Ka Wai Ola - Office of Hawaiian Affairs, Volume 16, Number 12, 1 December 1999 — OHA health care initiative: Haste makes waste [ARTICLE+ILLUSTRATION]

OHA health care initiative: Haste makes waste

Recent discussion and "action alerts" eoncerning OHA's attempts to create a kupuna health care program have caused mueh ado about nothing. The Board of Trustees' deferral of the recent proposal indicates more work needs to be done before we are able to move on a long-term heahh care hntiative. Recent articles in the Advertiser and Star Bulletin raise the specter that current HMO and health maintenance plans are facing serious eeonomie strains regarding direct services. Discussion in the Hawaiian eommunity suggests the Queen's and Kapi'olani Health Care systems are selhng their programs to better service the chents in the context of mounting eeonomie hardship. OHA would be remiss in committing money to a program that has no long-range plan, no concrete description of the beneficiaries to be served and no administrative staff to manage the day-to-day operations. OHA must closely analyze whether

this agency ean estabhsh, fund and manage a health care system for kupuna or all Hawahans. OHA should not rush into reinventing the wheel. Rather, OHA should begin developing plans to create partnerships with the other ah'i trusts such as Queen's and Kapi'olani, whose "business" is the wellness of our Hawahan people. When trustees question the feasibihty of the various heahh care plans floated by OHA's ehah, it's not because we oppose the idea of attending to Hawaiian health care needs. We want to be sure that OHA's funding commitment wih not fail for laek of planning or preparation. And we want to be sure the programs we create do not fah victim to the current fiscal crises forcing HMO's to shut down. This is a serious issue that deserves serious research and input firom ah our community and the ah'i trusts! OHA has made at least three attempts to develop a health care plan: On June 17, the Budget and

Finance Committee deferred an action to fund a $5 million heahh care plan targeting Hawaiian keiki, 'ōpio and

kūpuna because the plan was rushed and lacked the standard "due dihgence" analysis required for such an appropriation. On Aug. 27, the OHA board again deferred action on a sec-

ond plan that would have focused on the medication needs of an undetermined number of elderly Hawahans. Theproposed program would have authorized $500,000 for a medieal pharmacy discount to kūpuna. However, it did not identify the actual recipients or the total long-range cost per client. On Sept. 28, a third kupuna heahh care initiative was withdrawn for incomplete information, including laek of a due dihgence analysis. The plan called for the approval of $1,068,500 for Medicare Part B assistance and other related services for the elderly. OHA convened a task force and hired a consuItant to review the feasibihty of kupuna heahh care initiatives. Their preliminary findings follow: • OHA's Native Hawaiian heahh Insurance Plan was financially risky; • The plan to provide assis-

tance for uninsured children may not be feasible; • The potential for escalating costs of a prescription drug rider funded by OHA represented a significant risk; and • a pharmacy discount program ultimately offered too limited an impact for the kūpuna it was designed to serve. Onee trustees receive a eomplete feasibihty report, the Committee on Program Management will begin to develop a comprehensive programmatic review of heahh care for Hawahans. The board's action should be viewed as a step in the right direction. Every trustee beheves OHA must play a role in the health and wellness of our people. The key is due dihgence before OHA rushes into a hasty and costly decision. The Committee on Program Management will work dihgently to ensure that heahh care for Hawaiians receives fair and prudent consideration. ■

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