In this edition of “5 Things We’re Watching” we feature an update on the state’s efforts to develop data-driven solutions to address substance use, a conversation on women’s health policy, and a look at hospital price transparency compliance.

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Emily Boerger
State of Reform

1. Q&A: Rep. Linda Ichiyama discusses women’s health policy

Rep. Linda Ichiyama is the Chair of the Hawaii House Pandemic and Disaster Preparedness Committee and a co-convener of the bipartisan Women’s Legislative Caucus. In this Q&A, Ichiyama discusses her committee’s key achievements this past session, goals for next year, and legislation to address women’s health.

Ichiyama says lawmakers were able to pass several items this year related to women’s health including the extension of postpartum Medicaid coverage to 12 months and funding to support menstrual equity. Looking forward, she says she is paying close attention to the upcoming Roe v. Wade decision and ensuring that reproductive health access is protected in Hawaii.

2. DOH seeks input on substance use plan

The Alcohol and Drug Abuse Division within the Department of Health is seeking stakeholder and community input on the Hawai‘i State Plan for a Data Driven System of Care on Substance Use. Effective from June 2019-December 2022, ADAD is focusing on using data to target communities most in need of comprehensive substance use services and workforce recruitment.

To begin planning for future iterations of the state plan, ADAD and community partners are conducting a webinar series to review findings from the 2022 Statistical Report. The report offers details on substance use in Hawaii and its intersections with different parts of the care continuum including homelessness, the criminal justice system, and Native Hawaiian and rural communities.

3. AlohaCare announces Native Hawaiian health services

Last month, in partnership with Papa Ola Lōkahi, AlohaCare announced Ke Aloha Mau—a group of culturally responsive services that aim to support mental, physical, and spiritual health. The covered services include Lomilomi, Hula, Ho‘oponopono, and ‘Ai Pono.

AlohaCare CEO Francoise Culley-Trotman tells State of Reform that the ultimate goal is to provide these services long term. “It’s no longer enough to just coordinate health care or to deliver a standard benefit package,” she said. “We have to make it targeted to make a difference in someone’s overall care. For us, it’s a long-term investment in caring for our members and the whole-person health model.”

4. Child nutrition programs lack millions in federal funding

Hawaii is missing out on hundreds of millions in federal funding for child nutrition programs, according to a new report from Hawaiʻi Appleseed and other community organizations. Daniela Spoto, Director of Anti-Hunger Initiatives at Hawaiʻi Appleseed, said the reimbursement rate these programs receive from the US Department of Agriculture is based on 40-year-old data that no longer reflects Hawaii’s higher food and labor costs.

The USDA is currently conducting a new food and labor cost study and may raise Hawaii’s reimbursement rate according to the new data. However, that study is not scheduled to be completed before 2026 or 2027. On May 20th, Hawaii’s congressional delegation sent a joint letter to the USDA calling for a temporary reimbursement rate increase for all outlying states and territories until the study is completed.

5. Hospitals failing price transparency rule

About 6-9 months after federal hospital price transparency rules went into effect, just 5.7% of facilities were completely compliant, according to recent JAMA research. The new rules require hospitals to disclose standard charges for all services in an accessible file, and require that they provide a consumer-friendly display for at least 300 shoppable services.

Of the over 5,000 hospitals evaluated, 13.9% had the accessible standard charges file, 29.4% had the shoppable display, and over half had neither of the price transparency requirements. The research also finds that hospitals in highly concentrated markets are less likely to be transparent.