Keiki Care makes national news

FOX News is in town doing a story on Keiki Care, Hawaii's initiative to provide basic health coverage for uninsured children. Today, reporter Griff Jenkins interviewed the House Health Chair, Rep. Ryan Yamane, and Jennifer Diesman from HMSA, Keiki Care private partner provider. They filmed at Kewalo Basin State Park.

Rep. Yamane also brought along his own keiki, 1-year-old Gavan.

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.

Reviving Keiki Care - HB989

by Rep. Ryan Yamane - Chair, House Health Committee

In February 2008, it was estimated that the number of uninsured children in the state may be as high as 3500. In Hawaii, we have a gap group that is ineligible for any state or fderal health care coverage.

The majority of children in the gap group are those whose family income is at or over 300 percent of the federal poverty level.

These keiki have very minial access to preventive care and are often taken to the emergency room when a serious health problem develops.

Of ten these emergency visits are uncompensated and places a growing financial burden on Hawaii's hospitals and physicians.

To be eligible for the Keiki Care plan, children must be between the ages of 31 days and 19 years old, and live in Hawaii. In addition, children must have been uninsured continuously for at least six months and ineligible for any other state or federal health coverage.

As our State faces more fiscal constraints, we at the Legislature want to continue to support partnerships with good public and private entities to ensure that all our keiki are covered.

The reason that we wanted to partner with the Federally Approved Health Clinics is because they have the relationships, expertise and community commitment to cover all of Hawaii's people.

Click here to view bill passed: HB989

Keiki Care supporters seek new partner

Come January 1st, an estimated 1500 - 1800 Hawaii children may be without healthcare due to the State administration's surprise move to discontinue funding for the Keiki Care program. Keiki Care is basically universal health care for children who do not qualify for any other government assistance program. The State and the Hawaii Medical Service Association share the cost of the premiums; the program was established by the legislature and is considered groundbreaking. Had HMSA not stepped up to the plate to fund the entire program until the end of the year, the end of Keiki Care could have been this Friday. As time is of the essence, Health Chair, Rep. Josh Green, threw together a meeting yesterday to discuss options.

The Honolulu Advertiser's editorial staff covered the meeting, and the future of Keiki Care was the subject of this morning's editorial. KHON and AP were also there.

Chair Green, who will not be in the House after the November election, but who may be elected to the State Senate, would like to find another organization, public or private, to partner with HMSA. He plans to call a follow up meeting at the end of November to see where things stand.

Keiki Care Letter to the Editor

This appeared in today's Honolulu Star-Bulletin:

Lingle administration abandons kids in need

This is a sad day for children who have no health insurance and don't qualify for other government programs. The Lingle administration abruptly pulled out of its agreement to fund the Keiki Care program, even though the Hawaii Medical Service Association has partnered with the state to pay half the premiums (Star-Bulletin, Oct. 17). In August, the Legislature expanded Keiki Care to cover kids whose parents were laid off from Aloha Airlines, Molokai Ranch and other business closures.

HMSA was surprised by the administration's move, and so was the Legislature. We're proud that Hawaii became one of the first states in the nation to ensure that every child has access to health care. Human Services director Lillian Koller has not provided us with any information on why the program is ineffective. HMSA contends that it's working well, that more than 2,000 children may be impacted, and it has stepped up to the plate to take over the entire cost until the end of the year.

At the very time her administration is abandoning local children who have no other options for health insurance, Gov. Linda Lingle is on the mainland poisoning audiences with lines like Barack Obama is "not really from Hawaii." She's the very one who seems to have lost her way and her aloha spirit. Even in bad economic times, those who fall through the health care safety net should remain a core priority.

Rep. Kirk Caldwell
Majority Leader - House of Representatives

HMSA honors commitment to Keiki Care

The State administration announced today that effective November 1, 2008, the Department of Human Services will pull out of their agreement to fund 50% of the Keiki Care health plan, a program that provides health insurance for uninsured children. The plan, which was heralded as making Hawaii the second state in the nation to provide health insurance for every child in the state, began in January 2008 as a pilot program. In August, Keiki Care was expanded to include children whose parents were laid off due to the closures of Aloha Airlines, Molokai Ranch, ATA and other businesses.

The state and the Hawaii Medical Service Association split the cost of the premiums 50-50. HMSA reports that 2000 children are enrolled in the plan. However, the state claims that the program has had only limited success.

HMSA responded today by announcing that they will continue to honor their commitment to Keiki Care through the end of the year. From the HMSA press release:

“We’re disappointed in the state’s decision, but we feel we have an obligation to the children and their families,” said HMSA Senior Vice President Cliff Cisco. “Parents with children currently enrolled in the HMSA Keiki Care Plan can rest assured that we will continue the plan without changes at least through the end of the year.”

HMSA will be meeting with its community board of directors next week to discuss the issue and seek recommendations on the future of the plan. “If there are going to be changes to the plan for 2009, we will share that information with parents and the public as soon as we can,” said Cisco.

Early Childhood Learning and Children Issues Discussed at Summit

At today's Children and Youth Summit, leaders from early learning, children and family organizations recommended a list of priorities to the Keiki Caucus that they would like addressed in the 2009 Legislative Session. Below is a list of their concerns. Give us your input and add any concerns you have in our comments section.

-Shortage of early child care providers.
-Cost of early child care (>$10,000/year).
-Lack of quality child care providers.
-Encourage legislators to prioritize, protect and provide programs and services that meet the needs of the "whole child", ie. social and emotional (equal to academic programs) so they can learn.
-Sustaining current early prevention programs.
-Support innovative financing.
-Fund Keiki First Steps.
-Update labor laws to support families with child care issues.
-More awareness campaigns to educate parents on the importance of early childhood development and available programs.

Families who lost health coverage due to business closures may be eligible for Keiki Care program

Starting August 1, 2008, the Hawaii Medical Service Association (HMSA) will begin enrolling children from families affected by Hawaii business closures, and who have no other health insurance coverage, under the existing Keiki Care Plan. The coverage will be effective through the end of this year.

In response to several high profile business closures around the state, such as Aloha Airlines, ATA, and Molokai Ranch, the state legislature passed legislation this year, SB69 (which became law as Act 239 without the Governor's signature.) The bill temporarily expands eligibility for the children's health care program to assist children of workers employed by a Hawaii‑based corporation which filed for bankruptcy and ceased doing business in Hawaii between February 29, 2008 and September 30, 2008 or only ceased doing business in Hawaii during that time period.

The Keiki Care Plan was originally created by the legislature in 2007, and it provides basic health coverage for children between the ages of 31 days to 18 years who come from families at around 300% of the federal poverty level but do not qualify for other state or federal health programs – essentially a gap group. The premiums are paid by and split between HMSA and the State of Hawaii.

Parents and guardians should contact HMSA for information on enrollment. On Oahu, the number to call is 948-5555. Neighbor island residents may call toll-free by dialing 800-620-4672.

Mass Layoffs

As expected, the news from the Department of Labor today was not good. They released data on the impact of five mass layoffs in April of 2008, which includes a loss of 1,583 jobs for at least 31 days. Included were the high profile closings of Molokai Ranch and Aloha Airlines. A mass layoff is defined as 50 or more claims for unemployment insurance from one employer during a five week period.

Compared to a year ago, there were only three mass layoffs and a loss of 185 jobs in April 2007.

Good time to remind folks about the legislature's passing of SB69 which temporarily expands the Keiki Care health insurance coverage for the children of any Hawaii based corporation that ceased doing business between February 29 and September 30, 2008. The bill is awaiting the Governor's signature.

House Finance Passes Aloha Airlines Keiki Care Bill

The House Finance Committee passed SB69, proposed HD3 with technical amendments. This bill expands the Keiki Care program to include children of former Aloha Airlines employees, as noted in the post below. The Advertiser story is here. The SB story is here. The bill now goes to the House floor for a final reading.

Expanding Keiki Care for Aloha Airlines

House and Senate members held a press conference today to announce a proposal that would expand the Keiki Care health insurance pilot program for the children of former Aloha Airlines employees. Rep. Maile Shimabukuro (at podium) estimated that around 800 children would participate in the program, at a cost of about $23,000 per month.

The bill is SB69, SD2, HD3 (proposed). It comes up for hearing tomorrow in the Finance committee. The bill would allow the children of former Aloha Airlines employees, from the age of 31-days to 18 years, to receive health insurance coverage at no cost. The cost would be shared by the Department of Human Services and HMSA. The free coverage would be in effect from the date of approval to December 31, 2008, or until the parent gets a new job and is covered under a pre-paid health plan.