Gov. Josh Green used West Hawaii as a pulpit on Thursday to address state problems and sign several bills into law.
Green was the guest speaker at the Kona-Kohala Chamber of Commerce annual membership luncheon at the Fairmont Orchid where he spoke mostly about health care initiatives passed by the Legislature and the vision he has for the future.
He recounted his first years on the Big Island working as a new physician, landing in Ka‘u at a rural health clinic — serving 8,000 people — and seeing its challenges, some of which are still here today.
“Those months and years are what got into by blood. I saw limited access to trauma services in the rural parts of our state, which is all of the Big Island,” he said.
He said his perspective working in Ka‘u and Kohala Hospital has informed his solutions to Hawaii’s problems.
The governor illustrated that point with an analogy of treating a bleeding patient in the ER.
“They come in, you deal with it, find a solution and move on,” he said. “That is basically the role I am using to run our government now.”
A shortage of healthcare workers
Statewide, there is a 20% shortage of health care providers. On the neighbor islands, that number jumps to 40%.
“We have now formed the Hawaii Health Corp, so we have loan forgiveness for any health care provider that wants to come and practice in our state, whether it is a social worker, a psychologist, naturopath, physician, physician assistant, nurse practitioner, nurse, anyone who will commit themselves to working here to pay off their medical school debt.”
The allocated $30 million over two years will immediately create loan forgiveness for over 700 healthcare workers.
“You can be sure that will be focused on the neighbor islands where we need them the most.”
Promoting funds for Medicaid
He also said the healthcare system itself needs help, so $30 million has been allocated — with $43 million federal matching funds — to raise Medicaid reimbursement rates.
In 2010, when the legislature was dealing with the healthcare crisis, there were 252,000 people in the state on Medicaid. By the end of COVID, there were 465,000 people, or one out of three residents.
“Now people will get the healthcare they deserve,” he said.
Funding for hospitals and housing
According to Green, the Legislature and his administration are making sure hospitals get the funding they need. He touted that $18 million is being allocated to Kona Community Hospital and $50 million to Hilo Medical Center.
He elaborated on plans to increase tax credits for families making less than $80,000 per year.
On the subject of housing, Green said there is a 50,000-unit housing deficit in the state, with much of it on the neighbor islands. He said those homes will be built over time, but infrastructure problems such as a lack of water access need to be addressed first.
“We have to open up the water supply,” he said. “Because if we don’t have houses, we don’t have nurses or teachers. I will use my emergency authorities to cut down the red tape to allow us to build, especially where [we] already authorized building long term. These are our priorities going forward.”
On homelessness
Green cited the statistic that the unsheltered go to the hospital, on average, nine to twelve times a year — to the tune of an individual, annual cost of $82,000.
“But the moment we put a roof over their head, the cost drops 73%. A person that is houseless may consume as much as $1 million year using Medicaid resources.”
Renewable energy
The state has applied for a $2.2 billion grant to become a hydrogen hub, a facility based on Hawaii Island to add to green energy already produced in the state. He touted the Waikoloa Solar project as a step in the right direction.
“We are going to see more of these projects; before you know it, we will actually see solutions,” he said.
Green inks new laws
Following his speech in South Kohala, Green traveled to the Hawaii Island Community Health Center in Kealakehe for a signing ceremony for three bills related to health care and one for consumer telecommunications.
— SB404 Updates the Hospital Sustainability Program to clarify the use of the Hospital Sustainability Program Special Fund to support a hospital’s ability to continue to provide services to Medicaid recipients. The bill makes these programs permanent with passage, rather than allowing the program to sunset at the end of December 2023.
“This brings over $100 million a year of federal money because we are able to take the losses we have and essentially write them off based on under reimbursement and get them matched.”
— SB671, proposed by State Senator Joy San Buenaventura, repeals a Hawaii law that made fentanyl test strips illegal.
“This means some young people won’t overdose because they can check to see if someone, God forbid, didn’t lace their drink. As a state, we need to be compassionate and focus on harm reduction,” said Gov. Green of the bill. “It is important to legalize fentanyl test strips, because fentanyl is 80 times more powerful than morphine. It’s being laced into other drugs, and people are dying. If we can save lives, we should.”
— SB674 Allows Hawaii to enter into the Interstate Medical Licensure Compact (already in effect in 37 other states, the District of Columbia, and Guam) to allow physicians to more easily practice in Hawaii, while still meeting nationally established standards for education and training.
— HB907 HD2 SD2 which temporarily allows for the reimbursement of services provided through telehealth via an interactive telecommunications system and two-way, real-time, audio-only communications in certain circumstances.
“HB 907 represents a huge step forward in our effort to extend access to behavior health services to our rural and vulnerable communities, especially here on the Big Island,” said Hawaii Island Community Health Center CEO Richard Taaffe in a news release. “The new law will allow our behavioral practitioners to use audio-only technology to reach patients struggling with isolation, anxiety, depression, addiction and who would not otherwise seek care.
Governor Green, by signing this bill into law, gives us another method for reaching patients in their homes, where they live.”