Lawmakers Lead by Example in the Fight Against the Flu

Rep. Morikawa and Vice Speaker Mizuno at Capitol Flu Shot Day

This year's influenza virus has had a devastating impact on the continental United States and is starting to appear in Hawaii. Tourism and military traffic increase our vulnerability to the spread of infectious disease and we must do everything we can to prevent the flu epidemic from reaching full force in Hawaii.

Kaiser Permanente, HMSA, and CVS-Longs helped make the day possible

The tragic death of four-year-old Jianna Cabasag on Sunday afternoon marks the first flu related death in the state this year. Young children like Jianna and our kupuna are especially susceptible to catching and suffering severe complications from the flu. It's imperative that we be proactive to prevent any more unnecessary deaths.

Vice Speaker John Mizuno, Rep. Dee Morikawa, and Senate President Donna Mercado Kim have already taken action to curb the spread of this particularly viral and deadly strain of influenza. They coordinated with HMSA, CVS-Longs, and Kaiser Permanente to provide flu vaccinations for their working members at the State Capitol earlier today.

Vice Speaker Mizuno receiving his flu shot.

"We are urging other organizations to collaborate with their healthcare providers to follow our lead and set up a flu shot day at their workplace. Individuals should contact their providers as well and get inoculated. The flu season is in full swing and it's not too late to protect yourself and your family," said Vice Speaker Mizuno.

Kukui Connection: Adrianna Ramelli

April is Sexual Assault Awareness Month. In observance of this designation, Rep. Lee welcomes Adrianna Ramelli, Executive Director of the Sex Abuse Treatment Center of Hawaii, on the next episode of Kukui Connection.

In the episode, Ms. Ramelli provides some background on the treatment center, gives a rundown of the services they offer, and talks about what constitutes sex abuse. Started in 1976, the Sex Abuse Treatment Center of Hawaii offers 24/7 crisis care, medical services, counseling, legal support, a 24-hour hotline, and provides a host of prevention tools and information on their website.

Rep. Lee and Ms. Ramelli end the episode on a lighter note, discussing Adrianna's unique background and interesting personal story.

The episode can be seen on Olelo Channel 54 on the following dates and times:

Friday, May 4 at 8:30pm

Sunday, May 6 at 4:00pm

Sunday, May 13 at 4:00pm

Mobile Medical Van Brings Healthcare to Big Island Rural Communities

On March 10, there was a ceremony held in Kona for the blessing of a new mobile medical van, Kaa Hoola (Hawaiian for vehicle of revitalization and well-being), that will benefit rural communities in Hawaii County that are currently without any medical services. The event was the culmination of 10 years of effort by Rep. Bob Herkes, the legislature, Kona Community Hospital and HMSA. 


The van will be owned and operated by the Kona Community Hospital and funded by HMSA for the first two years. The 32 1/2 foot van has an exam room, indoor and outdoor reception areas, a lab, and refrigerated storage areas. 


The initial use for the van will be to provide screening, testing, preventative education, physical examinations, and vaccinations for school children in Ka'u, beginning at Pahala Elementary. The project will eventually offer these services to all members of the communities. 

The launching of Kaa Hoola is a testament to what years of sustained efforts by a coalition of dedicated individuals can accomplish. The people of South Kona finally have access to medical services.

HHSC - Update on New Electronic Medical Records System

Dr. Bruce Anderson, President and CEO of the Hawaii Health Systems Corporation (HHSC) sent out the following message yesterday. HHSC is our state's public hospital system.

July 14, 2011

MEMORANDUM

FROM: Bruce S. Anderson

President and Chief Executive Officer

TO: HHSC Employees and Medical Staff

SUBJECT: ELECTRONIC MEDICAL RECORDS UPDATE

I am extremely pleased to announce that the HHSC Corporate Board of Directors, during its monthly meeting held at the Kona Community Hospital today, Thursday, July 14, 2011, unanimously approved a motion that allows management to enter into a contract with Siemens Medical Solutions USA, Inc. for a new Electronic Medical Record system.

The board approval is the outcome of a comprehensive process that involved extensive discussion and collaboration among the HHSC regions and corporate office representatives from a range of functions, including: physicians, nursing, pharmacy, imaging, laboratory, therapies, revenue cycle, information technology, contracting, legal, administration, etc. Equally important, the selected vendor was able to respond effectively to the unique needs of our community-hospital system that provides acute, critical access, and long-term care to our island communities.

EMR is the new way that all hospitals, including all HHSC facilities, are required to keep patient records. The project involves bringing technology to HHSC in a manner that will drive excellence and automation in all of our operations. The EMR system will keep track of our patients' health and medical history in a computerized electronic format. All patient files, including history, diagnosis, medications, and other important information will be kept electronically and safely secured.

The HIS/EMR contract will include the following HHSC regions: West Hawaii - Kona Community Hospital and Kohala Hospital; Maui – Maui Memorial Medical Center; Kula Hospital, and Lanai Community Hospital; Oahu – Leahi Hospital, Maluhia, and Kahuku Medical Center; Kauai – West Kauai Medical Center and Samuel Mahelona Memorial Hospital.

The HHSC East Hawaii region – Hilo Medical Center, Ka'u Hospital, and Hale Ho'ola Hamakua – started its switch to EMR in May 2010, and will join the other regions in utilizing the accompanying Health Information System (HIS) function for some of its financials (i.e., patient accounting, order entry, admitting, etc.)

At this point, HHSC management is examining various funding options, and hopes to finalize a five-year contract with Siemens Medical Solutions, USA, Inc. by the end of July 2011.

Your regional leadership and I will be sure to keep you abreast on any new developments, including when the contract is finalized and details of the first phase of implementation.

On behalf of the HHSC Corporate Board of Directors, my sincere appreciation goes out to all of the HHSC hospital and Medical Staff, who have actively participated in this on-going effort up to this point, and who remain committed to making this implementation a success!

Wahiawa Health Fair

Rep. Marcus Oshiro (District 39 – Wahiawa, Whitmore Village, Launani Valley) announced today that the Wahiawa Hongwanji Mission, Wahiawa General Hospital, and community service providers will be participating in the 2nd Annual Health Fair to share information to the community on ways to achieve and maintain healthy lifestyles for all ages.

Place: Wahiawa Hongwanji Mission Social Hall – 1067 California Ave.
Date: Saturday, November 20, 2010

Time: 8:00 a.m. to 12 noon

“Having good health is the most important thing you can do for yourself and your family,” said Rep. Marcus Oshiro. “Without your health, you are unable to help others or achieve anything else in life. The Health Fair is a way for people in our community to get the information they need to get and stay healthy, and to determine which path to health, traditional, non-traditional, or a combination of both, is right for them.”

In additional to traditional and non-traditional medical practitioners, the Hawaii Blood Bank’s bloodmobile will be there and Wahiawa General will be providing health screenings and flu shots. Here is a list of providers scheduled to be at the health fair:

Aged to Perfection, Aloha Chapter Headquarters, Ask Acupuncture, Child and Family Service, Hawaii Blood Bank, Hawaii Department of Health, HSMA, Hawaii State Medical Reserve, Hawaiian Healer, Ilima at Leihano, International Culture and Friends, Kapuna Monitoring System, Meadow Gold Dairies, Office of the Ombudsman, The Plaza, Project Dana, St. Francis Healthcare System, State Farm, Wahiawa General Hospital.

Coming up - Hospital and ER care for sexual assault victims

What: Informational Briefing on the current system of care for sexual assault victims in Hawaii's hospitals and emergency rooms.

When: Tuesday, May 25, 2010

Time: 10:30 a.m.

Where: State Capitol, Room 325

Committee: House Committee on Health. Chair: Rep. Ryan Yamane (District 37 - Waipio Gentry, Mililani), Vice Chair: Rep. Scott Nishimoto (District 21 - Kaimuki, Kapahulu, Waikiki, Ala Wai, Diamond Head)

Let's take the stairs

Thanks to the folks at Governing.com, who found a great video on an initiative by Volkswagen to encourage more people to take the stairs. Changing behavior is easier when you include an element of fun.

Part time workers lack health coverage

USA TODAY covered Hawaii's healthcare system today, in a story by the Associated Press.

A statistic that stands out is that "Hawaii has the highest percentage of private sector part-time employees without employer sponsored health coverage in the country, according to a University of Hawaii study on the law's impacts."

That law is the historic Pre-paid Health Act, passed in 1974, which requires Hawaii employers to provide health insurance coverage for workers who work more than 20 hours a week. Since then, Hawaii has become one of the healthiest states in the country based on such factors as life expectancy, high number of insured, low number of emergency room visits, and others.

However, businesses looking to get around the law in order to save money hire more part time workers who work less than 20 hours a week.

The legislature passed a bill this session which would have required health insurers who offer health care coverage to regular employees of a group or association to offer the same coverage to part time employees who work at least 15 hours per week. HB690 Relating to Insurance.

The bill was vetoed by the Governor. The veto explanation stated that the bill "violates federal requirements governing employee benefits as set forth in the Employee Retirement Income Security Act (ERISA)." The legislature did not override the veto.

Health Care Reform - Can states afford to wait?

President Obama is scheduled to deliver a national address on his health care reform package today (8 pm Eastern/2 pm Hawaii). You can watch the live stream here. You can also follow the president on www.Twitter.com/BarackObama, where he has asked his 1.8 million Twitter followers to watch the news conference and declare support.

A few states have started plans for greater health care coverage stating that they can't wait for reform at the national level. On Monday, Connecticut overrode their Governor's veto to pass into law a universal health care measure. The plan is scheduled to be implemented by 2012, and to cover the state's 300,000 uninsured residents. The WSJ online story is here.

Connecticut follows Massachusetts, which enacted universal health care legislation in 2006, and Vermont and Maine, which have reformed parts of their health care system.

In the 2009 session, Hawaii passed HB1504 which creates the Hawaii Health Authority, charged with developing a comprehensive plan to provide universal health care for Hawaii residents. The bill was vetoed by the Governor and the legislature overrode the veto last week. The legislature appropriated $50,000 for the fiscal year 2009-2010 for the authority to perform its duties.

Laura Tobler, health policy expert with the National Conference of State Legislatures, says that much of the federal legislation will be modeled after what the states are doing. She warned, however, that these states could miss out on some federal subsidies.

Connecticut has indicated that if federal legislation is passed, they would make recommendations within 60 days on any changes needed to fit with the national program.

Legislature passes bill helping private hospitals to receive $12.5 million in federal funds

State House and Senate lawmakers have approved a measure that will enable Hawaii’s private hospitals to receive $12.5 million of federal disproportionate share hospital (DSH) funding for the next two fiscal years. Senate Bill 423, approved in final floor sessions Thursday, appropriates $12,291,054 in matching state funds to secure the DSH allowance obtained by Hawaii's Congressional Delegation.

"Hawaii is the only state in the country that does not get automatic disproportionate share hospital payments," said Senator David Ige, Chair of the Senate Health Committee. "We must continue to work closely with our federal delegation, especially Senator Akaka, to ensure we maintain support for Hawaii's private hospitals."

The Medicaid DSH allowance assists hospitals that treat Hawaii's most vulnerable and poverty-stricken people. Without this matching state appropriation, the federal funds cannot be expended to the state. In order to ensure that Hawaii's residents receive continued access to basic health care, Senator David Ige and Representative Ryan Yamane, chairs of their respective Health Committees, made it a priority this legislative session to seek state funding to maximize the availability of federal assistance.

Hawaii hospitals that serve Med-Quest patients lose tens of millions of dollars each year in order to provide healthcare services to low-income patients. DSH payments help offset some of the cost of uncompensated care delivered by hospitals and addresses inadequate reimbursement by Medicaid. These payments are supplementary to the regular reimbursements hospitals receive for treating Medicaid patients.

"Hawaii residents face rising health costs every day, and this bill helps to ensure that hospitals continue to provide care for those in our community who can least afford it, said Rep. Ryan Yamane, chair of the House Health Committee. "Private hospitals depend on this revenue, and I'm very pleased that we were able to find state revenues that allow us to take advantage of millions of federal dollars."

Photos: Rep. Ryan Yamane, chair of the Committee on Health, held a press conference with other lawmakers and hospital officials to announce the passage of SB 423.

UPDATE: The Honolulu Advertiser supports passage of bill and calls for Governor's speedy release of the funds. Editorial 5/12/09.

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.

Avoid the flu, wash your hands

An informational briefing held at the Capitol this morning provided lawmakers and office staff information on the H1N1 Swine Flu. University of Hawaii Chancellor Virginia Hinshaw discussed the facts of the swine flu, TAMIFLU, and prevention methods. Hinshaw has a background in research of pathogenesis, immune recognition and the ecology of influenza viruses.

Hinshaw warned that consumer stockpiling of anti-virals, such as TAMIFLU, is unnecessary and can be problematic to public health care. Some populations are more susceptible to contracting the flu. Anti-virals need to be saved for emergency response to a high-populated outbreak of H1N1 Swine Flu. The Hawaii State Department of Health has prepared for an outbreak of the Swine Flu in Hawaii by stockpiling TAMIFLU in all departments. She mentioned that the public must focus on remaining calm as the outbreak of Swine Flu is currently milder compared to the common seasonal flu, and told lawmakers that their leadership will be pivotal.

Flu Facts:

The flu changes and adapts rapidly by genetically mutating according to the environment and the carrier. That is why the flu vaccine is updated annually to meet genetic changes or modification made to the virus. It is a highly transferable by touch and other kinds of contact. The most recognizable symptom of any type of flu is the presence of a fever.

False Facts:

You cannot get Swine Flu from eating cooked pork or any other cooked meats. Paper masks do not offer much protection from Swine Flu. It merely blocks sneezes and coughs from others.

What is TAMIFLU?

Tami flu is an over-the-counter product, not a vaccine, used to alleviate the symptoms of influenza and reduces the productivity of the virus in the body. It does not prevent the entry of an influenza virus. When a person identifies the flu-like symptoms, including fever, cough, sore throat, body aches, headaches, chills, and tiredness. If a fever is absent then it unlikely that a person has the flu. Some people have also had diarrhea and vomiting with the Swine Flu. Before leaving the home people should call a physician who will then confirm Swine Flu symptoms and assist with local clinic instructions.

Preventive Tips from the U.S. Centers for Disease Control and Prevention (CDC):

1. Wash your hands with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
2. Avoid close contact with anyone who appears sick.
3. Cover your nose and mouth with a tissue when you cough or sneeze. Wash or sanitize your hands after you sneeze.
4. If you feel sick, stay home from work or school, and limit contact with others.
5. Clean your workplace environment regularly with sanitizer or rubbing alcohol, particularly equipment and surfaces shared by others.
6. Avoid touching your eyes, nose, or mouth.

Air Travel Tips

Travelers should drink lots of liquids before getting on an airplane because the high altitudes dry out nasal passages making a person more susceptible to invasion by the virus. The public should not be afraid to travel. It is no different from being in a conference meeting at the capitol, taking notes in a crowded lecture hall at UH Manoa, or in any other place putting people in close proximity.

Preparing for a pandemic

As Hawaii prepares for the possibility of a swine flu outbreak, the following information on past appropriations for pandemic influenza may be helpful.

In 2006, the state legislature passed SB2348 which was signed into law as Act 84. The bill appropriated $6.3 million from the general fund to prepare for a novel strain of influenza by acquiring medications, mass clinic supplies, laboratory supplies and equipment, personal protective equipment, and a data management system for tracking cases and contacts.

The legislature appropriated $5 million from the emergency and budget reserve fund for additional medication, laboratory equipment, supplies, personnel, and public education programs.

A link to SB2348, CD1: http://www.capitol.hawaii.gov/session2006/Bills/SB2348_CD1_.htm

In 2005, the legislature passed HB516 which was signed into law as Act 46. The bill authorizes the Department of Health to maintain an emergency response stockpile to prepare for or respond to an event.

A link to HB516, SD1: http://www.capitol.hawaii.gov/session2005/bills/hb516_sd1_.htm

Shocks through the House

The House of Representatives purchased three fully automatic Automated External Defibrillators (AED) that will be located in fire extinguisher cabinets on the Chamber level (next to the Sergeant-at-Arms Office), and in the mauka corridors on the 3rd (next to room 303) and 4th floors (between rooms 402 and 404).

In mid-January, over 40 staff and House members participated in a CPR/AED training course, earning a 2-year certification from the American Heart Association. (Check out a previous post, "Getting over the yuck factor", for more on the training).The House Defibrillator Program was coordinated by Lon Paresa, Assistant Sergeant-at-Arms.

The live-saving shock machines are alarm activated and should only be used in emergency situations. Clear and simple voice commands guide the user through proper application. The machines are safe and easy to use; they will not send electrical currents to a patients heart if it's not necessary.

Legislation about AEDs is now making its way through the House. The measure (HB 1537) protects individuals not covered under the Good Samaritan clause from civil liability when using the AED to help save a life. Rep. Tom Brower (Waikiki, Kakaako) introduced the bill to "see defibrillators placed in more buildings where our residents live, work and play."

HB 1537, RELATING TO AUTOMATED EXTERNAL DEFIBRILLATORS, specifies that any person who provides for an automated external defibrillator training program is generally immune from vicarious civil liability resulting from any act or omission of a Good Samaritan attempting to use the device to resuscitate a person.

Photo: Rep. Ryan Yamane, chair of the House Health Committee, restarts compressions after the mannequin receives a faux shock from one of the three AED machines that will be placed in the Legislature by the House of Representatives.

Riding backseat

Hundreds of social service advocates today gathered at the Rotunda of the Hawaii State Capitol in response to the Lingle administration's budget proposal to eliminate the Healthy Start program. The cut would save the state $23.2 million dollars over the next two fiscal years. The rally began immediately after the Governor's State of the State address.

Former State Rep. Alex Santiago, chief executive officer of PHOCUSED, an advocacy group for health and human services, took issue with what Governor Linda Lingle said about social-services programs in her address to the people of Hawaii.

After praising the Dept. of Human Services and its community partners for their substantial progress in child welfare services, Lingle pointed out that, because of recent reductions in revenue, balancing the state budget will take precedence over anything else, even notable services and programs.

"…they and other worthy programs will take a back seat to our more immediate need to balance the budget. Today's struggling economy has created a deep hole in our budget that we need to dig out of this session," Lingle said.

Santiago kicked off the human services rally under the volcanic opening of the state capitol with a bold statement firing back at the governor's comments and igniting cheers and applause from a swarm of social service advocates clad in neon green t-shirts.

"We take a backseat to no one," he announced. "You [Lingle administration and Legislature] will not balance the budget on the most vulnerable people of this state."

Rep. Ryan Yamane, chairman of the House Health Committee, has been quoted in a recent Honolulu Advertiser article saying that lawmakers will try to find money for the program. However, he did also relate the difficulties that this will entail.

"We're going to try," said Yamane, a social worker. "The difficult part is, when we give one dollar to one place, it means somebody else is not going to get that dollar. So the question comes down to looking at what are the core services of state government in the health area and looking at ways to help support valuable programs."

Legislative Hawaiian Caucus speaks with Native Hawaiian health community

By: Travis Quezon
Office of Rep. Mele Carroll

Rep. Mele Carroll and the Legislative Hawaiian Caucus met with leaders and practitioners in the Native Hawaiian health community at a meeting on Jan. 15.
Caucus members heard concerns from members of Hui No Ke Ola Pono, a non-profit that provides community-based health care services on Maui; Papa Ola Lokahi, a clearinghouse for data and timely information associated with the health status of Native Hawaiians; Mental Health Alliance; and Community Health Centers in Rural Areas.

“It’s a rare occasion, quite frankly, that we have been invited to speak in front of legislators,” said David Peters of the Kaua‘i Community Health Center. “We at Papa Ola Lokahi look at new initiatives to integrate into Native Hawaiian health care systems. … Initially, you could count the number of researchers on one hand. Now there are nearly 150 researchers [working with us].”

Rep. Karen Awana asked if Papa Ola Lokahi and Hui No Ke Ola Pono looks into different kinds of alternative medicines.


“The whole idea of traditional healthcare practices are organic to the Native Hawaiian Healthcare Act,” Papa Ola Lokahi’s Hardy Spoehr replied. The Native Hawaiian Healthcare Act was created by Congress to develop outreach programs addressing the unique health needs of Native Hawaiians, who were found to have suffered greatly from the early onset of chronic disease and other adverse health conditions.

Tom Foye, Planning and Development Director of Papa Ola Lokahi, described how many non-profit healthcare organizations are at risk during economic times because they are dependent solely on federal funding.

“We’re very much at risk because we have one funding source in Washington: Sen. Daniel Inouye,” Foye said. He explained to the caucus that they should look at funding community healthcare organizations through diversification and solid strategic planning.

“We hope that we can continue this conversation in all forums,” Rep. Mele Carroll said to the healthcare practitioners.

Alex Santiago spoke to the caucus on behalf of the Mental Health Alliance. As part of ongoing budget cuts throughout state departments, the Adult Mental Health Services division announced in November that it will be cutting over $25 million from its FY2009 budget by cutting services.

“We are not going to stand by and watch as we try to balance the budget on the backs of the poor,” Santiago said. “What we are going to try to do is bring the word to you [the Legislative Hawaiian Caucus].”

Rep. Pono Chong said that lawmakers need to hear from the community where cuts would be better made. “The state, unlike the federal government, cannot borrow money to operate,” he said.

Santiago replied, “We’ve been doing a lot with less. We’re willing to do more with less. We’re willing to collaborate. However, we’re at the point where critical services for the most needy are being cut.”

Rep. Mele Carroll asked Santiago if finding new ways to generate money has been part of the discussion within the mental health community.

Santiago said that all options are being discussed. “Whatever it is we do to get revenue, we have to make sure the money is going to the things we care about,” he said. “There’s a willingness of everyone to come to the table to find a solution.”

Getting over the yuck factor

Photo: House members and staff practice compressions during the first of two American Heart Association Heartsaver and Automated External Defibrillator training courses.

Put my mouth where? On whom? These types of questions flash through the minds of many people during a situation in which someone may need CPR assistance. Germs. Disease. Saliva. Cooties. The "yuck factor," as an Associated Press story put it.

Would the yuck factor deter you from jumping in to help save a stranger's life? I hate to admit it to myself, but I don't know if I would be willing to get fresh with Mr. Joe-next-door if I was placed in that situation. It's a terrible thing to admit, but it's the truth.

Yesterday, twenty-eight of my colleagues and I, including Rep. Ryan Yamane, chair of the Health Committee, and his staff, attended an American Heart Association Heartsaver and Automated External Defibrillator training course at the Hawaii State Capitol. Guess what we found out? Giving mouth-to-mouth is soooo last year. We learned that the American Heart Association (AHA) revised their CPR guidelines last March to include Hands-Only CPR as a possible method for people "unwilling or unable" to give two quick breaths.


Photo: Rep. Ryan Yamane prepares to give the mannequin two breaths with a resuscitation device.

Here's the gist of how to handle a situation: 1.) Send someone to call 911 or, if alone, call 911 yourself. 2.) Send someone to retrieve an AED, 2.) Push hard and fast in the middle of the chest (100 compressions per minute).

That's it. Not too tough on the hippocampus, eh?

During the two-and-a-half-hour course, we were also trained in traditional HeartSaver CPR and how to use an Automated External Defibrillator (AED), or " the shock machine," as I call it. It was by far the quickest, easiest and most effective CPR training that I have ever signed up for. I doubt that I will ever forget what I learned during this course. It was fun, informative and hands-on the entire time. The training was led by Pam Foster of the AED Institute.

The House of Representatives will soon have three PowerHeart AED machines that will be located with the fire extinguishers on the Mauka side of the third and fourth floors and the Ewa side of the basement level. The blue and white AEDs automatically turns on once the lid is opened. House Sergeant-at-Arms warns that "there are severe penalties for anyone playing with the machines if not used for emergency purposes."

This is the first year that the House has offered CPR/AED training to representatives and permanent staff. Concerned about the health, welfare and safety of House members, staff, and visitors, Speaker Calvin Say authorized the training to get as many employees as possible certified by the AHA for a two year period.

The next training date will be on January 20, 2009.

"At the conclusion of this training next week, over 50 members and staff will be ready to kokua in time of emergency," said Kevin Kuroda, House Sergeant-at-Arms.

Photos: Rep. Ryan Yamane looks on as Lon Paresa, House assistant sergeant-at-arms, finishes off two minutes of compressions on a mannequin before the next shock from the AED.

Hearing on tattoo licensing Monday

The House of Representatives Committee on Health will hold an informational briefing on the licensing standards of the tattoo industry to address issues related to the health and safety of consumers. The hearing will be held Monday at 10 a.m. in conference room 329 at the State Capitol. This is an informational meeting, so no public testimony will be accepted.

Last Session, HB2283 HD1, SD1, a bill that initially sought to allow tattoo artists coming to the state for tradeshows to apply for a temporary certificate of registration, failed to pass out of the Legislature when the last draft replaced the licensure law with a registration program.

The tattoo industry opposed the measure in that form as safety is critical to practicing tattoo and body piercing artists. Careless practicing methods create a greater risk to exposure to blood borne pathogens, including but not limited to, Hepatitis B, Hepatitis C, and HIV/AIDs.

Getting serious about Lupus

"I don't think people understand the seriousness of this disease that affects people in the prime of their lives. Lupus needs to be a household word." Dr. James McKoy, M.D.

Left to right: Rep. Rida Cabanilla, Cheryl Jong, Dr. James McKoy, Rep. John Mizuno

Dr. James McKoy is one of a handful of doctors in the state who specializes in rheumatology. He took time from his Kaiser Permanente practice this morning to come to the capitol and educate people on Lupus, a chronic disease of the immune system. It is an inflammatory, autoimmune disorder in which the body's immune system attacks its own healthy tissues and organs.

Cheryl Jong is president of Lupus Hawaii. Diagnosed at age 20, she believes she has had the disease since birth. Cheryl spends most of her time in a wheelchair, yet she manages to run the organization, lobby for Lupus awareness and education, and take care of 4 children, all of whom are symptomatic and are Shriner's kids.

Along with Dr. Morgan Barrett, Deputy Director at the Department of Health, Cheryl Jong and Dr. McKoy presented some sobering facts about the disease:

• Approximately 1 in every 2000 Americans has Lupus; many are misdiagnosed or undiagnosed


• 90% are women


• 80% are between the ages of 14 and 45


• Estimated that 10,000 people in Hawai are affected by Lupus; that is considered a low estimate


• Lupus predominantly affects people of color; Native Hawaiians, Pacific Islanders, African Americans, Asians, Hispanics and Native Americans

Dr. McKoy calls Lupus "The Great Masquerader". It's difficult to diagnose because the symptoms could indicate a number of illnesses. If you read the symptoms below, you can see why Lupus may be diffcult to pin down. That's why many patients go years before being properly diagnosed, a frustrating situation leading to depression, loss of employment and loss of income.

There is a direct correlation between Lupus and women's hormones, which is why few men and women past menopause are considered at risk.

Access to treatment is also a problem. There are few rheumatologists on Oahu, and none on the neighbor islands. Dr. McKoy said this morning that Kaiser Permanente does pay for patients on the neighbor islands to fly to Oahu for treatment. He emphasized several times the difficulty for neighbor islanders to receive the proper treatment.

Symptoms include: achy joints, swollen and painful joints, unexplained fever, prolonged or extreme fatigue, skin rashes, unusual hair loss, mouth or nose ulcers, butterfly shaped rash across the cheeks and bridge of the nose, chest pain or shortness of breath, sensitivity to sunlight, swollen ankles, fingers that turn white and/or blue in the cold, seizures.

For more information, visit Lupus Hawaii's website at LupusHawaii.org.

Battling Lupus

The House Committee on Health will hold an informational briefing on Monday, June 23, 2008 to discuss the impact of Lupus in Hawaii.

When: Monday, June 23rd - 10:00 a.m.
Where: State Capitol, Room 329

Lupus is a widespread and chronic autoimmune disease that causes the immune system to attack the body's own tissue and organs. Although there is no known cure for Lupus, we do know that there are genetic factors, environmental triggers and certain types of drugs that can cause Lupus.

The committee will address the services and programs that are available to individuals with Lupus and prospective policies to effectively deal with the disease.