Lawmakers revive Keiki Care

The Hawaii State Legislature approved a measure Thursday that would revive the Hawaii Children's Health Care program, best known as Keiki Care, which the governor terminated last October. The program ensures health insurance coverage for all of Hawaii's children, focusing on children who fall into the gap group of uninsured.

The legislation, House Bill 989, extends the Hawaii Children's Health Care program for three years, appropriating $200,000 for each year from 2009 to 2012. Representative Ryan Yamane (D-37 Mililani, Waipio Gentry), chair of the House Health Committee, introduced the measure this year to address the health needs of children whose parents are unable to afford health insurance or provide coverage through employment.

"We want to make sure that all our keiki under 18 years old receive insurance and quality care through public-private partnerships between federally qualified health centers, HMSA and government," said Rep. Yamane. "We can't let our children suffer."

In addition to restoring funding to the Keiki Care Program, HB 989 would require that primary health care services for participants be provided by a Federally Qualified Health Center (FQHC); this is generally located in an underserved area or population. FQHCs include all organizations receiving grants under Section 330 of the Public Health Service Act, certain tribal organizations and other FQHC look-alikes, and organizations that meet all requirements of the PHS Section 330 grant but do not receive grant funding.

As the economy weakens, community health clinics, such as Kalihi Palama Health Center, have seen a significant increase in the number of uninsured residents needing health care. Many of them are people who have lost their jobs or received a reduction in their work hours.

"Federally qualified community health centers offer a model that delivers quality community-based care," said Dr. Emmanuel Kintu. "Hawaii's FQHCs are an integral part of the safety net. They have the expertise to deliver comprehensive quality care to the most medically vulnerable members of our community in a respectful and culturally proficient manner. With this investment we will have healthier children. They will miss fewer days of school and parents will miss fewer days of work."

The Department of Human Services (DHS) will also be required to report various findings and recommendations to the Legislature before the 2010 regular session to ensure that children who qualify for free health insurance through Medicaid can take that route.

In addition, the managed care plan partner in the program will be required to establish payment plans with FQHCs to cover the costs of the participants' primary health care services.

HMSA entered into a contract with DHS to offer the Keiki Care plan and began providing services in April 2008 until the governor decided to eliminate funding for the program in October. The health insurance provider decided, with few days' notification of the programs halt, to fund Keiki Care through the remainder of the year. They also engaged in an extensive outreach program to help families find quality health care for their children.

"There are children in Hawaii without health insurance, and it's more than just a family problem," says Cliff Cisco, HMSA senior vice president. "It's a community problem. It requires a community-based solution where public and private sectors work together. That is what Keiki Care is all about, and HMSA is proud to be part of any effort that improves the health and well-being of the youngest in our community."

"The need to provide coverage to our uninsured children is vital," added Rep. Yamane. "I'm grateful for the response and collaborative efforts of our community health centers and HMSA to assist in providing the care for these children. The Keiki Care program is a valuable asset in our efforts to provide health care and coverage for all of the keiki of Hawaii."

The Legislature this session also put back a portion of funds, which provide health care services to immigrants, requested by Governor Linda Lingle, to be cut from the budget. In the state budget, $275,000 of the $550,000 cut requested by the administration was restored to assist health care providers, such as KPHC, serving large immigrant populations.

Photo Top: Rep. Ryan Yamane and Senator David Ige talk about the importance of the governor approving HB989 and releasing funds for Keiki Care during a press conference at Kalihi Palama Health Center. Pictured are (L-R): Speaker Calvin Say, Jennifer Diesman of HMSA, Sen. David Ige, Rep. Ryan Yamane, Beth Giesting, CEO of Hawaii Primary Care
Association and Dr. Emmanuel Kintu of KPHC.

Photo Bottom: Rep. Ryan Yamane and Senator David Ige with keiki patients of the KPHC and parents who will benefit from the passage of HB989.