ONE IN THREE HAWAI'I RESIDENTS RELY ON MEDICAID FOR THEIR HEALTH INSURANCE COVERAGE.

THAT'S MORE THAN 400,000 PEOPLE WHO RANGE IN AGE FROM KEIKI TO KUPUNA.

THIS YEAR, MEMBERS OF THE UNITED STATES CONGRESS APPROVED CHANGES TO MEDICAID.

BUT HOW WILL THE CHANGES AFFECT HAWAI'I RESIDENTS AND WHAT SHOULD PEOPLE DO TO PREPARE?

TONIGHT'S LIVE BROADCAST AND LIVESTREAM OF INSIGHTS ON PBS HAWAI'I START NOW.

♪ ♪ ALOHA AND WELCOME TO INSIGHTS ON PBS HAWAI'I.

I'M DARYL HUFF.

UPCOMING CHANGES TO MEDICAID HEALTH COVERAGE COULD AFFECT MANY HAWAI'I RESIDENTSBLY, PARTICULARLY THOSE IN LOW-INCOME, RURAL AND NATIVE HAWAIIAN COMMUNITIES.

NEW ELIGIBILITY RULES EFFECTIVE AFTER THE NEXT ELECTION MEAN SOME MAY FACE STRICTER INCOME VERIFICATION, MORE RED TAPE, AND IN SOME CASES, WORK REQUIREMENTS.

WITH OUR HIGH COST OF LIVING, EVEN SMALL ADJUSTMENTS COULD AFFECT ACCESS TO HEALTH CARE, INCLUDING DOCTOR VISITS, PRESCRIPTION DRUGS AND LONG-TERM SERVICES.

TONIGHT, OUR PANEL WILL DISCUSS HOW MEDICAID PARTICIPANTS SHOULD PREPARE FOR THESE CHANGES...AND WHETHER THE STATE WILL MITIGATE THE IMPACT.

WE LOOK FORWARD TO YOUR PARTICIPATION IN TONIGHT'S SHOW.

YOU CAN EMAIL OR CALL IN YOUR QUESTIONS, AND YOU'LL FIND A LIVE STREAM OF THIS PROGRAM AT PBSHAWAII.ORG AND THE PBS HAWAII YOUTUBE PAGE.

NOW, TO OUR GUESTS.

JUDY MOHR PETERSON HAS LED MED-QUEST, HAWAI'I'S MEDICAID PROGRAM, SINCE 2015.

UNDER HER TENURE, HAWAI'I BECAME THE FIRST MEDICAID PROGRAM IN THE COUNTRY TO COVER COMMUNITY-BASED PALLIATIVE CARE AND ACCESS TO LOCALLY GROWN HEALTHY FOODS AND MEDICAL RESPITE SERVICES.

HILTON RAETHEL HAS MORE THAN 30 YEARS OF EXPERIENCE IN THE HEALTHCARE INDUSTRY.

HE'S THE PRESIDENT AND CEO OF THE HEALTHCARE ASSOCIATION OF HAWAII, WHICH IS A NON-PROFIT THAT REPRESENTS 170 HEALTHCARE ORGANIZATIONS INCLUDING HOSPITALS, SKILLED NURSING AND ASSISTED LIVING FACILITIES AND HOSPICES.

EMMANUEL KINTU IS THE CEO OF KALIHI-PALAMA HEALTH CENTER, AN INDEPENDENT, NON-PROFIT COMMUNITY CENTER THAT PROVIDES HEALTH CARE AND SOCIAL SERVICES TO 22,000 HONOLULU RESIDENTS.

THE ORGANIZATION IS CELEBRATING ITS 50TH ANNIVERSARY, AFTER STARTING AS A FREE WALK-IN CLINIC IN THE BASEMENT OF A CHURCH.

AND FRANCOISE CULLEY-TROTMAN IS THE CEO OF ALOHACARE,D HAWAI'I'S SECOND LARGEST MEDICAID NON-PROFIT HEALTH PLAN.

DURING HER TIME, ALOHACARE LAUNCHED PROGRAMS INTEGRATING NATIVE HAWAIIAN HEALING, EXPANDED CARE FOR SENIORS AND ADVOCATED FOR THE RESTORATION OF ADULT DENTAL COVERAGE UNDER MEDICAID.

START WITH P CHRISTIAN PETERS FROM MED-QUEST NUMBER OF PEOPLE COULD BE FEABLGD BY CHANGES TO MEDICAID IS SPECTACULARLY LARGE NUMBER IN HAWAII.

COULD BE AFFECTED.

>> THAT'S TRUE.

THERE'S ABOUT 400,000 TODAY WHO ARE COVERED UNDER THE QUEST OR MEDICAID PROGRAM.

QUEST IS THE NAME OF OUR MEDICAID PROGRAM HERE.

AND OF THOSE, THE CHANGES FROM THE HR1 OR THE BIG BEAUTIFUL BILL, MOSTLY IMPACT LOW INCOME ADULTS WORKING AGE ADULTS, AND THERE'S ABOUT 135,000 IN THAT PARTICULAR GROUP.

THAT PARTICULAR ELIGIBILITY GROUP.

SO THAT'S NEARLY, ABOUT A THIRD OF THE POPULATION THAT WE'RE CURRENTLY SERVING.

WILL BE IMPACTED.

>>Daryl: HILTON RAETHEL, HOW DOES MEDICAID, HOW DOES IT FIT INTO THE FINANCING SYSTEM AND HOW IMPORTANT IS IT TO THE HEALTH CARE FACILITIES IN THIS STATE?

>> WELL, SIMPLY BECAUSE OF THE NUMBER OF MEMBERS IN STATE, REALLY CRITICAL FOR THE ENTIRE HEALTH CARE DELIVERY SYSTEM.

THERE ARE INDIVIDUALS ALL THE WAY FROM BIRTH THROUGH DEATH WHO CAN BE ELIGIBLE FOR MEDICAID.

NOT JUST FOR MOTHERS WITH YOUNG BABIES OR YOUNG CHILDREN FOR EXAMPLE.

SO IT'S A CRITICAL SOURCE OF REVENUE FOR DOCTORS FOUR HOSPITAL, FOR ALL OF OUR HEALTH CARE PROVIDERS.

SO ANYTHING THAT HAPPENS TO MEDICAID, IS REALLY IMPACTFUL.

WAKONE OF THE COMMENTS YOU NEED IN OUR INTRODUCTION THESE CHANGE GOING IMPACT MAICTD RECIPIENTS WHICH IS TRUE.

REALITY THESE TIME OF CHANGES IMPACT ENTIRE DELIVERY SYSTEM WE'RE VERY FORTUNATE IN HAWAII.

WE HAVE PREPAID HEALTH CARE.

WE HAVE UNION COVERAGE.

WE HAVE EXPAND MEDICAID.

WE HAVE VERY GOOD COVERAGE IN THIS THE STATE.

WHICH MEANS WE HAVE VERY LOW UNINSURED RATE.

RIGHT NOW, A LITTLE UNDER 3%.

WHICH IS ONE LOWEST IN THE NATION.

BUT ACCORDING TO SOLVE OF THE CALCULATIONS WE HAVE, SOME., DON'T KNOW EXACTLY WHAT WILL HAPPEN IN 2028, IT'S POSSIBLE THAT THE UNENSURED RATE IN THE STATE COULD DOUBLE.

IF THAT HAPPENS, THERE'S A LOT MORE PEOPLE WHO DON'T HAVE COVERAGE, NOT GOING TO SEEK CARE DOCTOR'S HOSPITALS COMMUNITY HEALTH CENTERS OR HOSPITALS AND THAT COST IS THEN TRANSFERRED TO THE COMMUNITY.

SO IMPACT NOT NEW TO MEDICAID RECIPIENTS BUT OTHER PEOPLE IN THE COMMUNITY AS WELL.

>>Daryl: EMMANUEL KINTU, AS A CEO OF SPECIFIC FACILITIES, THAT SPECIFICALLY IS MISTAKE CARE OF PEOPLE WITH LOWER INCOMES WHAT WOULD BE, HOW MANY OF YOUR PATIENTS OR YOUR CUSTOMERS ARE ON MEDICAID IN SOME FORM?

>> ABOUT 66%.

OF OUR PATIENT POPULATION IS ON MEDICAID.

AND FOR US, THAT IS THE BEST AND CRITICAL SOURCE OF REVENUE.

MEDICAID FOR US IS BEST PAYOR.

BECAUSE OF THIS SO-CALLED PPS RATE.

LIKE A PREPAID SYSTEM.

WE WOULD GET BACK EVERYTHING THAT WE SPEND IF WE DO OUR WORK PROPERLY.

AND JUDY HERE DECIDES TO CUT THE CHECKS.

SO LOSING THAT IS GOING TO HAVE IMPACTS ON SEVERAL LEVELS.

YES, THERE ARE PATIENTS.

GOING TO SUFFER.

BECAUSE OF THIS.

AND THEIR FAMILIES OF THOSE PATIENTS, AND LIKE HILTON SAID, THEY'RE THE OTHER ENTITIES, HOSPITALS ARE GOING TO SUFFER IF THE NUMBER OF UNINSURED GOES UP.

MANY OF FOLKS WILL SEEK CARE IN THE EMERGENCY ROOM DEPARTMENT.

WE'VE SEEN THIS BEFORE.

AND IT COULD HAPPEN AGAIN.

IF THAT HAPPENS, OR WHEN THAT HAPPENS, HOSPITALS WILL SUFFER.

THE OTHER THING IS ON THE REVENUE SIDE, YOU'RE TALKING ABOUT EMPLOYMENT AND ALSO TALKING ABOUT THE SERVICES THAT WE PROVIDE TO OUR COMMUNITIES TODAY TO HELP THEM TO ENROLL.

REMEMBER NOW, WE ARE GOING TO BE GOING THROUGH DIFFICULT TIMES TRYING TO ENROLL THE PEOPLE.

>>Daryl: SO LET ME MOVE ON TO FRANCOISE CULLEY-TROTMAN.

WITH ALOHA CARE, DO YOU FOLKSEN FOY ENTIRELY SERVE MEDICARE AND SOME MEDICAID FOLKS.

IS THIS PROCESS HOW DOES IT EFFECT YOU?

I DON'T PEOPLE UNDERSTAND MOST OF PEOPLE WHO HAVE MEDICAID ARE GOING THROUGH INSURANCE COMPANY FOR SERVICE.

CAN YOU EXPLAIN HOW THAT FITS AND WHY MAY COME SO CONCERNING TO YOU?

>> YEAH.

SO HILTON MENTIONED THAT THE CHANGES ARE COMING REALLY AFFECT WHOLE ECO SYSTEM.

SO ALOHA CARE IS ONE OF FIVE MANAGED CARE CAN HEALTH PLANS THAT HAVE A CONTRACT WITH MED-QUEST.

SO JUDY, WE WORK CLOSE LIHUE WITH JUDY CLOSE LIHUE WITH JUDY WE CLOSELY WITH JUDY.

ACTED AS THE INSURER FOR PEOPLE WITH MEDICAID IN SOME CASES THOSE QUALIFY FOR MEDICARE BECAUSE OF INCOME REQUIREMENT.

FOR US, MEDICAID IS NOT JUST HEALTH INSURANCE COVERAGE.

AS YOU SAID MANY FOLKS MAY NOT REALIZE THAT THE PEOPLE QUALIFIEDER FOR MEDICAID, ALSO HAVE ACCESS TO OTHER BENEFITS MANY CASES QUALIFY FOR SNAP.

MEDICAID PROGRAMS ITSELF, MYSELF AND OTHER PLANS OFFER, IT OFFERS WRAPAROUND SERVICE.

SO TRAFFIC TRANSPORTATION THEIR PRESCRIPTION BENEFITS ACCESS TO LANGUAGE TRANSLATOR.

AND SO FOR MANY OF THE FAMILIES IN HAWAII, MEDICAID IS WHAT IS HELPING WITH THEIR FINANCIAL STABILITY.

AND THEN HEALTH AND WELLNESS HELPS OUR COMMUNITY TO STRIVE.

I'M SURE YOU HEARD, JUDY MENTIONED THAT'S A THIRD OF THE PEOPLE AND FAMILIES THAT LIVE IN HAWAII.

>>Daryl: I WANT TO CLARIFY.

WITH JUDY FROM MED-QUEST.

WHAT YOU MENTIONED THIS POPULATION MIGHT BE AFFECTED BY WHAT'S PROPOSED IS THE CHILDREN AND WORKING PEOPLE UP TO 65.

PRIMARILY.

WHAT KINDS OF THINGS ARE BEING PROPOSED THAT WOULD CUT IN THEIR BENEFITS?

BECAUSE FROM WHAT I UNDERSTAND, CONGRESS DIDN'T SAY WE'RE CUTTING A TRILLION DOLLARS.

THEY'RE DOING IT BY A MILLION CUTS SORT OF.

MILLION DIFFERENT CHANGES.

>> YEAH.

THANKS FOR THAT QUESTION.

THAT IS, THAT IS WHAT IS HAPPENING IN THAT'S NOT A STRAIGHT, WE'RE JUST GOING TO CUT HOW MUCH WE'RE GOING TO PAY YOU OR WE'RE JUST GOING TO SAY, THIS GROUP OF PEOPLE NO LONGER COVERED.

THEY ADDED REQUIREMENTS.

THE POPULATION THAT IS MOST IMPACTED ARE WORKING AGE ADULTS.

WHO MAY OR MAY NOT HAVE DEMENT CHILDREN BUT MOST, THEY'RE MOST IMPACT IF THEY HAVE OLDER CHILDREN AND.

>>Daryl: LET ME GET THIS.

>> 1964.

>>Daryl: SO YEAH, WE'RE NOT RIGHT NOW, THERE'S NOTHING AFFECTING CHILDREN DIRECTLY.

>> THERE'S NOTHING AFFECTING CHILDREN DIRECT LAND NOTHING AFFECTING SENIORS, DIRECTLY.

AND NOTHING AFFECTING SENIORS DIRECT LI LINDSTROM AND PREGNANT WOMAN.

A LOT OF CHANGE AREN'T GOING IN RIGHT NOW.

DON'T GO INTO EFFECT UNTIL JANUARY 1 OF 2027.

SO THAT ALSO MEANS THAT FOR THOSE, PEOPLE WHO ARE LISTENING TO THIS STORY, ET CETERA, AND THEY KNOW PEOPLE, THEY HAVE FAMILY MEMBERS OR THEY'RE ON MEDICAID, HAVE QUEST COVERAGE, THEY SHOULD CONTINUE TO GO SEE THEIR DOCTORS AND THEY SHOULD GO CONTINUE TO SEEK CARE BECAUSE THOSE CHANGES AREN'T HAPPENING RIGHT NOW.

>>Daryl: ARE YOU HEARING FROM PEOPLE WHO THINK THEY SEE THE NEWS AND THEY GO, OH, MY, I'M GOING TO LOSE MY COVERAGE?

>> YES.

AND YOU ALREADY STARTED HEARING PEOPLE SAY WHY ARE THEY PICKING ON US?

AND IT IS CLEAR THAT MANY OF THE POOR PEOPLE ARE NOT GOING TO HAVE YOUR STEADY JOB, WHERE INFORMATION CAN ELECTRONICALLY BE SHARED.

SO IT IS HIGHLY LIKELY THAT THOSE ARE GOING TO BE THE PEOPLE WOULD GET DISENROLLED FIRST.

BUT JUST BECAUSE OF THE CHATTER THAT IS OUT THERE, ALREADY STARTED SAYING WELL, YOU KNOW, WHY SHOULD I COME WHEN I'M NOT GOING TO BE ABLE TO FOLLOW UP?

SO THE COMMUNITY HEALTH WORKERS AND ELIGIBILITY WORKERS ARE DOING DOUBLE DUTY RIGHT NOW TRYING A, TO GET PEOPLE ROLAND, AND TRYING TO CONVINCE PEOPLE TO CONTINUE SEEKING CARE AT THEIR PROVIDERS.

>>Daryl: ARE YOU ALSO -- LET ME ASK, ARE YOU HEARING THAT A ALOHA CARE TOO?

PEOPLE ARE PANICKING.

>> WE DO GET CALLS.

AND AGAIN, ONE OF THE THINGS WE'VE DONE VERY WELL IS TO BE ALIGNED ON THE MESSAGING, THAT YOU SHOULD SEEK COVERAGE.

DO NOT DELAY YOUR CARE.

GO SEE YOUR Y YOUR DOCS WORK HAR TO CONNECT PEOPLE TO THEIR PHYSICIANS BECAUSE OF THAT.

SEE YOUR DOCTORS.

>> I'M NOT SURE ACTUALLY SAID WHAT WHAT THE CHANGES ACTUALLY ARE.

>>Daryl: I'M SORRY,.

>> FOR THE WORKING AGE ADULTS, THERE'S TWO MAJOR CHANGES THAT ARE HAPPENING.

ONE IS TO INCREASE HOW OFTEN THEY HAVE TO BE RENEWED.

THEY HAVE TO GO THROUGH TO MAKE SURE THAT THEY REMAIN COVERED.

SO TODAY, IT'S 12 MONTHS.

WHICH IS PRETTY TYPICAL FOR HEALTH INSURANCE.

WE HAVE COVERAGE FOR ABOUT A YEAR.

AND THAT'S GOING TO BE HALVED.

WE HAVE TO RENEW THOSE INDIVIDUALS.

IN THIS PARTICULAR GROUP, THESE WORKING AGE ADULTS.

135,000 INDIVIDUALS.

EVERY SIX MONTHS.

>>Daryl: WOW.

>> WE HAVE TO DO IT.

THEN THE LAW ALSO INCREASED REQUIREMENTS THAT PEOPLE HAVE TO, THIS PARTICULAR GROUP, THIS POPULATION HAS TO HAVE IN ORDER TO KEEP THEIR COVERAGE.

IT'S CALLED WORK OR COMMUNITY ENGAGEMENT REQUIREMENTS.

SO EITHER HAVE TO WORK 80 HOURS, BE IN A TRAINING OR EDUCATIONAL PROGRAM,.

>>Daryl: 80 HOURS A MONTHS.

>> A MONTH.

SORRY.

YES, A MONTH AND THEY HAVE TO MEET THOSE IN ORDER TO EVEN BE, LIKE FOR EXAMPLE, FILLING OUT APPLICATION.

I LOST MY INSURANCE.

NEED TO GET COVERAGE.

ET CETERA.

THEY HAVE TO DEMONSTRATE THAT BEFORE WE CAN ENROLL THEM.

THEY HAVE TO MEET THOSE REQUIREMENTS.

SO IT'S A BIG CHANGE THAT WE HAVE TO PUT IN PLACE.

AGAIN, IT'S NOT UNTIL JANUARY 1 OF 2027.

>> THIS IS GOING TO BE TABLE A A LOT OF WORK.

135,000 INDIVIDUALS AND HAVING TO REENROLL THEM TWICE A YEAR AS OPPOSED TO WUDG ONCE A YEAR.

GREDOUBLES WORKLOAD FOR THAT.

WITHOUT ALL THE VERIFICATION WHAT MEETS REQUIREMENTERS WHAT DOESN'T MEET REQUIREMENTS DID MEET REQUIREMENT FOR THREE MONTHS OF THE OF FER OUT OF SIX MONTHS?

ALL OF THAT DOCUMENTATION PUT YOUS A HUGE BURDEN ON GUYED JUDY AND HER STAFF.

STATE DEPARTMENTS STRUGGLE TO FIND ANOTHER WORKERS ARE THIS IS GOING TO ADD MATERIALLY TO THAT WORK LOAD.

SO JUDE IS GOING TO HAVE TO MED-QUEST AGENCIES HAVE GOT STATE LEGISLATURE, TO ASK FOR MORE MONEY TO ACTUALLY HIRE WORKER TO DO ALL THE WORK TO MEET THESE FEDERAL REQUIREMENTS.

>>Daryl: YOU KNOW, WHAT IS THE ROLE OF THE HEALTH PLAN IN THAT?

IF YOU'RE SEEING, REENROLL EVERY SIX MONTHS, PEOPLE WILL FALL ON AND OFF.

MIGHT HAVE GOTTEN A LOT MORE MONEY IN THE CHRISTMAS SEASON THAN THEY DO IN JANUARY, THROUGH JUNE.

ALSO INCOME SPIKES AND THEY'RE OUT OF MEDICAID?

>> WE GET TO -- EVEN THAT OUT.

WE TRY TO EVEN THAT OUT.

BUT WE HAVE A LOT OF PRACTICES, JUDY AND I HAVE HAD A LOT OF PRACTICE WITH CRISES, WHETHER IT'S MAUI FIRE, OR REDETERMINATION.

AS YOU KNOW, PMPLET HE ENDED, PHE ENDED.

>>Daryl: PHE.

>> PUBLIC HEALTH EMERGENCY.

WENT BACK TO JOB AND HAD COMMERCIAL COVERAGE OTHER SITUATIONS.

YOU KNOW, WERE OFF THE MEDICAID PLAN.

SO THERE IS THIS INTENLS INTENSE EFFORT TO REALLY COMMUNICATE WITH ALL THE MEDICAID RECIPIENTS TO ORGANIZE COMMUNICATION, TO MAKE SURE WE REACHING THEM IN THEIR COMMUNITIES, A AND I ENVISION THE EFFORT WILL BE VERY SIMILAR TO TALK TO PEOPLE, AS MUCH AS POSSIBLE, CLEAR MESSAGING I MENTIONED ALIGNED COMMUNICATION.

ONE OF THE THINGS I DID REALLY WELL WAS REALLY COORDINATING WITH EACH OTHER THE CORE MESSAGES COME FROM MED-QUEST AND HEALTH PLANS TO ALIGN AND MAKE SURE WEE COMMUNICATING CONSISTENTLY IN PEOPLE'S LANGUAGE.

IT IS A HUGE EFFORT.

WE HAVE TO COMMUNICATE WHATEVER BEST WAY REACHES THE PERSON IN THE COMMUNITY.

MAY BE TEXT, MAIL, MAY BE MULTIPLE METHODS REPEATING SAME MESSAGE.

BUT IT IS INTENSE EFFORT.

AS I SAID WE DO HAVE SOME PRACTICE AND SO WE'LL HAVE TO PULL ON THOSING STRENGTHS TO ENSURE THAT NO ONE GETS LOST IN THE SHUFFLE.

>>Daryl: EITHER OF YOU COULD ANSWER THIS QUESTION.

HOW MANY PEOPLE IN THAT COHORT OF PEOPLE THAT YOU'RE DESCRIBING, ARE ALREADY WORKING?

>> WE FROM STUDIES THAT HAVE BEEN DONE, ABOUT 60% OF THAT POPULATION ARE CURRENTLY EMPLOYED OR EITHER FULL-TIME OR PART-TIME.

SO THE CHALLENGE ISN'T NECESSARILY THAT THEY'RE NOT ENGAGED IN WORK.

ET CETERA.

IT'S MATTER OF HOW DO WE GET THAT DOCUMENTATION.

HOW WE VERIFY.

WE'LL TRY TO VERIFY WITH THE DUETTHEDATA SOURCES WE HAVE AVAE TO US BUT THAT'S NOT ALWAYS GOING TO BE POSSIBLE.

A LOT OF PEOPLE THEY MIGHT BE WORKING OR MIGHT BE WORKING SELF-EMPLOYED, OR PERHAPS HOUSELESS, AND KIND OF JOB THAT THEY'RE WORKING ARE MORE CASH BASED.

SO IT WILL BE, CHALLENGE IS GETTING THE INFORMATION FROM THE POPULATION.

>>Daryl: EMMANUEL KINTU OF THE PEOPLE YOU WORK WITH, CUSTOMERS IN YOUR HEALTH CARE, WE ARE THE IMPEDIMENTS TO THEM MEETING THESE REQUIREMENTS?

WORK, SCHOOL AND SO ON, MANY ARE IMMIGRANTS.

SECOND LANGUAGE.

ENGLISH SPEAKERS?

>> CORRECT.

PERHAPS WE'LL START WITH NOT SO OBJEC OBVIOUS.

START WITH THE STIGMA CHANGES ENVIRONMENT WITHIN WHICH THEY OPERATE.

THE PERSON WHO WOULD HAVE BEEN HIRED AS DAY LABORER, MAY NOT BE HIRED AS A DAY LABORER BECAUSE OF ALL THE CHATTER THAT IS GOING AROUND.

>>Daryl: ABOUT IMMIGRATION.

>> CORRECT ABOUT IMMIGRATION AND HOW THIS ACT ITSELF.

HR1 IS BEING LOOKED AT.

WHY ARE WE EMPHASIZING THE WORK REQUIREMENT AND PEOPLE ARE TALKING ABOUT THAT?

WHY ARE WE EMPHASIZING WORK REQUIREMENT.

>>Daryl: POLITICAL, RIGHT?

THAT'S WHAT YOU'RE SAYING.

STIGMA.

BIG STIGMA STIGMATIZED YOU'RE T WORKING?

>> YES.

THE OTHER THING IS LANGUAGE.

PEOPLE ENGLISH IS SECOND LANGUAGE TO ABOUT 60% OF THE FOLKS WE SERVE.

IS THEN ALSO THE SENSE OF PRIDE.

SOME OF THE CULTURES THAT WE SERVE.

AND THEY RATHER NOT BE BURDEN ON ANYBODY.

NOW, IF YOU HAVE TO REENROLL AND REAPPLY AND YOU HAVE TO HAVE BRING IN THE PROOF THREE, FOUR, FIVE TIMES, BECAUSE THEY'RE NOT GOING TO BRING EVERYTHING THE FIRST TIME THEY COME IN.

AND HAVE THEM TO GO WELL, BRING THIS COPY TO ME.

BRING THIS OTHER DOCUMENT FOR ME.

SO THAT I CAN APPLY P FOR YOU.

ASSIJUDY TALK ABOUT THE VERIFICATION.

HOW DO YOU VERIFY THAT SOME OF THESE FOLKS ARE REALLY WORKING?

THERE ARE NO SOURCES OF BEING ABLE TO VERIFY.

SO ONE OF THE THINGS THAT WE ARE DOING IS ENGAGING THE COMMUNITY.

WE HAVE GONE BACK TO SOME OF THE METHODS THAT WE USED DURING THE PANDEMIC.

BRINGING SOME OF THE COMMUNITY LEADERS TOGETHER AND TRYING TO ENGAGE THEM THIS EARLY TO MAKE SURE THAT THEY KNOW THAT THEY'RE ELIGIBLE, THEY KNOW THAT THEY'RE CONTINUE SEEING THEIR DOCTORS, THEY KNOW THAT THEY CAN CONTINUE SEEKING TREATMENT BECAUSE FEAR IS ONE OF THOSE OTHER THINGS.

WHEN THEY HEAR THESE MESSAGES BEING BOMB B BOMBARDED AROUND IS TELLING ME YOU DON'T NEED ME HERE.

>>Daryl: YOU MENTIONED SEEMS SO FAR OUT.

BUT IT'S WE'RE GOING INTO OCTOBER.

15 MONTHS.

>> VERY SHORT PERIOD OF TIME.

AGAIN, PLEASE HAVE PEOPLE GO TO THE DOCTOR RIGHT NOW.

>>Daryl: LET ME ASK YOU.

SO FOR WHAT I'M HEARING HERE, REAL ISSUE IS NOT SO MUCH THEY'RE GOING TO PAY PEOPLE LESS OR PAY LESS FOR THEIR CARE.

BUT TWHOANTD EVEN BE ON THE SYSTEM.

WON'T BE ON THE SEASON.

SEEMS LIKE REAL FEAR PEOPLE WILL FALL OFLT SYSTEM ENTIRELY AND BECOME UNINSURED.

>> ABSOLUTELY CORRECT.

THAT'S A REAL PROBLEM FOR A NUMBER OF DIFFERENT REASONS.

ONE OF THEM IS NO PAYMENT FOR THOSE INDIVIDUALS.

SO FOR ANY PROVIDERS WHETHER FQHC, HOSPITAL, HOSPITAL, CLINIC, LONGTERM CARE FACILITY THAT MEANS THAT INDIVIDUAL NO LONGER HAS COVER RAM.

COVERAGE.

REAL ISSUE.

REAL ISSUE IN TERMS OF DELAYED OF CARE.

DELAY OF CARE.

WE SAW IT'S REPERCUSSIONS OF THAT DURING THE PANDEMIC.

DURING THE PANDEMIC, THERE WERE A LOT OF PEOPLE WHO PUT OFF GETTING SCREENING, GOING TO SEE THEIR DOCTOR, JUST VISITING FOR A VARIETY OF REASONS.

AND ONE OF THEM DIDN'T WANT TO BE AROUND A BUNCH OF SICK PEOPLE.

DURING THE PANDEMIC.

SO WHAT WE SAW THROUGHOUT THE PANDEMIC, WE TRACK OUR HOSPITAL SENSORS EVERY SINGLE DAY.

WHAT WHAT I SAW THERE WAS THE REPERCUSSIONS OF THIS DELAY OF CARE THAT WENT ON FOR ABOUT 12 TO 18 MONTHS AFTER THE END OF THE PANDEMIC.

OR THE PUBLIC HEALTH EMERGENCY.

WHERE WE HAD PEOPLE WHO HAD DELAYED CARE, DID NOT GET SCREENING, MAMMOGRAPHIES COLONOSCOPIES OTHER TYPE OF SCREENING BECAME SICKER WHEN THEY SHOWED UP AT THE HOSPITAL THAT'S A REAL ISSUE WE'RE CONCERNED ABOUT.

PEOPLE IF THEY DON'T HAVE COVERAGE, WON'T RESEARCHER TIMEOUT A DOCTOR.

WON'T GO REACH OUT TO DOCK.

WON'T GO TO EMERGENCY ROOM UNTIL SOMETHING GETS REALLY BAD OR GETS REALLY SICK OR DISEASE HAS PROGRESSED IT'S POTENTIALLY, MUCH HARDER TORE TREAT OR NOT EVEN POSSIBLE TO TREAT.

>>Daryl: DID GET A QUESTION FROM COUPLE QUESTIONS FROM THE AUDIENCE.

SUZANNE VIA EMAIL, PARENT OF ADULT WHO RECEIVES LONGTERM CARE SERVICES UNDER DD ADMINISTRATION.

DISABLED.

>> DEVELOPMENTAL DISABILITY DIVISION.

>>Daryl: THROUGH THE HEALTH DEPARTMENT.

RECEIVES HER FATHER'S SOCIAL RETIREMENT BENEFITS THAT PLACE HER ON THE HIGHER END OF ELIGIBILITY.

WILL THESE CHANGES IMPACT HER LONGTERM BENEFITS?

>> EXCELLENT QUESTION.

THANK YOU SUZANNE.

IT SHOULD NOT.

HAVE DIRECT IMPACT.

THERE'S A POSSIBILITY INDIRECT IMPACTS BUT THESE CHANGES THAT WE'RE TALKING ABOUT RIGHT NOW, SHOULD NOT IMPACT PEOPLE WITH DISABILITIES, WHETHER YOUNG OR OLD, ET CETERA.

SO PROGRAM SHOULD REMAIN INTACT FOR THEM.

>>Daryl: I DON'T QUITE UNDERSTAND THIS QUESTION.

I KNOW SOMETHING ABOUT MEDICAID.

WILL HAWAII BE IMPLEMENTING MEDICAID BUY-IN PROGRAM?

SUPPORT SOMEONE WITH HIGH MEDICAL NEEDS WOULD WORKS.

MAY EVENTUALLY LOSE MEDICAID COVERAGE DUE TO INCOME, CANNOT AFFORD THEIR CARE WITHOUT IT.

EXPLAIN THAT TO.

SOMETHING THEY SHOULD WORRY?

>> WE ACTUALLY CURRENTLY DO OPERATE VERSION OF MEDICAID BUY-IN PROGRAM.

WHAT THE INDIVIDUAL, THE BUY-IN PROGRAM I'M FAMILIAR WITH IS FOR PEOPLE WITH DISABILITIES WHERE THEY, THEY MAY EVEN HAVE COMMERCIAL INSURANCE, ET CETERA.

THEY'RE EMPLOYED.

BUT THEY EARN TOO MUCH.

TO STAY ON THE MEDICAID PROGRAM.

AND SO THERE'S A, THERE IS A SOMETHING CALLED MEDICAID BUY-IN PROGRAM IN WHICH YOU CAN CONTINUE TO EARN UP TO CERTAIN AMOUNT.

AND THEN MEDICAID WILL STILL, YOU CAN STILL HAVE MEDICAID COVERAGE, AND UNDER THOSE CIRCUMSTANCES, THE KIND OF CARE THAT MEDICAID PROVIDES THAT THE INDIVIDUAL IS LOOKING FOR.

>>Daryl: HIGH NEEDS.

>> IS THE PERSONAL CARE, PERSONAL ATTENDANCE, THAT ALLOW THEM TO LIVE.

>>Daryl: DO PEOPLE HAVE EXPLAIN THIS TO LOTS OF PEOPLE ALL THE TIME?

>> I DO.

>>Daryl: ALSO, YOUR FOLKS HAVE TO DO IT TOO EXPLAIN EXAMPLE ELIGIBILITY TO PEOPLE.

EXPLAIN ELIGIBILITY TO PEOPLE.

YOU DON'T ACTUALLY SCREEN THEM?

>> NO MED-QUEST EIGHT AGENCY DETERMINES ELIGIBILITY.

WE TRAIN OUR EMPLOYEES TO ANSWER BASIC QUESTIONS AND HCONNECT THOSE PEOPLE IN THE MED-QUEST THE AGENCY.

>>Daryl: KIND OF POLITICAL QUESTION CAME IN.

WHICH IS POLITICAL QUESTION.

I GUESS.

REPUBLICANS LOSE NEXT PRESIDENTIAL ELECTION IN 3 YEARS, WILL THAT SIGNIFICANTLY CHANGE WHAT'S HAPPENED TO MEDICARE?

ANY OF YOU GUYS CAN WEIGH IN ON THIS.

MIKE FROM MAKIKI ASKED A QUESTION.

ACTUALLY WE'RE TALKING ABOUT FOR SOME REASON, THEY START AFTER CONGRESSIONAL ELECTIONS.

WHAT DO YOU THINK GOING ON THERE?

>> VERY HARD TO PREDICT THE FUTURE OBVIOUSLY.

BUT IS IT POSSIBLE THAT SOME OF THESE CHANGES COULD BE DEFERRED OR OVERTURNED.

THAT IS POSSIBLE.

WE'RE VERY FORTUNATE TO BE ABLE TO WORK WITH SOMEONE LIKE JUDY AND HER TEAM ADD MED-QUEST.

REALLY GREAT TEAM TO WORK WITH.

AND VERY, VERY SUPPORTIVE OF WORKING WITH OUR PROVIDER COMMUNITY.

SO WE SOME OF THOSE DISCUSSIONS WE'RE HAVE, TALKING TO OUR CONGRESSIONAL DELEGATION, VERY CONCERNED ABOUT THIS, SO IF THERE'S ANY WAY THAT SOME OF THESE CHANGES CAN BE DEFERRED, THAT WOULD BE VERY GOOD.

BECAUSE OF ALL THE IMPACTS THAT WE'RE TALKING ABOUT ON THIS PROGRAM.

SO THERE'S THE THERE IS IT A POSSIBILITY POTENTIALLY TO DEFERRER SOME OF THESE CHANGES.

WE DON'T KNOW IF THAT'S GOING TO OCCUR OR NOT.

THEN WHEN IT COMES TO THE PRESIDENTIAL ELECTION, IF THERE IS TO BE A CHANGE FROM REPUBLICAN TO DEMOCRAT, IT IS POSSIBLE THAT A LOT OF THESE CHANGES WOULD BE UNDONE.

>>Daryl: OCCURS TO ME THAT NEXT ELECTION IS GOING TO BE NOVEMBER.

THEY DON'T TAKE OFFICE UNTIL JANUARY.

THESE THINGS HAPPEN IN JANUARY.

>> THAT JANUARY.

>>Daryl: NEW CONGRESS WOULD BE COMING IN.

SO IT'S GOING TO HAPPEN.

>> THESE CHANGES ARE GOING TO HAPPEN.

>> IT WOULD REQUIRE CHANGE.

EVEN IF THE HOUSE FLIPS END OF NEXT YEAR, STILL GOT A REPUBLICAN PRESIDENT AND A REPUBLICAN SENATE.

>>Daryl: YOU NEED A SUPER-MAJORITY.

>> YOU NEED A SUPER-MAJORITY.

BECAUSE THE REPUBLICANS SINCE THEY HAVE SUPPORTED THESE CHANGES, THEY WOULD NOT BE WILLING TO GO ALONG, LIKE THE REPUBLICAN SENATE, AND PRESIDENT WOULD NOT BE WILLING TO ALONG WITH THE DEMOCRAT HOUSE IS LOOKING FOR.

THE POTENTIAL ANY POTENTIAL FOR SUBSTANTIVE CHANGE OR OVERTURNING THESE WOULD REQUIRE, MEANS WE HAVE TO WAIT TO A CHANGE IN THE PARTY THAT ALTHOUGH, OR THE AFFILIATION THAT THE PRESIDENT HAS, WHICH IS LONG WAY FROM NOW,.

>>Daryl: PARTICULARLY DIRECTED THIS QUESTION TO YOU BECAUSE THESE FOLKS RUN NONPROFITS AND NOT ALLOWED TO TALK ABOUT POLITICS.

RIGHT?

>> THANK YOU DARYL.

WALK A FINE LINE.

>>Daryl: SO JUDY PETERSON, HOW DO YOU PREPARE?

IF WE START WITH A PREMISE THIS IS GOING TO HAPPEN, IT'S HARD TO HIRE PEOPLE TO GET INTO STATE GOVERNMENT IN THE FIRST PLACE.

ARE YOU DO YOU HAVE ENOUGH PEOPLE NOW FOR THE WORKLOAD YOU HAVE?

>> AND WOULD YOU, HOW WOULD YOU RAMP UP FOR THIS DOUBLING OF ELIGIBILITY FOR EXAMPLE,?

DOUBLE THE WORKLOAD.

>> RIGHT.

IT IS, I AM NOT GOING TO SUGARCOAT THIS.

IT IS VERY, VERY CHALLENGING TIME.

AND VERY, VERY DIFFICULT.

WE'RE WE ARE DOING EVERYTHING WE CAN DO.

WE UNFORTUNATELY HAVE A PRETTY HIGH VACANCY RATE.

WE'VE BEEN ACTIVELY HIRING, ET CETERA.

WE'RE ANALYZING RIGHT NOW HOW MUCH, HOW MANY MORE PEOPLE DO WE THINK WE WOULD NEED AND WOULD IT BE DO WE NEED NEW PEOPLE OR NEED PEOPLE TO FILL THE VACANCIES THAT WE HAVE CURRENTLY?

ACTUALLY ALSO A LOT OF INFORMATION SYSTEM CHANGES THAT HAVE TO HAPPEN.

AND A LOT OF BUSINESS THAT PROCESSES, WORK FLOWS, TO DO THIS WORK.

WE HAVE TO CHANGE OUR, THERE'S LIKE RULES THAT ARE, THAT SAY, OKAY, IN THE INFORMATION.

>>Daryl: YOU MEAN LIKE THE STATE SYSTEM OF RULE MAKING?

>> NO.

NOT THOSE RULES.

INFORMATION SYSTEM.

ALL THOSE RULES.

WE HAVE TO DO THAT TOO.

BUT WE HAVE TO CHANGE, PUT IN NEW INFORMATION SYSTEMS.

WE HAVE TO CONNECT WITH NEW DATA.

DATA SYSTEMS TO BE ABLE TO VERIFY AND GET THE INFORMATION ON INCOME AND WORK.

AND ACTUALLY ALSO LOOKING AT TRYING TO HAVE NEW CONNECTIONS WITH VOLUNTEERING AS WELL.

SO IT'S IT WILL BE A LOT AND AT THIS POINT, WE'RE HAVING TO THINK ABOUT PHASING THE WORK SO WHAT IS IT THAT MINIMALLY WE HAVE TO GET IN PLACE SO WE'RE COMPLIANT WITH THE LAW AS OF JANUARY 1, AND THEN HOW QUICKLY CAN WE GET THESE OTHER THINGS INTO PLACE.

SO THAT WE CAN MINIMIZE THE DAMAGING IMPACTS THAT WE'RE THINKING THAT THESE RULES WILL HAVE.

>>Daryl: CIRCLE BACK SOME OF THE COST BENEFITS BALANCING.

I GOT A GOOD QUESTION FROM KALEI.

NOW THAT WE HAVE PRETTY MUCH ESTABLISHED THIS IS GOING TO HAPPEN, I THINK MIGHT HAVE BEEN SOME WISHFUL THINKING OUT THERE.

THAT IT WANE GOING TO HAPPEN BECAUSE WASN'T GOING TO HAPPEN AFTER THE ELECTION.

MAYBE THE POLITICS WILL CHANGE.

SO THE QUESTION FROM KALEI IS WORKING AGE ADULTS ON MEDICAID, WHAT SHOULD THEY DO TO PREPARE FOR JANUARY 2027?

YOU MENTIONED YOU'RE ALREADY TRYING TO EDUCATE PEOPLE.

BUT FROM A INDIVIDUAL PERSON, WORKING AGE ADULT, MAKING PROBABLY, WHAT IS IT?

30, $40,000?

WHAT IS THE ELIGIBILITY MEDICAID NOW.

>> I DIDN'T BRING THAT WITH ME.

I DON'T KNOW.

>> I THINK 49,000 FOR INDIVIDUAL PERSON.

FOR A FAMILY COULD BE 80, 85?

>> YEAH.

>>Daryl: I REMEMBER WORKING, NOT GOING TO SAY THAT OUT LOUD.

SO WHAT SHOULD THESE FOLKS DO?

ALL WORKING?

SHOULD THEY BE TALKING TO EMPLOYER ABOUT MAKING SURE THEY HAVE THE DOCUMENTATION?

WHAT SHOULD THEY DOING?

>> YES AND.

YES THEY HAVE TO START GETTING REALLY BUSY WITH DOCUMENTATION.

MAKING SURE THIS THEY HAVE THEIR DOCUMENTS IN ORDER.

YES, THEY HAVE TO START THOSE CONVERSATIONS WITH THE PEOPLE IN THE COMMUNITIES.

COMMUNITY LEADERS.

PEOPLE WHO ARE GOING TO THEM WITH ACCURATE INFORMATION.

BECAUSE ONE OF THE THINGS THAT IS OUT THERE IS INACCURATE INFORMATION.

OR SOMETHING THAT COULD BE PURPORT THE TO BE INACCURATE INFORMATION.

>>Daryl: WITHIN THE IMMIGRANT POPULATION, THEY MAY HAVE WORK BUT MAY BE ONE SPORADIC.

NOT EVEN IMMIGRANT POPULATION I GUESS.

LOW INCOME PEOPLE.

BUT ALSO, THEIR EMPLOYER MAY NOT BE THE BEST KEEPING RECORDS.

>> YES.

MIGHT BE CASH.

CASH EMPLOYMENT.

>> WE TALK ABOUT DOCUMENTATION AND WE TALK ABOUT AMOUNT OF WORK THAT PEOPLE HAVE TO GO THROUGH JUST TO GET A PERSPERSONELIGIBLE.

PERSON IS ELIGIBLE BUT DON'T HAVE THE DOCUMENTATION THEY NEED TO DEMONSTRATE THAT THEY ARE ELIGIBLE.

AND PART OF DOING SOME VOLUNTEER WORK THAT IS WHY WE PUT IN THIS COMMUNITY ENGAGEMENT AS WELL.

YOU CAN START ENGAGING WITH THE COMMUNITY SOME OF THESE COMMUNITY LEADERS, AND EVEN IF IS DIFFICULT FOR A PERSON TO FIND A JOB, THEY MIGHT BE A WAY OF FINDING THEM SOME VOLUNTEER WORK WHICH IS IS WELL DOCUMENTED WOULD THEN QUALIFY THEM FOR THE BENEFITS.

THAT'S ANOTHER PART THAT THEY NEED TO COME OUT AND SEEK OUT.

SEEK OUT THOSE OPPORTUNITIES.

>>Daryl: IS IT LIKE TO DO ORGANIZATIONS ALSO NEED TO BE TRYING TO FIND VOLUNTEER OPPORTUNITIES FOR PEOPLE LIKE FOR EXAMPLE, HOSPITALS, IF SOMEONE CAME, ONE OF YOUR CLIENTS, AND SAID, I NEED TO KEEP MY MEDICAID UP, CAN I BE A CANDY STRIPER OR SOMETHING LIKE THAT?

HAVE CANDY STRIPERS ANY MORE?

I DON'T KNOW.

IS THAT SOMETHING THAT THE COMMUNITY NEEDS TO LOOK AT?

GIVE OPPORTUNITIES FOR PEOPLE?

BECAUSE SO MANY PEOPLE DON'T SEE OPPORTUNITIES.

>> THERE ARE MANY ORGANIZATIONS INCLUDING HOSPITALS AND OTHER FACILITIES DO HAVE ROLES OF VOLUNTEERS.

SO THAT IS SOMETHING THAT WE CAN EXPLORE TO SAY, HOW MANY MORE TUNES CAN WE OPEN UP IF NECESSARY OR WHAT ARE THE NUMBERS?

IT'S NOT CLEAR TO ME YET HOW MANY PEOPLE ARE EXACTLY HOW MANY PEOPLE ARE WORKING, HOW MANY PEOPLE MAKE THE WORK REQUIREMENTS.

I DON'T KNOW HOW MANY RULES JUDY COME OUT HOW SPECIFIC THIS INFORMATION THAT IS AVAILABLE RIGHT NOW.

>> PRETTY SPARSE.

INFORMATION.

I MEAN, ALSO GOOD NEWS IS THAT THERE ARE EXEMPTIONS AND EXCEPTIONS.

SOMEONE IS HAS COMPLEX, CONSIDERED MEDICALLY FRAIL, TRYING TO THINK THROUGH WHAT THAT MEANS, BUT MEDICALLY FRAIL, THERE ARE SOME EXCEPTIONS AND SOME EXEMPTIONS.

WE'RE HAVING CONVERSATIONS WITH LOTS OF DIFFERENT COMMUNITY BASED ORGANIZATIONS NONPROFITS, WHO THEY'RE USED TO PROVIDING HELPING TO PROVIDE ENGAGE WITH MANY OF THE PEOPLE WHO MIGHT BE SERVED BY QUEST AND MEDICAID PROGRAM, AND NOW, THEY'RE THINKING ABOUT OH, MAYBE WE CAN THINK ABOUT WHAT VOLUNTARY WITH US PART OF THAT ENGAGEMENT.

>>Daryl: ASK FRANCOISE.

IS THAT A ROLE THAT HEALTH PLANS WILL PROBABLY BE PLAYING TOO?

>> ABSOLUTELY.

ALOHA CARE AS WELL AS OTHER HEALTH PLANS.

ONE OF THE THINGS WE DO AND DID VERY WELL IN TROUBLED TIMES IS WE CONNECT WITH TRUSTED ORGANIZATIONS IN THE COMMUNITY THAT IN TURN, COMMUNITY LISTENS TO AND SO A LOT OF ORGANIZING HAPPENS THERE.

HAWAII IS RHYT RICH IN NONPROFIT AND COMMUNITY-BASED ORGANIZATIONS.

FOR EXAMPLE, WE HAVE WHAT'S CALLED SOCIAL REFERRAL PLATFORM.

WHERE WE CONNECT PEOPLE DIRECTLY TO THOSE RESOURCES THAT CAN HELP THEM ADDRESS WHATEVER IT IS THEY'RE TRYING TO DO, FIND A JOB, GET CONNECT TO HELP, ANY TYPE OF HELP IN THE COMMUNITY.

THAT IS NATURAL ROLE THAT WE COME TO PLAY OVER THE LAST SEVERAL YEARS.

>>Daryl: STRIKES ME INSURANCE COMPANY ORGANIZATIONS, COMPANY TECHNICALLY I GUESS, YOU'RE FOLKS ACTUALLY HELP PEOPLE FIND WORK AND HELP PEOPLE CONNECT?

>> CONNECT THEM TO RESOURCES THAT DO THAT.

CONNECT PEOPLE TO ORGANIZATIONS FROM LEGAL AID, TO TEMP AGENCIES, ET CETERA.

WE FORM THAT NETWORK.

AND JUST RECOGNIZESING THAT HEALTH CARE GOES WAY BEYOND PEOPLE ACCESSING MEDICAID BENEFIT.

WHATEVER IT IS THAT HELPS THEM TO STAY WELL AND HEALTHY.

WE PROVIDE CONNECTIONS TO THOSE RESOURCESES.

COMMUNITY-BASED ORGANIZATIONS HAVE DONE AN AMAZING AND TREMENDOUS JOB AT STEPPING UP IN TIMES OF TROUBLE.

>> I HAVE TO THROW THIS QUESTION OUT.

>>Daryl: I INTERVIEWED AT LEAST ONE REPUBLICAN MAYBE MORE, DURING THE DISCUSSION ABOUT THIS PROCESS, AND WAS TOLD OVER AND OVER AGAIN, THIS IS A APPROACH TO WASTE, FRAUD AND ABUSE.

PEOPLE ARE ABUSING SYSTEM.

PEOPLE WHO AREN'T WORKING BUT HEALTHY.

AND ABUSING SYSTEM.

HOW MUCH WOULD YOU SAY AMONG YOU FOLKS WHO DEAL WITH THIS POPULATION THE MOST OFTEN, HOW MUCH WAST WASTE IS THERE?

ARE PEOPLE 'OIWI TV THERE CHEATING THE SYSTEM.

>> I DID SAY SPEAK TO THAT AND SAY AT LEAST IN THE POPULATIONS THAT WE SERVE, I HAVE NOT SEEN THAT.

WE FLAG THOSE KINDS OF THINGS.

IF OUR ELIGIBILITY WORKERS ARE WORKING WITH A PERSON, WHO IS TRYING TO GET INTO THE MED-QUEST PROGRAM, THEY REVIEW THE DOCUMENTS WITH THEM.

AND THEY POINT OUT FOR THEM THE THINGS THAT DISQUALIFY THEM.

SO THAT THE WORD IS OUT THERE THAT DON'T JUST THINK YOU'RE GOING TO GO TO KALIHI-PALAMA HEALTH CENTER.

GOING TO PUT YOU INTO THE MED-QUEST PROGRAM.

NO.

BECAUSE FOR US, ONE OF THE MOST IMPORTANT THINGS FOR ELIGIBILITY WORKERS IS THAT THEY HAVE THE TRUST OF THE MED-QUEST PEOPLE.

SO THAT WHEN THAT ELIGIBILITY WORKER SAYS, THIS PERSON QUALIFIES, MED-QUEST IS NOT GOING TO QUESTION IF THEY WILL REVIEW IT, BUT THEY WILL NOT LET THE PERN MA PERSON MAKING THAT DETERMINATION.

PERSON IS ELIGIBLE IS ON SOUND FOOTING.

WE DON'T WANT TO LOSE THAT RELATIONSHIP.

WE WANT TOP WANT MAKE SURE WE'RE EDUCATING THE COMMUNITY.

I HAVEN'T SEEN IT IN THE POPULATIONS WE SERVE.

I CAN'T SPEAK FOR OTHERS.

>> I THINK PEOPLE NEED TO THAT W THAT THIS IS A HIGHLY REGULATED SPACE.

MEDICAID AND MEDICARE.

SO FOR THOSE OF US LIKE MYSELF THAT HAVE A CONTRACT WITH THE STATE AND FEDERAL GOVERNMENT, WE ARE HELD TO VERY INTENSE REQUIREMENTS FRAUD WASTE AND ABUSE.

AUDITED AGAINST THOSE REQUIREMENTS.

AND THEN I HAVE JUDY CHIME IN.

JUDY IS AUDITED AGAINST THOSE REQUIREMENTS.

WE HAVE SYSTEMS AND INFRASTRUCTURE THAT MANDATE US TO REVIEW FOR FRAUD WASTE AND ABUSE AND IDENTIFY IT.

FOLLOW THROUGH TO INVESTIGATIONS AND RECOVERY.

SO ON.

>>Daryl: LET ME JUST, I UNDERSTAND WHAT YOU'RE SAYING.

AGREE WITH YOU.

BUT SO WE'VE GOT NOT JUST STATE REVIEWING ELIGIBILITY, WE HAVE YOUR ELIGIBLE WORKERS REVIREVIEWING IT.

YOU HAVE YOUR AUDITING SAYS IF YOU KNOW SOMEONE IS CHEATING, YOU HAVE TO REPORT IT.

SO THERE'S A LOT OF LAYERS OF REGULATION IN THIS SYSTEM ALREADY.

>> YEAH.

AND THERE'S A SPECIFIC EXAMPLE WE CAN TALK TO THAT PROVES THAT.

DURING THE PANDEMIC, THERE WAS A PROHIBITION ON REDETERMINATION OR WHAT THAT MEANS IS MEDICAID AGENCY ACROSS THE COUNTRY COULD NOT KICK PEOPLE OFF THEIR ROLES UNLESS SOMEONE CAME THROUGH.

SO THEY COULDN'T ACTUALLY DO THAT ELIGIBLE VERIFICATION FOR A PERIOD OF TIME.

THE NUMBER OFTEN ROLE PERCY IHARA IN HAWAII -- ENROLLEES, MEDICAID RECIPIENTS UP TO 480,000.

ONCE THAT PROHIBITION WAS LYFTED LOOK AT THE DOCUMENTATION, THE WHAT HAPPENED IS ARER WE NOW HAVE JUST UNDER 400,000 INDIVIDUALS.

SO 80,000 INDIVIDUALS THROUGH THE PROCESS, RIGHT?

DID NO LONGER MET REQUIREMENTS AND WERE TAKEN OFF THE ROLES.

SO THAT VERY SPECIFIC EXAMPLE OF HOW THE SYSTEM WORKS TO ACTUALLY ENSURE THAT PEOPLE ARE ELIGIBLE.

>>Daryl: I DON'T KNOW THAT PEOPLE KNOW HOW THE MONEY FLOWS THROUGH THE SYSTEM.

I MY UNDERSTANDING IS FEDERAL GOVERNMENT DOESN'T PAY ALL OF THE MEDICAID COSTS.

ISN'T THAT A SHARED COST WITH THE STATE?

>> IT IS A SHARED COST WITH THE STATE.

THIS IS -- THE COLOR OF THE MONEY THAT WE PAY TO T HEALTH PLAN OR GOES TO KALIHI-PALAMA, IS GREEN.

BUT THE FEDERAL DOLLARS, LET'S SAY THEY'RE BLUE, AND SPHAITD SE DOLLARS THEY'RE YELLOW.

TOGETHER, SO ANY DOLLAR THAT SPENT IN THE MEDICAID PROGRAM, THAT IS GREEN DOLLAR, IS MADE UP OF BOTH FEDERAL PORTION AND A STATE PORTION.

THE FEDERAL PORTION IS SET BY A FORMULA THAT SET AT THE NATIONAL LEVEL THAT WE HAVE NO CONTROL OVER.

>>Daryl: SO TO BE REALLY CYNICAL, IF YOU LOSE PEOPLE OFF THE PROGRAM, DOESN'T THAT SAVE STATE PAIR MONEY?

>> GOT TO ASK THE QUESTION.

>> IT'S ONE OF THOSE SITUATIONS WHERE IN THE SHORT TERM, IT COULD SAVE, IT COULD SAVE THAT IMMEDIATE DOLLAR.

IN THE LONGTERM, YOU PAY HIGH COST.

BECAUSE OF WHAT WE WERE TALKING ABOUT BEFORE.

THOSE INDIVIDUALS WIND UP BEING UNINSURED.

AND THAT HAS AN IMPACT NOT ONLY ON THE HEALTH CARE SYSTEM ITSELF, THAT NOW GETTING PAID FOR DOING THAT CARE.

BUT THAT ACTUALLY HAS A DRAMATIC IMPACT ON THOSE FAMILIES.

AND WE'RE TALKING ABOUT THAT AGAIN, WE'RE SERVING NEARLY A THIRD OF THE POPULATION.

YOU'RE TALKING ABOUT IF THOSE INDIVIDUALS BECOME UNINSURED, AND THEN THEY HAVE SOME SERIOUS ILLNESS, THEY WIND UP IN THE HOSPITAL, THAT IS GOING TO DRAMATICALLY IMPACT THEIR HOUSEHOLD, THEIR WELL-BEING, AND IT MAKES LIVING IN HAWAII, IS ALREADY DIFFICULT AND CHALLENGING GIVEN AFFORDABILITY ISSUES, AND THIS JUST ADD DOES IT.

PEOPLE GO INTO MEDICAL DEBT.

AND IT IS ESSENTIALLY RUINS LIVES.

SO YES, IT'S A SHORT-TERM BUT SHORT-TERM FIX.

>>Daryl: I'VE GOT A COUPLE OF QUESTIONS ABOUT FOR PROFIT ASPECTS OF MEDICAID INSURANCE PLANS.

MOST OF OUR MEDICAID INSURANCE PLANS ARE NONPROFIT.

HMSA, KAISER, ALOHA CARE.

AND THERE ARE SOME THAT ARE FOR PROFIT PRIVATE OR MAINLAND COMPANIES.

I GOT A QUESTION THAT STATE MEDICAID CONTRACT IS GOING TO ANOTHER LOCATION, MAYBE TAMPA?

TO UNPRIVATIZE CONTRACT AND BRING THE DOLLARS BACK TO THE STATE.

FROM WHERE IT WOULD SPRING.

DOES THAT MAKE ANY SENSE TO YOU?

IF NOT WE CAN JUST MOVE ONLINE.

I DON'T UNDERSTAND THE QUESTION.

MOVE ON.

>> I THEY THIS ARE WORRIED ABOUT THE FACT WE DO HAVE FOR PROFITER HEALTH PLANS A AS WELL AS NOT FOR PROFITS.

WHAT I WOULD SAY IS THAT WE ACTUALLY HAVE SEVERAL DIFFERENT FINANCIAL CONTROLS THAT LIMIT HOW MUCH HEALTH PLANS CAN EARN AND THAT ALL OF HEALTH PLANS EVEN THOUGH THEY MIGHT HAVE NATIONAL COMPANY, AND COMPANY MIGHT BE SOMEWHERE ELSE, THEY'RE ALL LOCAL.

ALL HAVE LOCAL OFFICES, ET CETERA.

>>Daryl: OKAY.

LET ME ASK FRANCOISE FROM LO CARE.

WHAT IS THE FINANCIAL IMPACT ON COMPANY LIKE ALOHA CARE WHERE YOU ARE 100, ALMOST 100% MEDICAID, WHAT IS THE IMPACT IF YOU LOSE CUSTOMERS BECAUSE OF THIS?

>> NATURALLY, IF WE SEE SIGNIFICANT MEMBERSHIP LOSS, THEN THE REVENUE DECLINES.

SO THAT'S NATURAL CONSEQUENCE OF PLAN GETTING SMALLER.

AND OBVIOUSLY TASK FOR US WOULD BE MANAGING THAT.

TO THE WORKFORCE WE HAVE.

AND INSURING THAT WE CAN STILL TAKE CARE OF PEOPLE.

BUT I THINK THAT THIS IS ONE OF SORT OF THE NATURAL THINGS THAT ONE HAS TO ANTICIPATE.

SIGNIFICANT CHANGE LIKE THIS HAPPENS.

SO FOR EXAMPLE, WE STARTED DURING COVID, WHEN FOLKS WERE BEING ASSIGNED TO THE MEDICAID PROGRAM, AND WE WERE NOT ABLE TO WORK WITH MED-QUEST.

DISENROLL THEM.

HAD MAYBE 80,000 MEMBERS.

THAT ENROLLMENT.

>>Daryl: BIG DROP.

>> YES.

ALSO HAD A BIG DROP ALREADY.

THOSE WERE THINGS WE PLAN FOR.

OUR RESPONSIBILITY.

AS A HEALTH PLAN AND AS STEWARDS OF GOOD STEWARDS OF FINANCIAL RESOURCES IN OUR STATE.

SO WE CAN MANAGE ACCORDINGLY.

>>Daryl: ANOTHER QUICK QUESTION.

FROM SPECIFIC PERSON ASKING, HOW ARE THE CHANGES AFFECT SOMEONE IN LONGTERM CARE IN NURSING FACILITY?

THERE'S A LOT OF PEOPLE THAT ARE HERING MEDICAID MIGHT BE CUT AND THINKING PEOPLE CAN GET KICKED OUT OF THE NURSING HOMES.

>> THAT'S ONE OF THE BIG CONCERNS IS THAT, I THINK THAT'S EMANUEL ACTUALLY ALSO REFLECTING THAT.

SENSE THAT THRSES THERE'S A LOT OF TALK OUT THERE.

A LOT OF CONCERN, AND DRAMA.

LIKE OH, MY GOOD, MEDICAID IS GOING TO BE CUT.

ET CETERA.

AND SO IT'S PART OF THIS MESSAGE IS YES, THERE ARE GOING TO BE IMPACTS, BUT THEY'RE IN THIS AREA.

THERE'S NOT GOING TO BE IMPACTS ON PEOPLE IN NURSING FACILITIES, OR RECEIVING LONGTERM CARE.

OR KIDS, THAT KIDS WHO ARE COVERED BY THE QUEST PROGRAM, WE SERVE ONE IN TWO KIDS IN THE STATE, SO 50% OF KIDS.

>>Daryl: HALF THE KIDS.

>> HALF THE KIDS ARE COVERED BY QUEST PROGRAM.

>>Daryl: THEIR PARENTS DON'T HAVE TO WORRY ABOUT THAT.

>> PARENTS.

SO IT'S PARENTS AND WORKING AGE ADULTS THAT WHERE THE CHANGES ARE HAPPENING.

AND THEN IT'S NOT RIGHT NOW.

IT'S IN JANUARY OF 2027.

>>Daryl: DOES ANYONE HERE THINK THAT THIS WOULD REALLY SAVE A TRILLION DOLLARS TO THE FEDERAL GOVERNMENT?

>> NO.

>>Daryl: WHY NOT?

IF THAT'S WHAT THEY'RE EXPECTING.

EVERYBODY SAYS A TRILLION DOLLARS.

I DON'T KNOW.

>> AS WE TALKED ABOUT, IT'S NOT JUST IF PEOPLE LOSE COVERAGE, THAT IS NOT A GOOD THING FOR THE INDIVIDUALS AND NOT GOOD FOR THE COMMUNITY.

SO THOSE COSTS JUST GET SHIFTED TO OTHER SECTIONS OF THE COMMUNITY.

SO MAYBE A COST REDUCTION IN ONE AREA, BUT IT ACTUALLY DRIVES UP COSTS IN THE OTHER AREA.

WE HAVE HMSA AND KAISER FOR EXAMPLE AS A TWO BIGGEST COMMERCIAL PLANS IN THE STATE.

AND THEY PREMIUMS WILL GO UP BECAUSE IF YOU HAVE MATERIAL INCREASE, IN THE NUMBER OF UNINSURED INDIVIDUALS, BEING TREATED, IN OUR HOSPITALS FOR EXAMPLE, THEY WILL THEN GO BACK HOSPITALS GO BACK TO THE COMMERCIAL PLANS AND SAY, WE NEED MORE MONEY FROM YOU TO COVER THE COSTS OF THESE TAKEN CARE OF UNINSURED INDIVIDUALS.

AND SO THAT PUTS PREMIUMS FOR EMPLOYERS, WHICH ALSO PUTS UP COST FOR THE EMPLOYEES AS WELL.

>>Daryl: EMMANUEL KINTU, FOR A HEALTH CARE CENTER LIKE YOURS, YOU WOULD PROBABLY SEE A LOT OF THESE PEOPLE SHOWING UPUP IN NAY UNINSURED.

ISN'T FED PAY YOU MONEY TO TAKE CARE OF INUNSURED PEOPLE?

>> NO.

FEDERAL GOVERNMENT INVESTS IN THE FEDERAL QUALIFIED COMMUNITY HEALTH CENTERS.

THAT INVESTMENT IS ABOUT 17% FOR US.

STILL SIGNIFICANT.

>>Daryl: 17% OF WHAT?

>> 17% OF OUR TOTAL BUDGET.

IT'S ABOUT THAT.

BUT THAT IS NOT JUST FOR INDIGENT.

WHOLE COMMUNITY.

SO WE'RE THERE TO SERVE THE WHOLE COMMUNITY.

WHOLE COMMUNITY.

INCLUDING INDIGENT PEOPLE WE HAVE PROVIDE CULTURALLY APPROPRIATE CARE.

WE END UP DOING GAZILLION THINGS THAT PEOPLE WILL NOT GET IF THEY GO OUT THERE IN THE COMMUNITY.

OR SEEK CARE AT DIFFERENT PRIMARY CARE FACILITY.

IN OUR CASE, WE PROVIDE SO-CALLED WRAPAROUND SERVICES TO MAKE SURE THAT THESE HARD TO REACH POPULATIONS GET ACCESS TO QUALITY CARE.

AND WE TRY TO DO THAT CONSISTENTLY.

>>Daryl: YOU HAVE COMPLETE OPEN DOOR SOMEONE WALKS IN AND DOESN'T HAVE INSURANCE, CAN YOU TAKE THEM AND TAKE CARE OF THEM.

>> ANYBODY PRESENTS WE SERVE.

NOW, WE WILL ASK THEM TO BRING SOME DOCUMENTS MAYBE NEXT TIME AROUND, LIKE IF THEY'RE THERE, WE WILL SEE THEM.

IF THEY'RE THERE, WE'LL SERVE THEM.

>>Daryl: SAME DEAL WITH OTHER FACILITIES?

>> WELL, HOSPITALS ARE GOVERNED BY MTALA, FEDERAL LAW THAT REQUIRES, ANY EMERGENCY ROOM TO TREAT AND STABILIZE A PATIENT.

SO REGARDLESS OF WHEN THEY HAVE INSURANCE OR NOT OR WHATEVER INSURANCE THEY MAY OR MAY NOT HAVE, HOSPITALS BY LAW, EMERGENCY ROOMS FOR HOSPITALS ARE WE QUEERED TO TREAT AND STABLE-REQUIRED TO STREET AND STABILIZE ALL PATIENT THAT IS PRESENT.

>>Daryl: CONCERN IS GET SO SICK, DON'T HAVE A DOCTOR TO GO TO SHOPO UP AT THE EMERGENCY ROOM.

>> SHOW UP AT EMERGENCY ROOM.

TAKE CARE OF THEM.

YEAH.

>>Daryl: VERY IMPORTANT QUESTION IS WHAT IS THE STATE'S LEVERAGE OR FLEXIBILITY TO SUPPLEMENT FEDERAL CHANGES OR MEET THE GAPS FOR HAWAII'S PEOPLE?

THE LAST TIME WE TALKED GOVERNOR ABOUT THIS, HE WAS VERY PLEASED THAT THERE'S GOING TO BE A SUPPLEMENT FROM THE FEDERAL GOVERNMENT FOR OUR STATE.

FOR RURAL HEALTH CARE.

I THINK HE WAS SAYING IT'S EQUAL PORTION FOR EVERY STATE.

NOT BASED ON POPULATION.

HE SAID THAT'S A FAIR AMOUNT OF MONEY.

HE TALKS ABOUT THE STATE'S SURPLUS.

I MEAN, IS THE STATE PREPARED TO MAKE UP THE DIFFERENCE HERE?

>> I DON'T KNOW HOW YOU GO DO IT.

ELIGIBILITY REQUIREMENTS.

IS THAT SOMETHING STATE CAN DO, JUST PAY THE MONEY?

>> I DON'T THINK THE STATE CAN JUST PAY THE MONEY.

I THINK THAT WE AS A COMMUNITY HAVE TO COME TOGETHER AND FIGURE OUT, TBTS GOING TO TAKE MANY DIFFERENT KIND OF SOLUTIONS IN ORDER TO RESPOND.

TO THESE KINDS OF CUTS.

SO THE MONEY OR THE GRANT THAT THE GOVERNOR WAS TALKING ABOUT IS RURAL HEALTH TRANSFORMATION PROGRAM.

IN WHICH THERE IS $50 BILLION.

>> $50 BILLION.

>> $50 BILLION OVER FIVE YEARS.

HALF OF THAT AMOUNT OF MONEY IS EQUALLY DIVIDED AMONGST THE 50 STATES.

AND OTHER HALF.

>>Daryl: BY GRANTS.

>> IS BY HOW RURAL YOU ARE, AND INITIATIVES YOU'RE CHOOSING.

THE APPLICATION WAS JUST RELEASED BY THE FEDERAL GOVERNMENT.

FOR THE STATES TO APPLY.

>>Daryl: SECOND 500 MILLION.

>> NO.

THEY'RE PUTTING WHOLE THING, YOU HAVE TO APPLY FOR THE WHOLE AMOUNT.

EVEN THAT AMOUNT THAT IS.

>>Daryl: SEEMED TO BE GUARANTEED, SEEMINGLY GUARANTEED.

YES.

YOU STILL HAVE TO APPLY FOR IT.

AND TURN IN THE APPLICATION.

STATE IS WORKING ON THAT RIGHT NOW.

WE HAVE UNTIL NOVEMBER 5 TO TURN IN THE APPLICATION AND THEN DECISION IS MADE BY THE END DECEMBER.

THAT BECAUSE IT'S FIVE YEAR TIME PERIOD, IT'S NOT DESIGNED FOR, TO SUPPLEMENT MEDICAID PROGRAM.

AND TO COVER OR TO COVER PEOPLE WHO ARE UNINSURED.

THAT'S NOT, IT'S ONLY FOR FIVE YEARS.

AND IT'S MAINLY ENTER TARGETING THINGS LIKE INFRASTRUCTURE, OR SCHOLARSHIPS OR TECH INNOVATIONS, ET CETERA.

>>Daryl: NOT A MAGIC BULLET.

>> WON'T HELP IN WITH THE MEDICAID, WON'T HELP DIRECTLY WITH THE MEDICAID, WITH THESE KIND OF MEDICAID CHANGES.

BUT IT CAN HELP WITH FOR EXAMPLE, IF WE NEEDED TO FIGURE OUT WHAT'S A BETTER WAY THAT WE CAN GATHER INFORMATION AROUND PEOPLE VOLUNTEERING?

SO PERHAPS WE COULD INVEST IN TECHNOLOGICAL SOLUTION TO HELP US WITH THAT.

SO IT CAN HELPS BE PART OF THAT SOLUTION.

BUT IT'S GOING TO TAKE OUR CREATIVITY, AND TAKE SITTINGING DOWN TOGETHER AND GOING, WHAT WOULD YOU LIKE TO DO ABOUT THIS?

>>Daryl: I GUESS WHAT I THINK I'M ASKING IS IF THE IMPACT THAT WE THINK IS GOING TO COME, IS PEOPLE JUST DROPPING OFF THE SYSTEM BECAUSE THEY DON'T QUALIFY OR CAN'T MEET REQUIREMENTS OR DON'T HAVE THE DOCUMENTATION, OR WORK IS NOT ELIGIBLE, DO WE HAVE A SYSTEM TO TAKE CARE OF THOSE PEOPLE WHO GET DROPPED OFF THAT YOU WOULD SUBSIDIZE OUTS OF THE STATE'S SURPLUS FOR EXAMPLE?

>> I THINK THE LEGISLATURE AND GOVERNOR GET TO WRESTLE WITH THOSE VERY QUESTIONS.

>> PROBABLY SHOULD JUMP IN HERE AND SAY, JUST SLIGHT CORRECTION HERE.

IT IS NOT THE PEOPLE WE ARE TALKING ABOUT ARE NOT ELIGIBLE.

MANY OF THE FOLKS WE ARE TALKING ABOUT ARE GOING TO BE ELIGIBLE.

BUT IT IS THE DEMONSTRATING THAT THEY'RE ELIGIBLE.

THAT IS GOING TO KEEP THEM OFF.

YES, SOME WILL NOT QUALIFY.

BUT MANY OF THEM ARE GOING TO BE ELIGIBLE, BUT WE WON'T BE ABLE TO DEMONSTRATE IT.

I KNOW SOMEBODY NEEDS TO THROW IN A FEW WORDS HERE.

>> WAIMAN ONE.

THINGS FORTUNATE HERE IN HAWAII WE DO WORK TOGETHER COLLABORATIVELY.

WE ARE COMMITTED AS A COMMUNITY WHETHER IT'S PAYORS, REGULATORY AGENCIES PROVIDERS, ALL COMMITTED TO WORKING TOGETHER TO MINIMIZE IMPACT OF THESE CUTS TO THE STATE.

SO THE GOVERNOR AS YOU MENTIONED, WE HAVE RURAL HEALTH TRANSFORMATION FUND.

FORTUNATELY THE STATE BUDGETS FAIRLY GOOD PLACE R RIGHT NOW THAT COULD CHANGE.

SHIFTING DEMOGRAPHICS GOING ON.

VISITOR INDUSTRY IS NOT AS STRONG AS IT WAS.

COUPLE OF YEARS AGO, SO WE ARE IN A FAIRLY GOOD PLACE ROA THE T NOW.

WE'RE GOING TO WORK TOGETHER TO WHATEVER WE CAN.

VERY SUPPORTIVE LEGISLATURE THAT THEY WILL, JUST NEED TO TELL THEM HOW MUCH MONEY SHE NEEDS.

I'M CONFIDENT THEY WILL A APPROPRIATE THE MONEY THEY NEED.

WHETHER JUDY JUDY CAN FIND THE WORKS TO DO THE WORK OTHER MATTER ENTIRELY WE ARE COMMITTED TO.

WORKING TOGETHER AND EVEN AS US PROVIDERS, WE WILL BE SUPPORTIVE OF FINDING ELIGIBLE.

>>Daryl: I HAVE TO P P STOP YOU BECAUSE WE'RE DONE.

MAHALO TO YOU FOR JOINING US TONIGHT — AND WE THANK OUR GUESTS - MED-QUEST DIVISION ADMINISTRATOR JUDY MOHR PETERSON AND KALIHI-PALAMA HEALTH CENTER CEO, EMMANUEL KINTU, AND ALOHACARE CEO FRANCOISE CULLEY-TROTMAN, AND HEALTHCARE ASSOCIATION OF HAWAII CEO HILTON RAETHEL.

NEXT WEEK ON INSIGHTS, WE'LL FIND OUT HOW HAWAI'I'S PUBLIC SCHOOL SYSTEM IS HANDLING MOVES IN WASHINGTON TO ELIMINATE THE FEDERAL DEPARTMENT OF EDUCATION.

PLEASE JOIN US THEN.

I'M DARYL HUFF FOR INSIGHTS ON PBS HAWAI'I.

ALOHA!

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