Health

Which is the bigger issue in healthcare today:  spiraling costs or accessing quality care regardless of whether you live in an urban or rural community?   Hawaii faces both challenges.  With federal support, we have a spectrum of solutions.  Federal community health centers provide quality healthcare to those in need.  Moreover, telehealth utilizes internet and broadband connections to bring specialists to rural community hospitals and health centers.  The new University of Hawaii at Hilo pharmacy school trains a new generation of practitioners for our communities.  On tough issues like these, there is only one way forward:  together.

Below are some of my health accomplishments for Hawaii:

Community Health Centers.  Realizing the health disparities in Honolulu’s urban core and in rural communities on all of the islands, I have long supported healthcare access for all residents, with or without insurance, by ensuring a growing network of federal Community Health Centers.  They target services to medically underserved people including low-income families, Native Hawaiians, immigrants, the homeless, and those who lack health insurance.   To date, 14 Community Health Centers with 47 service sites, serving over 117,000 patients per year, are up and running on the Islands of Kauai, Oahu, Molokai, Lanai, Maui, and the Big Island.  The annual average aggregate federal subsidy for these 14 centers is about $15.7 million.  In addition, I support another $1.8 million annually in congressional initiatives to make investments in their healthcare delivery systems, jump-starting or expanding high demand areas such as dental and mental health services.  Most recently, $2.7 million dollars in economic stimulus funds was provided to the 14 centers to extend services to more uninsured members of our community.  Additional economic stimulus funds are expected shortly to support capital improvements for each of the centers. 

Emergency Medical Services for Children.  For 25 years, I have spearheaded legislation and funding for the Emergency Medical Services for Children (EMSC) program which is designed to ensure that all children and adolescents, no matter where they live, receive appropriate care in a health emergency.  Since its establishment, the EMSC Program has provided grant funding to all 50 states.  $20 million dollars in annual funding has been used to help transform pediatric emergency care in a range of areas, including training EMTs how to care for ill and injured children, developing lists of equipment and drugs that should be in ambulances and in hospitals, and developing handbooks and tools for providers to use in caring for children.  Since the program was created in 1984, the rates of child death from unintentional injuries have dropped by 40 percent, due in part to improved emergency care.  The State Department of Health is the recipient of Hawaii’s allocation of funds for this program.

Administration on Aging Grants.  I have facilitated $20 million in funding over 10 years for the Administration on Aging grants to Native Hawaiian organizations.  This funding promotes the delivery of supportive programs, including nutrition services, to older Native Hawaiians and provides multifaceted systems of support services to family caregivers.

Pharmacy and Pre-Pharmacy Programs at University of Hawaii at Hilo (UHH). 
The College of Pharmacy program will begin graduating about 90 doctorally prepared pharmacists annually beginning in 2011.  The inaugural class was seated in 2007, and currently, about 115 students are enrolled, including at least 23 via distance learning.  Once completed, the pharmacy programs at UHH are projected to generate $50 million per year in economic activity for the state, $4.2 million in tuition revenue per academic year for the university, and another $15 million in earnings.

A pre-pharmacy program was also established to meet the needs of students in the Pacific Region who may not have access to formal training opportunities.  Realizing that many students do not have campus access due to geographical or transportation barriers, student access was increased through enhanced partnerships and distance-learning efforts.   The pre-pharmacy program is offered to students in American Samoa, Guam, Marshall Islands, Micronesia, Northern Marianas College, Saipan, and Palau.  In addition to fulfilling the two-year requirement of pre-pharmacy training, the curriculum is designed to fulfill some or all of the prerequisites for other health science degrees such as nursing and medicine. 

Papa Ola Lokahi - Native Hawaiian Healthcare.  Providing quality healthcare services to Native Hawaiians has always been critical.  Cancer, diabetes, and heart disease continue to plague the Native Hawaiians at a greater rate than all other ethnic groups.  Early health prevention and promotion greatly improve the chances of providing proper treatment to increase their longevity.   Over the years I have secured over $115 million for Native Hawaiian healthcare.  These funds have been used to provide preventative care, traditional healing practices, and general health services. 

Akamai.  Akamai supports applied research, development and deployment of telehealth and healthcare technology, biotechnology, and clinical informatics, to improve access and the quality of care to military families, federal beneficiaries and impacted communities.  Building on an annual investment of approximately $25 million, this project has been successful in advancing the development of clinical diagnostic systems, regenerative medicine, human physiology sensors, medical information systems, medical simulation, vaccine development, clinical research in Post Traumatic Stress Disorder and other biotechnology and medical projects.  Through this effort, Hawaii technology companies have succeeded and new technologies and services are in the marketplace. 

Pediatric ECMO – Hanuola.  ECMO stands for extracorporeal membrane oxygenation, and it is the temporary support of heart and/or lung function using mechanical devices.  With an investment of $6 million, a sustainable partnership was established in July, 2007 between Tripler, Kapiolani Medical Center, Kaiser Permanente, and the University of Hawaii to provide very sick children with a state of the art lifesaving technique.  Nine children have been saved with ECMO-Hanuola.

Cancer Research Center of Hawaii.  My involvement in support of cancer research in Hawaii dates back decades.  During President Reagan’s administration, I spearheaded a National Institutes of Health (NIH) National Cancer Panel site visit to Hawaii which ultimately led to the creation of the cancer center building on the Queen’s Medical Center campus during  President Carter’s tenure.

In May, 2002, the Governor’s Blue Ribbon Panel on Cancer Care in Hawaii found that comprehensive cancer care in Hawaii was poorly coordinated, due to a highly fragmented and competitive healthcare system.  Existing cancer screening, cancer care and cancer research initiatives were complicated by Hawaii’s geographical isolation and by the State’s extraordinary ethnic and socioeconomic diversity.  However, this same diversity provides an unparalleled opportunity for innovative new epidemiological cancer research which in turn should lead to better care and treatment.

Wanting to ensure that Hawaii patients could get the best treatment locally, instead of having to travel to the mainland, one of the identified solutions was to establish a new cancer research center.  My goal was to spur on this important development.  It seems that we are moving much closer to breaking ground and realizing this goal.  To support this effort, I secured $10 million in 2004 for the planning and design of a new cancer center in Kakaako, which would expand upon an existing UH facility and add a clinical component for actual patient care and clinical trials. 

Also in 2004, I worked to secure an additional $8.5 million for a collaboration between Tripler and the Cancer Research Center of Hawaii to work on the causes and optimum treatment of cancer.  The research projects, started as a result of this funding, are still ongoing and reporting substantial increases in patients enrolled in clinical trials, which offer the most cutting edge drugs and treatment plans.

Veterans.  The Tripler Army Medical Center (TAMC), attends to the medical needs of our fighting men and women.  It also shares space with the Spark M. Matsunaga Veterans Affairs (VA) Medical Center, which provides outpatient services to Hawaii’s veterans.  Hawaii has a proud tradition of service to our nation and is reflected in the number of veterans – 118,017 -- that reside in the State.  In Fiscal Year 2008, over 14,433 veterans utilized the facilities located in Honolulu, and on our neighbor islands, over 5,700 veterans used the VA’s outpatient clinics.  Statewide, the total number of visits to VA facilities was over 20,000 during Fiscal Year 2008.  Over the last two years, Congress has provided more funding to the VA than it has in the last 12 previous years to ensure a higher level of care.

Upon their return from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), our service members have been receiving improving care from the Department of Defense (DOD) and VA.  At Congress’ insistence, a concerted effort was made to help facilitate a smoother transition for our warriors from active duty to civilian life.  This included compelling closer coordination between DOD and VA on medical records, service records, and receipt of benefits.  The impacts of combat are not restricted to the fighting man or woman, and their spouses.  Families also feel the strains of our warriors’ sacrifices, as evidenced by the numbers of divorce, substance abuse, and homeless veterans. 

Currently, efforts are underway to address the signature wounds of our engagements in OEF/OIF -- traumatic brain injury and psychological health.  Ensuring that there are an adequate number of DOD mental health providers to both our service members is critical to helping them cope with the experiences of war.  As veterans, meeting the physical and mental needs of our brave men and women becomes the responsibility of the VA.  Following the U.S. experience in Vietnam, psychological conditions suffered by our soldiers like Post-Traumatic Stress Disorder, were recognized as “legitimate” ailments.  Our painful lessons from the Vietnam War remind us that wounds from past conflicts do not end with one’s service.  As a result, Congressional funding for both DOD and VA mental health treatment and research have steadily increased.  The VA now focuses some of its research efforts on the long-term effects of physical and mental wounds to improve treatments and their efficacy on our veterans.

Yukio Okutsu Veterans Home officially opened in November 2007, and recently received their VA certification.  To build the first state-run veterans’ home in Hilo, $18 million in federal support for the $28 million construction project was secured.  Until the completion of this new facility, Hawaii was one of two states that did not have a state run veterans’ care home.  The new 95-bed facility is located next to the Hilo Hospital provides affordable long-term care to our heroes, with an area dedicated to adult daycare services.