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Monday, September 13, 2021
September 13, 2021 News Read
By Andrew Walden @ 5:52 PM :: 2273 Views

What happened to our state’s balance of powers?

“The biggest reason Hawaii doesn’t have enough beds is that certificate of need requirement”

CB: … the state has made it hard for new entrants into the market. According to the Mercatus Center, a conservative think-tank at George Mason University in the Washington D.C. suburbs, Hawaii has more regulatory hurdles for new health care facilities than any other state, with 28 separate services subject to state limitations. These restrictions are called “Certificate of Need” laws, which are administered by the state health planning agency, which decides which projects can go forward and which it will block.

“The number of services where a certificate of need is needed is quite high, and the fees in Hawaii are quite high as well,” said Mathew D. Mitchell, senior research fellow at Mercatus, who did the state-to-state comparisons. “Big hospital systems like certificates of need. They don’t protect patients but it protects the bottom line.”

In 2006, as a result of a certificate of need review, the state agency rejected the application of a proposed 150-bed hospital in Kihei, Maui, on the grounds that it was not needed and would injure the island’s primary hospital, Maui Memorial Medical Center in Wailuku.

Joseph Pluta, a real estate broker who also serves as president of the West Maui Improvement Foundation, was a vocal supporter of the proposed Kihei hospital, and said the state’s decision to block its construction has cost lives on Maui.

“The biggest reason Hawaii doesn’t have enough beds is that certificate of need requirement,” Pluta said. “It’s a self-inflicted problem.”

In the past year, more than a dozen states have suspended their certificate of need requirements or enabled emergency provisions to speed building additional capacity, according to Mercatus. New Jersey and New York, which have the nation’s highest and third-highest Covid death rates, both waived state hospital-bed review requirements last year in response to the emergency….

read … Over Decades, Hawaii Cut Acute Care Hospital Beds. Then Came The Pandemic

Prosecutors immediately appeal judge’s approval of bail for Miske business partner

ILind: … Mansfield said his decision was supported by an updated report by the court’s pretrial services office, which concluded Yokoyama could be released with appropriate conditions and restrictions.

However, it’s not yet a done deal. Within hours, prosecutors appealed Mansfield’s decision directly to Judge Derrick Watson, who is in charge of the overall case. The appeal simply reasserts arguments the government made unsuccessfully during Friday’s hearing.

Mansfield’s release order came just 48 hours after he turned down a similar bid for freedom by Mike Miske’s younger brother and co-defendant, John Stancil….

Court records also show Yokoyama has been under financial pressure and without substantial resources for several years.

Yokoyama stopped making payments on the Lamborghini in January 2018. Court records show the car was repossessed and Yokoyama sued for the outstanding balance, resulting in a judgment against him in the amount of $149,914.76 plus post-judgment interest.

This wasn’t Yokoyama’s only outstanding debt. The owners of downtown Honolulu’s Waterfront Plaza sued and obtained a $266,758.37 judgment in July 2017 against Yokoyama and Encore Investments, which briefly operated the Encore nightclub at the same location as Miske’s M Nightclub. Prosecutors allege Encore, like M Nightclub, was actually controlled by Miske.

And in June 2021, Yokoyama was hit with another judgment for $109,664.75 for back rent after the failure of a Japanese restaurant, Izakaya Kei in Pearl City, which he and a partner had launched in 2016….

(Two Words: Money Laundering.)

read … Prosecutors immediately appeal judge’s approval of bail for Miske business partner

Over Decades, Hawaii Cut Acute Care Hospital Beds. Then Came The Pandemic

CB: … The alarming prospect of rationed care is revealing an underlying problem: As a result of government policy, Hawaii does not have enough acute care hospital beds.

In fact, Hawaii has among the fewest beds per capita of any state in the nation, according to the Kaiser Family Foundation. Nationwide, the U.S. average is 2.4 beds per 1,000 people, but Hawaii has only 1.9.

Only eight states have fewer beds per thousand people, according to the Kaiser foundation. Two of those with the lowest numbers, Idaho and Oregon, are similarly running out of intensive care beds, with government officials warning that it may be difficult to provide the same level of care as in more normal times.

All three states had prided themselves on cost reduction strategies that made health care operations more profitable in good times…

2013: Survey: 195 Patients in Hospitals Waiting for Long Term Care Beds  -- Hawaii hospitals have an excess of acute care beds and a shortage of long term care beds.  While these patients wait, they occupy acute care beds.

read … Over Decades, Hawaii Cut Acute Care Hospital Beds. Then Came The Pandemic

Oahu doctor describes what it's like to suffer or die from the coronavirus    

KITV: … What happens if you get seriously ill from the coronavirus? An Oahu physician describes for us what the last days look like for someone suffering from the virus. Or how, even if they're lucky to survive, their lives are often changed forever.

People go to the hospital because they're having trouble breathing. If the breathing treatments don't work, the intensive care unit is next. "It's in there liquefying their lung tissue, says Dr. Scott Miscovich of Premier Medical Group.

He says the next step is to intubate the patient. Their lungs are filling with fluid, so they are placed on their stomach. "The people end up having to lie on their belly for the last month of their life, intubated with the breathing tube."

Miscovich says they're lying there usually for two to eight weeks. "A sedated, paralyzed place on your stomach with tubes in your bladder, rectum, and you never see your family," he says….

And if it's determined the patient is not going to recover, "They die alone. You're not able to see your family. You're not able to have visitation. At the very end, they will have a Facetime or something before they disconnect your life support. And that's the last thing anybody will see of you," states Miscovich.

It's also traumatizing for the hospital staff. "These poor nurses watch death again and again and again," he adds.

And if this patient actually pulls through, what does life look like for them after that "About eight percent of everyone who survives hospitalization with COVID will never work again. A large number of people will go home on oxygen because their lung tissue has been destroyed," he answers.

During COVID-19 treatment, air can leak into the chest cavity because of the tubes inserted. The kidneys might require dialysis from so much medication. And life-threatening blood clots may form after lying in bed for weeks. It's a harsh process. "We don't talk at all about disability or life after," points out Miscovich. "You have a mortality rate of 40% a year."

If this sounds like a situation you'd rather avoid, he has some simple advice: "Get vaccinated."…

read … Oahu doctor describes what it's like to suffer or die from the coronavirus

Hawaii Kindergarten Enrollment Has Dropped Sharply Since The Pandemic Began

CB: … School enrollment has taken a big hit during the Covid-19 pandemic, with the heaviest toll at the earliest grade level. Consider these figures: Linapuni Elementary and Palolo Elementary on Oahu saw their kindergarten classes shrink by about half from the fall of 2019 to the fall of 2020.

This year, kindergarten enrollment started to climb back up at Linapuni, but it dropped further at Palolo, which is down nearly 56% from pre-pandemic levels to 19 kids, based on the latest Hawaii Department of Education enrollment report.

While showing some signs of improvement, Hawaii’s kindergarten enrollment free fall since the pandemic has been one of the steepest in the country, with the most pronounced declines in low-income areas hovering below or just above the poverty line, according to a recent analysis by the New York Times in conjunction with Stanford Graduate School of Education….

Overall, statewide kindergarten enrollment in Hawaii declined 15% from 13,074 in the fall of 2019 to 11,103 in 2020, when schools were largely dependent on distance learning. In comparison, the drop in enrollment across all K-12 grades between those same years was 2.6%.

This year, the DOE is counting 11,456 new kindergarteners, slightly more than the year before but still down 12% from 2019. Enrollment figures for that grade level were 13,485 in 2018-19 and 13,427 in 2017-18….

read … Hawaii Kindergarten Enrollment Has Dropped Sharply Since The Pandemic Began

Marines eye land for ‘future force’ at former Barbers Point base

SA: … A space-crunched Marine Corps is looking for additional locations to house and train its “future force” in Hawaii, and one consideration may be hundreds of acres of undeveloped land on the east side of the former Naval Air Station Barbers Point….

A couple of years ago, high-­ranking Marine Corps officials came from Washington, D.C., to look at what remains of the 3,819-acre Barbers Point base that was shuttered in 1999 as part of the “base realignment and closure” process.

More recently, barracks and electrical work at the Kaneohe Bay base was identified as the top unfunded military construction priority for fiscal 2022 for the entire Marine Corps, with an appropriation of $166 million needed to make needed improvements, the Corps said.

The east end of the former Barbers Point base is now a patchwork of land distribution, with large plots of undeveloped acreage reaching to the sea still in the hands of the Navy and/or conveyed or awaiting conveyance mainly to the City and County of Honolulu, Hunt Cos. Hawaii and state Department of Hawaiian Home Lands.

Some of the remaining Navy land conveyances have been put on hold, according to one property user….

NDM: Marine Corps Retiring Older Training Systems to Pursue New Tech 

read … Marines eye land for ‘future force’ at former Barbers Point base

Some flexibility on vacation rentals

SA: … the 30-day minimum for renting a home without a special permit would be increased to 180 days. The intent is to curb violators who continue to accommodate short-term visitors under the guise of a 30-day rental.

At a meeting last week, the city Planning Commission got an earful from more than 200 testifiers, most of whom opposed some or all of the proposed changes.

Predictably, the vacation rental industry is fuming, while the hotel industry — facing fierce competition from a highly desirable product — is generally supportive.

But individual homeowners have a stake, too. One goal of the stricter rules is to encourage would-be B&B operators to rent to long-term tenants, helping to alleviate the critical housing shortage on an island where the median price for a single-family home just topped $1 million.

The problem: They may not want to. As one Star-Advertiser letter writer put it, “I will never open my guest suite for long-term renters because I want to keep the unit for my family to visit. I believe if the homeowner is a resident on property, he or she should be allowed 30- to 180-day rentals.”

The writer has a point. DPP, acknowledging that it’s not just tourists who need a place to stay temporarily, amended the proposal to add exemptions to the 180-day restriction for temporary employees at health care facilities, full-time students, full-time remote workers, military personnel and homeowners in transition. The city should consider more flexible options as well, perhaps changing the 180-day minimum to something shorter, like 90 days….

read … Some flexibility on vacation rentals

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