No Good Intention Goes Without Consequences
HIRA Candidate for GOP Chair Stars in Gay Pride Parade
Hawaii Rifle Association Supports Council Resolution 13-74
Hawaii Obamacare Leaders tell 'Scary Truth': System Strained to the Breaking Point
SA: The somewhat patchy network of health care providers across the country will be strained further to deal with the shortages — to the breaking point, in some places....
"The scary truth is we'll see more people retire and not enough graduates to replace them," she said. "We see more interest, but I don't see them lining up outside our door to get in."
In the short and medium term, various strategies are emerging to cope with the workforce gaps. Not surprisingly, some of them are technological. Gon cited the development of inexpensive and accurate at-home tests for colon cancer and other illnesses, each one signaling one fewer reason for patients to go to the clinic.... (If you think you have cancer, don't call us.)
The technological advance that is top of mind for those driving health care reform is the move toward electronic medical records...
"We are moving away from the ‘make an appointment' model to increased use of email communication and care management by nurses...."
Many doctors in private practice are simply not set up for all this partnering and data-sharing....
All professions in the industry will be pressed to "work to the top of their license," Hedges said.... (Translation: No MDs. Nurses will do MDs job, orderlies will do nurses job.)
on the financial front, Hedges is concerned that with all the system efficiencies that could accrue from reform, that some of it come to the health care providers themselves. (MDs pay cut) There's already a workforce shortage, and without compensation it will become even harder to lure them to the profession.... (But who needs MDs? They're just too expensive to be allocated to you peasants.)
The difficulty will be encountered partly with practitioners who have done things a certain way for many years and are unenthused by the prospect of a total overhaul, he said. (Mass retirements coming, yet the leaders of this reform march forward over the cliff.)
"It's not that they can't be redirected, it's just that there's just so much change being thrown at people," Hedges added. "Change is painful." (Translation: The disaster is nirvana. Believe in our Faith.)
read ... A dose of new health reality
Abercrombie Holds Secret HGEA-HHSC Meeting
WHT: Initially, House Bill 1483 had been set up to open the door for the hospital system’s privatization, but the bill was watered down (into a redundant task force) as it went through the legislative process, said Avery Chumbley, chairman of HHSC’s Corporate Board.... HHSC’s regional boards ultimately submitted testimony to legislators withdrawing their support of HB 1483, and the measure was deferred.
In a phone interview this week, state Sen. Josh Green, chairman of the Senate Committee on Health, said ... “My hope had been to still pass out the task force to work out the details in the off-session.”
Green added that Gov. Neil Abercrombie’s office has gotten involved, helping to bring the various parties together to discuss the situation.
“He’s set up some meetings, some of which have occurred already, that involved the head of HHSC and the CEOs of the other hospitals, as well as some of the union leadership to discuss solutions going forward,” he said.
A spokeswoman for the governor’s office confirmed that there had been a meeting held in April, but she was not able to provide details about what was discussed or who was present....
“Banner has not entirely given up at this point,” Chumbley said on Wednesday. “At the conclusion of the session, they said ‘We still are interested, but you folks need to get governance structure and the statutory authorizations, the legal process, in place.’ That would allow them to come back and enter into some kind of partnership.” (Translation: "B-bye.")
read ... Despite delays, Banner Health still interested
Bill would raise vehicle tax, fees
HTH: The Hawaii County Council signed off on Thursday on Mayor Billy Kenoi’s proposed operating budget for next year, but county residents get another chance to weigh in on proposed tax and fee increases.
On Tuesday, the council’s Finance Committee picks up Kenoi’s recommended increases to the vehicle weight tax, minimum vehicle tax and yearly registration fee. Bill 85 raises the vehicle weight tax from 0.75 cents per pound of vehicle to 1.25 cents per pound for noncommercial vehicles and passenger-carrying vehicles, such as buses, and from 2 cents to 2.5 cents per pound for trucks and nonpassenger commercial vehicles.
The minimum tax will go from $6 to $12, and the county’s annual registration fee will go from $5 to $12.
The Finance Committee will meet at 1:30 p.m. Tuesday at the West Hawaii Civic Center. County officials estimated the increases will range from $24.70 to $176.70 annually, depending on the vehicle. This would be the first county rate increase since 2004.
HTH: County approves funding for Papaikou trail
read ... More Tax Increases
Honeymoon Over at Honolulu Hale
SA: The honeymoon is over at Honolulu Hale — if there ever really was one.
Mayor Kirk Caldwell and the leadership of the Honolulu City Council have drawn swords over the correct approach to the city's operating and capital budgets.
The mayor ran into a brick wall when Council members balked at his idea of adding taxes to keep Honolulu in the black.
But what they are now proposing is not much better. The Council's budget balances without raising taxes — and that's good — but it employs some sleight-of-hand, moving about $20 million in capital improvement project money to the operating budget and then floating bonds....
But what's even more irksome about the Council spending plan is its unexamined expansion of grants to nonprofits serving Oahu, particularly as it entirely lacks a review process. This goes even above and beyond the 0.5 percent of annual general revenues that now must be set aside for nonprofit grantmaking, now that voters approved adding that amendment to the City Charter in last November's election.
read ... Vet nonprofit grants as new law requires
Abercrombie and Caldwell go together like rice and poi
Shapiro: From Abercrombie on the authenticity of his close political friendship with Caldwell: "You can't fake sincerity."
From French dramatist Jean Giraudoux: "The secret of success is sincerity. Once you can fake that you've got it made."
I guess it all depends on which dramatist you believe.
read ... Rice, Poi
Watson: New Federal Judge Not 'Activist'
SA: In private practice in San Francisco, he worked mostly in environmental litigation involving the obligations of companies to clean up contaminated industrial and agricultural sites.
He returned to Hawaii in 2007 to work as an assistant U.S. attorney. In 2009, he was promoted to head of the office's civil division.
His Hawaii cases include successfully defending the Coast Guard's 2007 creation of a security zone in Kauai's Nawiliwili Harbor to protect the Superferry.
He also prevailed in defending federal agencies in the 2011 Waikele fireworks blast that killed five men and the federal government in the 2008 death of a 2-week-old infant from American Samoa at Honolulu Airport while the child's mother was going through U.S. Customs screening....
Watson said he shies away from labels such as judicial "activist" or "conservative."
He noted that trial judges like himself might be considered more conservative because they are bound to apply the law and cannot ignore precedent, but appellate judges have more leeway in issuing "activist" decisions.
He said he admires the way some of the "old guard" federal judges in San Francisco ran their courts and insisted that those in courtrooms abide by the rules.
"They had a presence about them," he said. "You knew not to mess with them."
If he has a credo, Watson said, it would be:
"The rules are there for a reason; it's not to flout."
read ... Not Activist?
Tsutsui leasing space for Maui office from county
MN: Last month, the Maui County Council passed a resolution to lease space on the ninth floor of the building to Tsutsui for $1 a year. Tsutsui lives in Waiehu and still spends some weekdays and weekends on Maui after working on Oahu for much of the week.
On Friday, Tsutsui said that the 10-by-10-foot office will give him a place for official meetings and alleviate the need for him to run from place to place to meet people, as well as enhance county and state collaboration.
He thanked Mayor Alan Arakawa and the County Council for leasing the space to him for his office.
read ... Campaign Subsidy
Task Force Reports Gather Dust
Borreca: We are still getting reports. We must have some place to hold all the reports issued by task forces created by Hawaii's state government.
The state Legislature's own search engine found more than 10 pages detailing the various task forces either adopted or called for by the 2013 Legislature.
Task forces are mostly about their creation; rarely are they about the task force activities and almost never are they about a task force's results.
In other words, a task mostly accomplishes its goal by being announced....
read ... The task of task forces? Their creation does the job
Graduation rate still 'awful'
SA: Fewer than 1 in 5 freshmen at the University of Hawaii's flagship Manoa campus earn a degree within four years — a rate that lags far behind the national average and which has prompted school officials to experiment with ways to boost students' progress.
School officials point to various factors behind Manoa's 19 percent four-year graduation rate,...
Nationally, close to 39 percent of full-time, degree-seeking students finish school within four years on average....
Hawaii's four-year graduation rate was 38th among the 50 states and the District of Columbia....
read ... Awful
Hawaii Among only 7 States to Eliminate Welfare Asset Limit
SA: Gov. Neil Abercrombie signed a law in April that removed the $5,000 asset limit that used to disqualify families from receiving cash assistance. The asset limit was meant to help reserve welfare for the neediest families, but it also acted as an incentive for some to spend down their assets to qualify.
The consequence, social-service advocates say, was that many on welfare could not build the kind of savings necessary to become self-sufficient without losing the short-term cash assistance they relied on for basic needs, trapping them in poverty....
In fiscal year 2012, more than 28,600 recipients in Hawaii were on welfare — or 9,811 cases — and received $64 million worth of cash assistance, according to the state Department of Human Services....
Families must fall under an income threshold to qualify for welfare. For a family of three, a typical welfare household in Hawaii, the gross income threshold is $2,941 a month, or $35,292 a year.
The state's self-sufficiency standard — the amount of money needed annually to meet basic needs without government assistance or other subsidies — was $61,893 for a single adult with one child in preschool and one child in grade school in 2011....
In Hawaii, according to the department, only a few welfare cases had been rejected each month because of excess assets, a reflection of the lack of financial resources among low-income families. Officials say it will likely take several years for the law to have a meaningful impact on asset building....
read ... Welfare
Mayor Wright: Ouansafi Orders Tenants Not to Listen to FACE
HNN: "Some of the residents had reported that the buildings were coming down in six months and that the residents were getting kicked out," said James Fitzpatrick of the group Faith Action for Community Equity, or FACE. The group has been an advocate for tenants for several years.
But FACE became alarmed at a letter from Hakim Ouansafi, the executive director of the housing authority, which was distributed to Mayor Wright tenants Friday. The organization said it sounded like the authority was urging tenants not to work or cooperate with FACE.
"The letter did cause a lot of confusion, because we have tried very hard to let the Hawaii Public Housing Authority know what we're doing, what we've been saying to residents," said Fitzpatrick.
In the letter, Ouansafi tells tenants, "We are extremely disappointed with FACE's current leadership's attempt to spread panic amongst our tenants. We are unsure regarding FACE's motivation for communicating to you that you will be kicked out -- I am writing to set the record straight and tell you that their information is blatantly false."
The letter also said that any information from outside organizations are "nothing but rumors."
"The letter is self-explanatory," Ouansafi told HNN. "We're just telling our tenants, do not hear information from anybody else."...
Ouansafi said there are plans to renovate and improve Mayor Wright Housing, but said in the tenant letter that there will be a series of meetings with tenants to gather feedback, and that no construction will start for at least a few years.
read ... Rumor mill at Mayor Wright Housing creates rift between FACE, housing authority
Vermont Legalizes Terminal Elder Abuse, Star-Adv Celebrates by Lying about Hawaii Law
SA: The new Vermont law, which the governor signed on May 20, contains provisions similar to Oregon's Death with Dignity Act and policies in Hawaii (a lie). It follows Oregon's model, but after three years, those requirements expire, at which time professional practice standards will prevail, as they do in Hawaii (a lie).
Hawaii is in the enviable position of having aid in dying as a standard medical practice (a lie). Two years ago, Compassion & Choices, the largest and most comprehensive choice-in-dying organization in the U.S., analyzed our state's statutes and determined that a constellation of Hawaii laws gives our citizens broad autonomy over end-of-life decisions, including aid in dying. (And the State Attorney General refuted their lie.)
Hawaii does not need legislation to permit this practice. (So stop trying, then.) It already trusts doctors to set best practices for aid in dying and other end-of-life procedures. Terminally ill individuals are able to make these very personal decisions in consultation with family, doctors and their own personal and spiritual beliefs. Patients should not have to suffer intolerably at the end of their lives, and Hawaii doctors can help. (Not legally.)
read ... Who needs a Death Panel?
End of protest period clears way for new Handi-Vans
SA: An effort to buy new Handi-Vans for the 3,500 or so Oahu residents who use the aging vehicles each day is moving ahead, now that a deadline to contest the city's decision to go with a Honolulu-based company for the vans has passed.
Four protests against the city's bid-selection process had already stalled efforts to replenish the 162-van fleet for more than two years. Honolulu transit officials say the city expects to buy 25 to 30 new vans each year.
The delay has kept older Handi-Vans on the road longer, and many of the passengers say the vehicles are showing their age with rickety seats, exterior lifts that don't work and other issues.
The latest firm to protest the bid award was West Sacramento, Calif.-based Electro-Hydraulics LLC.
City officials recently rejected the company's protest, but expressed concern that Electro-Hydraulics might appeal to the state Department of Commerce and Consumer Affairs, a move that would further delay the arrival of 99 new vans.
However, no such appeal was filed by the deadline Tuesday
read ... Handi-Vans
Moth Eats All the Koa on Big Island
WHT: A voracious outbreak of koa moths has continued its spread across Hawaii Island, having now defoliated 50,000 acres of the rare, native Acacia koa trees.
But, scientists said this week that a glimmer of hope may be on the horizon: The moths could be eating so much so quickly that they are will exhaust their food supply and fall back under the control of native predators.
The outbreak of the native pest was first detected in January, and has now impacted every major koa forest on the island, according to Will Haines, a University of Hawaii at Manoa entomologist who is assisting the state Department of Land and Natural Resources with monitoring the situation. While the pest could always experience a resurgence in some areas, Haines argued that it may have depleted most of its food source, effectively halting its own population explosion.
MN: Full-time position added in deer battle
read ... Its OK, it's a Native Moth
Napoopoo Landing was once a busy port, now You need Permit for Paddleboard
WHT: The concrete wharf at Napoopoo is a reminder that this spot was a busy port and active commercial center from the late 1800s to the early 1900s. H. Hackfeld & Co. Ltd., prominent German agents and shippers for sugar plantations throughout the islands, built a large store next to the wharf in approximately 1900, which served local farmers and ranchers. Interisland steamers visited this bay regularly, unloading supplies and mail, picking up cattle, coffee, hides, butter and local produce for Honolulu.
Today: DLNR Requires Permit for Canoe, Paddleboard--Swimmers OK for Now
read ... Regression
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