mosman in May of 2013.
Ms. Mosman was a client in Polintan’s care home which was licensed as a Community Care Foster Family Home (CCFFH) in Waipahu. The State Department of Human Services (DHS) certifies these care homes to enable individuals needing 24-hour care in an intermediate care facility or a skilled nursing facility to remain in a home setting as part of a family. The state licensing rules for a CCFFH require that during extended absences the licensed caregiver must provide duly qualified individuals to act as substitute caregivers. The rules also require the licensed caregiver to follow a care plan as directed by the client’s primary care physician and state contracted case management agency.
Ms. Mosman became non-ambulatory in late 2012 and was bedbound in early 2013. Once bedbound, Ms. Mosman became susceptible to bed sores and needed to be repositioned every two hours throughout the day. Ms. Mosman was completely dependant on Polintan for her activities of daily living, including eating, drinking, general hygiene, toileting, and basic self-maintenance.
An investigation conducted by Special Agent Derrick Kiyotoki of the Department of the Attorney General Medicaid Fraud Control Unit revealed that Polintan worked full time at Schofield Barracks and was absent from the home for 10 hours a day, Monday through Friday. During her extended absences, Polintan left Ms. Mosman in the care of individuals who were not duly qualified and who were incapable of carrying out the care plan. As a result of Polintan’s neglect, Ms. Mosman’s health declined rapidly, culminating in her death in May of 2013.
Acting Attorney General Taira acknowledges that providing care to elderly persons can be difficult and trying, but says that, “When someone makes a conscious decision to bring a dependent adult into their home under the guise of providing care, and is getting paid to provide that care, then it is inexcusable and can have tragic consequences when they fail to do so.” Taira adds that while these cases are difficult to investigate and prosecute, "the Department is committed to protecting the safety of vulnerable members of our community who can’t look out for themselves."
Polintan, who cooperated in the investigation and prosecution, will be sentenced on January 7, 2015, before First Circuit Judge Richard K. Perkins. The plea agreement provides that Polintan will serve one year in jail, and in addition will pay $8,980 in restitution to Ms. Mosman’s family, $4,888.00 in restitution to the State of Hawaii, a $600 fine, and court costs.
According to Deputy Attorney General Michael Parrish, who is prosecuting the case, “This type of case can go undetected without the vigilance of medical professionals and oversight agencies. Thankfully an akamai hospice nurse and social workers with the DHS Adult Protective Services branch broug
Alston Hunt Floyd & Ing (AHFI) and the Hawaii Disability Rights Center filed a lawsuit on September 5th in U.S. District Court accusing the State of Hawai`i Department of Human Services of denying critically needed treatment for autistic children.
Without the service, called applied behavioral analysis (ABA) treatment, children with autism are less likely to reach their full developmental capacity and are more likely to be institutionalized as adults.
The suit seeks an injunction to require the state to provide ABA to be in compliance with federal Medicaid rules. AHFI attorneys Paul Alston, Kristin Holland and Maile Osika represent the plaintiffs.
Founded in 1991, Alston Hunt Floyd & Ing counsels and represents clients in all types of civil matters,
including business disputes, real property matters, bankruptcy and insolvency, civil rights, healthcare law, employment law, government contracts, government relations, and strategic planning.
Alston Hunt Floyd & Ing is a member of the International Society of Primerus Law Firms.
REPORT FROM DHS - HONOLULU – The Department of Human Services (DHS) Benefit, Employment and Support Services Division (BESSD) has successfully closed a February 2011 class action lawsuit for failure to issue Supplemental Nutrition Assistance Program (SNAP) benefits within timeframes outlined by federal law. To address the application backlog, BESSD developed and implemented the Business Process Re-engineering (BPR) project, which converted the former Case Management system to a Process Management system.
Between Oct. 1, 2013 and Aug. 31, 2014, the average monthly timeliness rate for SNAP applications increased to 96.83 percent, a 30-percent improvement since Gov. Neil Abercrombie came into office.
“BESSD eligibility workers now consistently review and determine applicant eligibility within the federally mandated period of 30 days and seven days for emergencies,” said Pankaj Bhanot, BESSD Administrator.
As a result of these measurable improvements and successes, the U.S. District Court recently issued an Order of Settlement and Dismissal. “The dismissal is most welcome,” said DHS Director Patricia McManaman. “It is really a testament to the dedication and hard work of the DHS BESSD staff.”
Dismissal of the lawsuit follows a $724,000 federal Food and Nutrition (FNS) Service bonus to BESSD for the nation’s most improved SNAP Program Access Index. The BESSD also received the 2014 Global Case Management Award for Excellence in Social Services for its nationally recognized enterprise content management solutions. Combined with the reengineered business processing, both initiatives contributed significantly to the improved application processing rates.
The class action lawsuit addressed application backlogs that accrued between 2008 and 2011, a period when the number of Hawaii SNAP recipients increased from 93,956 to more than 179,700 participants. During that same period, DHS also was operating with a severely reduced workforce and limited program funding. In some locations, timely application processing rates dropped to 29 percent.
Today, SNAP application processing rates vary between 96-98 percent, and BESSD continues to exceed federal requirements. Currently, an estimated 98,360 Hawaii households (193,446 individuals) receive SNAP assistance each month. On average, BESSD issues $43.3 million in benefits each month to Hawaii SNAP recipients.
HONOLULU – Attorney General David M. Louie announced that Roselani Wise (51, Lihue) was charged with Theft in the Second Degree on July 23, 2014 and arraigned on August 12, 2014, before Judge Randal Valenciano, Fifth Circuit, Island of Kauai. Her trial has been set for October 6, 2014.
Ms. Wise, a former Department of Human Services (DHS) investigator on the island of Kauai, was charged with Theft in the Second Degree for receiving unearned compensation from the State of Hawaii from 2008 through 2012.
An investigation revealed that during the hours for which she was being paid by DHS to conduct criminal fraud investigations, Ms. Wise was employed and actually working for the Federal Transportation Security Administration at the Lihue Airport.
Ms. Wise received in excess of $10,000 for work she did not perform.
A charge by way of Written Information is merely an allegation against Ms. Wise and she is presumed innocent until found guilty of the charge beyond a reasonable doubt by a judge or jury.
HONOLULU — House Majority floor leader Rida Cabanilla is out of a job after losing the Democratic primary to Matt LoPresti.
Hawaii Reporter was first to report in May that Cabanilla controlled a 501-c-3 nonprofit that received a $100,000 grant from the Hawaii State Legislature, which had lost its federal tax-exempt status with the IRS when it neglected to file required paperwork for at least three years.
Cabanilla told Hawaii Reporter she filed paperwork with the IRS for the Ewa Historical Society Inc. to rectify the issue, but that was after she already applied for — and was granted — funding from the Legislature. Cabanilla had not told fellow lawmakers she controlled the charity - or that it was out of IRS compliance - before they granted the charity’s request, and her name did not appear anywhere on the application submitted to the Legislature.
The Old Ewa Cemetery, a historic site founded in 1896, has been owned by the city and county of Honolulu since the 1970s and is maintained by the city and county and volunteers, including descendants of people buried there.
Former City Council Member Berg, who lives in Ewa, noted the charity applied in January for a $200,000 grant from the Legislature to hire three landscapers at $42,000 a piece and three grounds keepers at $23,000 each to take care of the 3-acre Old Ewa Cemetery.
If the grant had been awarded it would have equated to $17,000 a month in state funding going toward maintenance, in addition to what the city already does monthly, Berg said.
Since the Legislature awarded Cabanilla’s charity just half the money it requested, she told Hawaii Reporrter, “The $100,000 is just for weed whacking.”
Cabanilla explained she originally listed six positions on the application because she didn’t want anyone to work at the cemetery alone because of safety concerns, including sink holes near graves and ghost sightings. The state attorney general said in July that Cabanilla's charity would not receive the grant because of the tax filing issue.
The controversy over the cemetery isn't the only one that likely contributed to Cabanilla's political demise.
In Nov. 2013, the state Campaign Spending Commission fined Cabanilla $500 for filing “false or inaccurate” campaign spending reports and $50 for filing the reports late. Cabanilla held a fundraiser in March 2013, which raised nearly $5,800 and expended nearly $2,900. Her campaign spending report said she had no activity during that period. She apologized publicly for her “error.”
In January, Cabanilla brought media coverage after she proposed solving Hawaii’s financial troubles by legalizing cultivating, manufacturing and exporting marijuana and marijuana food products internationally.
In July, Cabanilla proposed implementing “Return to Home,” which would set aside $100,000 over three years to buy homeless people from the U.S. mainland one-way airfare home. Cabanilla said giving the homeless airline tickets would reduce the ever-growing problem of homelessness in Hawaii and ensure the homeless can reconnect with family and support networks in their home states.
Neither the governor nor the state Department of Human Services, the agency that establishes and administers the program under state law, has implemented it. The Department of Human Service director said she believes the program would attract more homeless people to Hawaii.
In the general election, LoPresti will take on Berg, who is running as a Libertarian. Brian Jeremiah, a New Hope pastor who reformed himself after criminal past, is running as a Republican.
By Tom Yamachika - Our legislative session for this year is now over. Among other things the legislature passed this year was the state budget. With the exception of a few line-item vetoes, Gov. Neil Abercrombie signed the bill and now we have a budget.
Our state's fiscal year started on July 1st. With that new budget in place, can agencies like our Department of Taxation start implementing the plans that are in their approved budget? The answer is no. Despite having a budget in place, the Governor's office has ordered spending restrictions. The restrictions are across-the-board, meaning that every agency must take its general fund budget and cut it again by a certain percentage. For the fiscal year that just began, that percentage is 10%, double the amount restricted last fiscal year.
Kalbert Young, director of the state Department of Budget and Finance, said this restriction was ordered because state revenues are predicted to be flat to nearly a half percent lower than for the fiscal year that just ended. "While the ten percent is admittedly larger, it's still only preliminary and it's really until certain financial and fiscal metrics are more thoroughly evaluated for the state," he told HawaiiNewsNow.
The restrictions mean departments will not be able to spend money buying new vehicles and other equipment, hire new personnel or expand new programs or start new ones, at least for the next few months.
But what about fixing things that could use some repair?
Witness our Department of Taxation. In its annual reports, it said that when taxpayers called, their employees were able to answer the phone only some of the time. This percentage has varied over the years: 90% in the fiscal year ended June 30, 2007, 81% in 2008, 80% in 2009, 61% in 2010, 40% in 2011, 57% in 2012, and 59% in 2013.
Folks, if our tax agency can only pick up the phone half the time, and they are making the news for duplicate bills and other issues, a 10% indiscriminate budget cut is not going to help fix them. We need to realize that we depend on tax revenue, and that we depend on this department to bring it in. Are we going to starve the golden goose to make it lay more eggs?
We already know that the Department of Education has asked for reconsideration from the cut since it comes at the beginning of the school year when public schools have their largest start-up costs. If our government leaders are inclined to grant requests like this one, shouldn't reconsideration be given to our tax agency which brings in the funds so desperately needed?
Sure, every department and every office will argue that their programs and services are essential, and they all will have good arguments. Thus, one may think that to be fair, every agency must feel the ax equally. But in practice that isn't how it works. The Department of Transportation and the Department of Commerce and Consumer Affairs are funded by federal money and special funds, which means they are exempt from the restrictions. So: two agencies bring in their own money and are exempt, while DOTAX brings in their own AND everyone else's money, and has to feel the pain.
Come on, folks. Let’s go back to the original problem, which is state revenues. The restrictions were ordered because we aren’t sure how much money is going to come in. If we are going to starve the agency whose primary job is to bring in that money and cripple its operations, we will increase the chances that the money will not, in fact, come in. Put another way, if we need the golden goose to pull us out of our financial doldrums, we better make sure the goose is healthy.
Tom Yamachika is the President of the Tax Foundation of Hawaii. Mr. Yamachika's commentary is printed each week in: The Maui News, West Hawaii Today, The Garden Island, Civil Beat , Hawaii Free Press and the HawaiiReporter.com.
Thousands of Hawaii households remain without electricity in the aftermath of Tropical Storm Iselle this past weekend. Most people affected by power outages reside on the east side of Hawaii Island. Others are scattered across Oahu and Maui County.
The Department of Human Services (DHS) reminds beneficiaries of the federal Supplemental Nutrition Assistance Program (SNAP) (formerly known as Food Stamps) that beneficiary households may request reimbursement for the actual dollar value of food destroyed by storm related power outages. The reimbursement cannot exceed the household's current monthly allotment (HAR 17-681-31).
To qualify for reimbursement, the affected household must have been participating in the SNAP when the disaster occurred, and report the loss to the DHS Benefit, Employment and Support Services Division (BESSD) within 10 business days of the severe weather event. The deadline to submit reimbursement requests for food spoiled during Tropical Storm Iselle is Wednesday, Aug. 20, 2014.
To be considered for the reimbursement, the affected SNAP household must provide the DHS BESSD a signed statement that includes the following information:
1) Name of the storm and dates of impact;
2) General list of food items lost due to storm related power outage;
3) Length of time household power was out of service;
4) Statement that the household is aware of the penalties for the intentional misrepresentation of the facts; and
5) Statement that the household is aware that SNAP replacement allotment will not be issued if the required statement is not signed and returned within 10 days.
BEFORE MAILING OR DROPPING OFF the reimbursement request, SNAP beneficiaries should contact the BESSD Processing Center that maintains their case file for additional instructions. Individuals who don’t know which Processing Center maintains their file may call (808) 586-5720 to inquire.
An estimated 98,000 households currently receive SNAP benefits statewide. There are approximately 25,000 SNAP households on Hawaii Island; 5,000 on Kauai; and 12,000 in Maui County. To learn more about the Hawaii SNAP, visit the DHS website www.humanservices.hawaii.gov/bessd/snap.
The southern U.S. state of North Carolina is stepping up efforts to guard against the possible spread of the Ebola virus to the United States.
On Sunday, the North Carolina Department of Health and Human Services said anyone returning from Africa who worked with Ebola patients will be put into quarantine.
That precautionary measure will mean isolation for three weeks after a missionary’s last contact with an Ebola-infected person.
Two missionaries from North Carolina-based aid organizations contracted the deadly virus working at a clinic in Liberia with Ebola-infected patients.
The missionaries - one from SIM USA and the other from Samaritan’s Purse - are being treated at Emory University Hospital in Atlanta, Georgia.
The current Ebola outbreak in West Africa is on pace to infect more people than all previous outbreaks of the virus combined.
The World Health Organization on Friday said 1,779 people in four West African nations have contracted the deadly virus so far, and that 961 of them have died.
The U.S. Centers for Disease Control and Prevention has activated its emergency operation center at the highest level.
HONOLULU — As the Big Island of Hawaii and Maui were impacted by weather generated by two passing hurricanes last week, some residents believed any substantial damage could be alleviated by the state’s $126 million hurricane relief fund.
But that well has nearly run dry after the state Legislature snatched the funds to balance the budget in 2011.
The fund was established in 1993, shortly after Hurricane Iniki slammed into the islands of Oahu and Kauai on Sept. 11, 1992. That Category 4 hurricane, the most powerful storm to ever hit Hawaii, killed six people and caused $1.8 billion in damage. More than 1,400 homes on Kauai were destroyed and another 5,000 homes severely damaged in the 145-mph winds.
After the storm, several insurance companies either went out of business or refused to insure the Hawaiian market, and as a result, hurricane coverage availability and affordability became major issues for homeowners.
In response, the state established the hurricane relief fund, requiring homeowners to contribute.
As the hurricane insurance market improved in the following years, the fund discontinued issuing hurricane policies, but there was still a substantial fund balance remaining.
Some homeowners wanted their money returned. Senate Minority Leader Sam Slom, R-Hawaii Kai, introduced legislation to facility refunds, but that bill was defeated. The fund proved too tempting for the Legislature and governor, and they raided the fund in 2011 to balance the state budget.
Some $55.5 million was repaid as of August 2013. State Finance Director Kalbert Young said another $55.5 million will be refunded this month.
“I warned against any special fund being established because the funds would be in danger of being raided by the Legislature or the executive branch, as was the case in 2011,” Slom said. “We cannot guarantee funds that are supposed to be earmarked will ever be used for that purpose.”
So if not for homeowners to access, what’s the purpose of the fund?
There is now adequate insurance coverage available in the marketplace for homeowners to get private hurricane so the fund isn’t “active” for coverage, Young said. The fund will remain dormant until sufficient private hurricane insurance policies aren’t available, he added.
The fund is considered state reserve and use of the funds is limited, extensively controlled, and future use would require legislative authority, Young said.
However, if a catastrophe occurs and funds are needed to repair infrastructure, the governor and Legislature could use the money for that purpose.
“Clearly, one source could be the Hawaii Hurricane Relief Fund, but others could include cash appropriation, debt authority or special funds,” Young said.
Slom said he opposes any further raids on the fund. “Raiding it to balance the budget for excessive spending is outrageous,” he said.
Hurricane Iselle first hit the Big Island of Hawaii on Thursday evening as a weak hurricane, and then transitioned into a tropical storm as it doused the island chain Friday with heavy rains. Hurricane Julio went north of the islands.
HONOLULU - The Hawaii Bankers Association (HBA) today announced a coalition named Hawaii's Partnership Against Fraud (HPAF), led by the HBA to generate greater awareness about the threats of financial scams. HPAF brings together community resources dedicated to protecting local citizens, especially the elderly, from the many scams perpetrated in the community. As over 80% of the victims of financial scams are over the age of 60, the coalition is specifically geared towards this age group.
The coalition partners include:
The campaign kicked off in early July with media advertising on television and radio, funded by the HBA. The advertising, running statewide, will continue through the end of the year. The advertising poses various fraud scenarios and asks the question: "Is This For Real?"
The coalition is also available to make presentations to community groups to discuss prevailing fraud schemes, and tips to protect consumers. Brochures and other printed materials will be available from participating coalition partners. Participating banks will also be distributing educational materials to its customers. To request a presentation, call Diane at the State of Hawaii Executive Office on Aging at (808) 382-1904.
Members of the public with questions about the legitimacy of offers or who feel they have been victimized may contact the Better Business Bureau at (808) 628-3950 or (888) 333-1593 (for neighbor island calls). For more information regarding HPAF, visit http://www.bbb.org/hawaii/hawaii-partnership-against-fraud.
Since 1961, the Hawaii Bankers Association (HBA) has brought together all FDIC-insured depository institutions doing business in Hawaii, including banks, thrifts and a financial services company. The HBA represents its members by advocating for Hawaii's economic vitality and sustainability through collaboration with legislators, regulators and the community. Its members have $44 billion in total assets and employ 7,000 people. For more information about the HBA, visit http://hawaiiba.org/.
BY MALIA ZIMMERMAN - HONOLULU — Although 2,500 miles from the continental United States, Hawaii has joined the list of states temporarily housing unaccompanied minors from Central America who have illegally crossed into America through the Southwest border.
Who's paying the freight? You, the taxpayer.
Some 60,000 Central American youths fleeing drug cartels, human traffickers and gangs have come to the United States in the past few months. That number could reach 90,000 by the end of the year. Politicians, border agents and social service workers call the migration a "humanitarian crisis."
Kenneth Wolfe, a spokesperson the U.S. Department of Health and Human Services, told Watchdog.org that "between January 1 and July 7, a total of eight minors were discharged from the unaccompanied alien children program to sponsors in Hawaii."
Wolfe couldn't offer any details on the ages and countries of origin of the children, where the children are now living, or who their Hawaii sponsors are. However, he added the sponsors are "mostly family members of the child. In fact, more than half are parents of the minor."
Federal taxpayers cover the cost of transportation and housing for the refugee children, including their airfare to Hawaii, Wolfe said.
Federal taxpayers also pay sponsors’ costs of transportation, Wolfe said.
Former Congressman Charles Djou, R-Hawaii, said while he feels for the children and is sympathetic to their plight, he doesn’t believe taxpayers should be covering their airline tickets to Hawaii.
Djou said if children in Central America hear that they could get an all-expense trip paid to Hawaii via the American government, more might cross the border illegally.
"What an incentive," Djou said.
The average length of stay in the program is now less than 30 days, according to Wolfe.
However, Hawaii immigration attorney Clare Hanusz said the children could be here much longer, depending on the immigration court calendar.
Compared with other states, Hawaii’s federal immigration court isn’t busy, she said, and cases can move quickly through the system. However, cases that have special circumstances and require witnesses or experts can take five to six months, she said.
Some Hawaii residents have reached out to Hanusz, a well known immigration attorney with the law firm of Damon Key, to offer the children accommodations and money — and even to adopt them. However, Hanusz said unless the children or their sponsors come forward, no one will know who they are or where they are living.
HONOLULU -- With the shortage of affordable housing options for the moderate income workforce, Hawaii lawmakers today held a joint Senate and House informational briefing to learn more about affordable housing needs in Hawaii.
Senators and representatives heard from various government agencies to learn about the status of existing and planned affordable housing projects, and their plans to address the growing need for affordable housing as the state’s population and housing demands increase.
“We convened this informational briefing because there’s an urgent need for affordable housing,” said Sen. Suzanne Chun Oakland, chair of the Senate Committee on Human Services. “And it’s necessary that we get everyone involved at each level and at the same table to discuss where we are at, what we are doing and what needs to be done to meet the housing needs of Hawaii's residents.”
In 2011, the Hawaii Housing Finance and Development Corporation (HHFDC) released the Hawaii Housing Planning Study which revealed 50,000 new units needed to be built between 2012 and 2016 to meet demands. Of that number, based on HUD income guidelines, about 19,000 are needed for household incomes of 80 percent of area median income (AMI) and below. (This is $43,250 for 1-person household, and $61,750 for 4-person household). HHFDC has procured a new updated study that will be released later this year.
“Hawaii’s workforce deserves to live in housing they can afford,” said Rep. Mark Hashem, chair of the House Committee on Housing. “Nearly half of Hawaii’s homeless population are working persons who are unable to afford steady permanent housing. In addition to addressing the housing shortage for those at AMI, we also need to ensure there is enough help for hard-working low-income individuals to obtain housing units.”
During the briefing, lawmakers questioned the Hawaii Community Development Authority (HCDA) about reserved housing requirements for workforce housing in the Kakaako district.
“Our constituents remain concerned that developers are reserving affordable housing units at the 140% of AMI mark, which is not reasonable for many of Hawaii’s working population,” said Chun Oakland. “HCDA needs to be doing more to address the housing needs of the people at 100% of AMI and below.”
Sen. Donovan Dela Cruz, chair of the Senate Committee on Economic Development, Government Operations and Housing, questioned the siloed approach to planning for affordable housing projects for transit oriented development (TOD).
“It seems like all agencies have their own plan and no one is working together,” said Dela Cruz. “Instead of this siloed approach to workforce housing in relation to TOD, there must be an overall statewide approach. There’s going to be housing located around the various TOD stations. Why are we not working together?”
This past session, the legislature created a TOD Working Group to bring together all major players to plan for the future in a comprehensive and succinct way.
Sen. Will Espero, chair of the Senate Committee on Public Safety, Intergovernmental and Military Affairs, expounded on the effect veterans returning home will have on Hawaii’s housing needs in the future.
“Our veterans fought for our nation’s principles of freedom and liberty and deserve to raise their families in housing they can afford,” said Senator Will Espero, chair of the Senate Committee on Public Safety, Intergovernmental and Military Affairs. “As our veterans return home, we need to ensure they have access to services to ensure a smooth transition back to civilian life.”
Other issues related to affordable housing discussed included the growing number of people on the waitlist of public housing and Hawaiian homelands. In public housing, there is approximately 30,000 people waitlisted (using three people per family as the average). That is about 10,000 families on the waitlist. For Hawaiian homelands, 26,926 applicants are waitlisted and 43,080 applicants are pending.
During the 2014 Legislative Session, lawmakers approved measures to help with affordable housing. They include:
SB2542 (Act 163) - Restores the allocation of conveyance tax collections to the rental housing trust fund to 50% beginning July 1, 2014. It is estimated that this law will generate $33,100,000 for the Rental Housing Trust Fund, which is used to leverage funds for the building of affordable housing units.
HB2251 (Act 162) - Increases the Hula Mae Multifamily Revenue Bond authorization limit from $750 million to $1 billion. The program will help first-time buyers afford a 30-year mortgage at a competitive rate and provides down payment assistance. There’s a high demand for this type of financing and in 2013 the total dollar value of requests exceeded the amount available. Increasing this amount will allow for the continuation of development and preservation of affordable housing for lower income households.
The following government agencies who provided testimony include Hawaii Community Development Authority (HCDA), Hawaii Housing Finance and Development Corporation (HHFDC), Department of Hawaiian Home Lands (DHHL), Hawaii Public Housing Authority (HPHA), Department of Defense, City and County of Honolulu’s Office of Housing.
The entirety of the hearing can be viewed online at http://olelo.granicus.com/ViewPublisher.php?view_id=13/XXXXXXXXXXXXXXXX
See all of the briefing material here: http://www.capitol.hawaii.gov/session2014/testimony/INFO_TESTIMONY_HMS-EGH-PSM-HSG_07-23-14.pdf
BY MALIA ZIMMERMAN - HONOLULU — New statistics released by the state Department of Human Services show about a quarter of Hawaii’s population relies on Medicaid.
Of Hawaii’s 1.3 million people, some 320,000 qualify for the government health-care program.
According to the state Department of Human Services, the number of people on federal health-care subsidies in Hawaii has jumped since the implementation of the Affordable Care Act in Hawaii in October.
State figures show net enrollment increased 12 percent between Oct. 1 and June 30.
“The target is for all Hawaii residents to have health insurance. As an entitlement program, Medicaid plays an important role,” said Kayla Rosenfeld, a state Department of Human Services spokeswoman.
The Medicaid program is jointly funded by the federal government and states, according to Medicaid.gov, with the federal government paying states for a specified percentage of program expenditures — the Federal Medical Assistance Percentage. The percentage varies by state based on criteria such as per capita income, averaging about 57 percent but going as high as 82 percent.
Criteria for Medicaid recipients depends on the eligibility group, which can include children, pregnant women, parents and other caretaker relatives, adults, individuals determined on the basis of being aged, blind, or disabled, Rosenfeld said.
Under new federal guidelines established under President Obama, recipients have no limits on assets, but for the new eligibility group authorized under the ACA, adults must have an income at or below 138 percent of the federal poverty level, Rosenfeld said.
To handle the expected boom in enrollment under the Affordable Care Act, the Department was awarded a $100 million federal grant to build an “eligibility system” to process the applications.
The state hired KPMG, which built the online web portal KOLEA, enhanced the State’s IT infrastructure and added new functionality such as document imaging. The state contracted with the company to perform maintenance and operations over the next two years.
While state legislators said Tuesday in a House hearing they've gotten complaints about the system, Rosenfeld said KOLEA processed 250,000 individual eligibility determinations and redeterminations between Oct. 1 and June 30.
Timeliness in processing applications has also improved, Rosenfeld said, noting as of June the average application approval takes 13 days, compared with 32 days in previous months.
The state has appropriated another $400,000 for the program for this fiscal year to enhance DHS operations and policies surrounding security for the system, including determining who should have access, Rosenfeld said. The state has issued a request-for-information proposal to solicit private bidders on the project.
Hawaii’s political landscape is largely dominated by Democrats, which control the state administration, the Legislature and its congressional seat. There are no Republicans in Congress and just eight in a state Legislature of 76 . The majority of Hawaii’s elected politicians believe heavy dependence on Medicaid is a positive step for Hawaii; their goal is to eliminate the state's remaining 6 percent who are uninsured.
Other federal and state subsidies are heavily used in Hawaii, including SNAP or food stamps. As of June, 194,865 people and 99,320 households received SNAP benefits, Rosenfeld said.
An August 2013 report by Cato Institute, which examines the state-by-state value of welfare for a mother of two, said benefits in Hawaii average $49,175 — tops in the nation.
Michael Tanner, co-author of the Cato study, said that since welfare isn’t taxed, a person would have to earn $60,590 in Hawaii to take home the $49,175 for someone on welfare.
Part of the plan for the Department’s new and improved eligibility system web portal – and the state’s Obamacare web site, HawaiiHealthConnector.com — involves qualifying even more people for Medicaid and other government benefits through a one-stop shop.
BY MALIA ZIMMERMAN - HONOLULU — The Hawaii Health Connector, has been unable to produce a fully functional website since it launched in October.
That's especially troubling, because CGI Group got $53 million for its creation and another $20 million for operation and maintenance.
A separate $100 million web portal operated by the state Department of Human Services and designed by KPMG to connect Hawaii residents with Medicaid services has been problematic, leading the department to set aside another $400,000 to fix the software.
Lawmakers questioned connector and state officials about reports of residents unable to get insurance or being delayed after applying for subsidies and getting directed instead to the Department of Human Services’ Medicaid site, Kolea. The two websites “didn’t play well together” as one lawmaker noted, leaving some 11,000 applications unprocessed.
The state’s chief information officer, Keone Kali, told House lawmakers in a hearing Tuesday his department plans to create another more user-friendly site, a one-stop shop to process requests for health insurance and Medicaid.
Until the site is built, Kali is proposing a web link and page be added to Hawaii.gov web site, which houses information on all state agencies, to drive traffic to Affordable Care Act and Medicaid sign ups, which could be done at minimal cost.
"I'm really skeptical any of this you're talking about is going to happen, but it is heartening to hear you say it's going to be a low-cost portal," said House Health Committee Chair Della Au Belatti, D, Makiki, who co-chaired the hearing.
The state’s goal is getting at least 100,000 people – 8 percent of the population – to obtain health insurance through the Obamacare exchange. A state report estimated half were eligible for Medicaid.
After spending or allocating the majority of a $204 million federal Affordable Care Act grant, just more than 8,500 people signed up for health care through the exchange as of the spring deadline.
Another 26,010 people enrolled in Medicaid between summer 2013 and April this year, according to a July 11 report by WalletHub — 2014 Health Insurance Coverage Report. In total, 28.01 percent of Hawaii’s population younger than 64 is on Medicaid, the July 11 report said.
Tom Matsuda, the connector's interim executive director, provided some updated enrollment figures, saying the connector and Medicaid sign-ups are at 43,746 as of this month, but he didn’t provide a breakdown between the two.
Hawaii has the fourth-lowest uninsured rate in the country. Just three other states ranked higher than Hawaii in terms of its uninsured population, including Massachusetts — 1.20 percent — Rhode Island — 5.60 percent — and the District of Columbia — 6.29 percent, the WalletHub report showed.
Many people in Hawaii already had health insurance because of a 1976 Hawaii Prepaid Healthcare law, which requires employers to provide health-care coverage to their employees if they work at least 20 hours a week.
Belatti said she is concerned about the money the connector and Department of Human Services are spending on technology that isn’t working properly, and how the systems and the connector will be sustained going forward.
The Legislature allocated $1.5 million to the Obamacare exchange operations for 2015.
Matsuda said the connector will continue to seek ways to use the remainder of the $204 million grant set to expire at the end of 2014, as well as look for ways to reduce expenses and boost revenues.
The connector’s only source of revenue, besides government grants and subsidies, are fees charged to insurance companies, including a 2 percent sign-up fee for each plan booked.
HONOLULU – Diamond Bakery, a locally-owned cracker and cookie company with a mission of Sharing Heartwarming Aloha, recently announced a company-wide project to help Hawaii’s less fortunate.
“We are 100% committed in our support of IHS, The Institute for Human Services, and its dedication to provide respite for those who are unsheltered to help transform their lives,” said Brent Kunimoto, president of Diamond Bakery. “Giving back to those less fortunate in our community is always a top priority for us so we’re mobilizing our employees to do what we can to help IHS continue to make a difference in this escalating situation.”
According to June Namba, Diamond Bakery customer coordinator, “I love to help those who are less fortunate because it makes me appreciate more of what I have. We’re always complaining about not having this or that in life but, when you’re looking at people in real need, it makes you feel like you already have a lot!”
IHS is currently the only 24-hour walk-in, emergency shelter on Oahu, providing a full range of services to anyone who may be homeless or are in danger of becoming homeless. Of their eight major service areas, Diamond Bakery is focusing on their Community Food Programs – specifically the IHS Meal Program which serves three hot meals a day, seven days a week. For more information on The Institute for Human Services, visit http://www.ihshawaii.org/.
During the weekday work hours when IHS can use the most help, Diamond Bakery employees are providing hands-on assistance preparing meals. Luckily, IHS’s close proximity to Diamond Bakery’s location makes it convenient for employee participation.
“As a company doing business in Hawaii for more than 90 years, Diamond Bakery truly cares about people. The efforts of our employee volunteers giving of their time, energy and aloha to share Heartwarming Aloha that our founders valued so much is priceless,” added Kunimoto. “Our goal is to have 100% employee participation so the Institute of Human Services is the first partner to benefit from our new policy to pay employees two days a year to perform charity work.
“I was thrilled and proud to learn about the work volunteer opportunity the company is giving us,” said Bryan Sabado, Diamond Bakery production worker. “I’m excited and looking forward to being part of the giving back process!”
Diamond Bakery was founded in 1921 as a dream between three friends to create the perfect Hawaiian-made cracker. Through the founders’ dedication, sacrifice and secret ingredient of “Heartwarming Aloha”, Diamond Bakery has grown to become a household name in Hawaii and the demand keeps growing for the company’s Hawaiian crackers and cookies.
In 2009, Diamond Bakery filled a much-needed niche selling sea biscuits—what most locals know as Saloon Pilot crackers—along the continental East Coast. Distribution of products has also expanded to Japan and the South Pacific, allowing Diamond Bakery to share heartwarming aloha with people throughout the world.
Open for over 90 years, the company is located on Oahu and was named after the famous Diamond Head landmark.
WHAT: The purpose of this informational briefing is to receive updates from the Hawaii Health Connector and various state agencies regarding the continued implementation of Hawaii’s insurance exchange and other matters relating to the implementation of the Affordable Care Act (ACA), including updates on preparations for the next open enrollment period for individuals and reports on the status of Medicaid enrollment and eligibility determinations through either the Health Connector or the Department of Human Services KOLEA system.
The following individuals or representatives from their organizations are invited to attend:
1. Tom Matsuda, Interim Executive Director, Hawaii Health Connector
2. Keone Kali, Chief Information Officer, Office of Information Management & Technology
3. Patricia McManaman, Director, Department of Human Services
4. David M. Louie, Attorney General, Department of the Attorney General
5. Gordon Ito, Insurance Commissioner, Department of Commerce & Consumer Affairs
WHEN: Monday, July 21, 2014
WHERE: Conference Room 325
415 South Beretania Street