The more honest one is, the easier it is to continue being honest, just as more lies one has told, the more necessary it is to lie again. By their openness, people dedicated to the truth live in the open, and through the exercise of their courage to live in the open, they become free from fear. Human beings are poor examiners, subject to superstition, bias, prejudice, and a PROFOUND tendency to see what they want to see rather than what really there. The ultimate goal of life remains the spiritual growth of the individual, the solitary journey to peaks that can be climbed only alone.
- M. Scott Peck, “The Road Less Traveled”
The VA healthcare system is inefficient due to policies that resulted in veterans dying while waiting for appointments. An investigation found VA employees were falsifying appointment times. The VA's goal of seeing patients within 30 days is unacceptable compared to Medicare patients seeing doctors within 3 days. Two alternative policies are proposed to increase efficiency: 1) A hybrid system using Medicare for non-service related care and the VA for service-related care. 2) Removing priority groups 7 and 8 from VA healthcare to reduce wait times by 50% for service-disabled veterans in groups 1-6.
Reaching the Missing Middle: Ensuring Health Coverage for India’s Urban PoorHFG Project
This document discusses health coverage challenges facing India's urban poor population and opportunities to expand coverage through the new National Health Protection Scheme (NHPS). It notes that India's urban poor, estimated at 27% of the urban population, have been excluded from existing public health insurance schemes that target those below the poverty line. The NHPS, announced in 2018, aims to provide health insurance of up to 500,000 rupees per family annually. The document argues that integrating primary health care benefits into insurance schemes could help manage population health and reduce costs by keeping people healthy and out of hospitals. There is no single solution, but the NHPS could play a major role in expanding safety nets for the urban poor through financial protection and investing in
Extending health insurance coverage to the informal sector: Lessons from a pr...HFG Project
As a growing number of low‐ and middle-income countries commit to achieving universal health coverage, one key challenge is how to extend coverage to informal sector workers. Micro health insurance (MHI) provides a potential model to finance health services for this population. This study presents lessons from a pilot study of a mandatory MHI plan offered by a private insurance company and distributed through a microfinance bank to urban, informal sector workers in Lagos, Nigeria.
Sustaining the HIV and AIDS Response in St. Vincent and the Grenadines: Inves...HFG Project
National surveillance reports estimate that there were about 649 persons living with HIV in St. Vincent and the Grenadines at the end of 2011, which translates to 1.2% of the adult population (15-49 years) or 0.7% of the total population. The epidemic is male-dominant, illustrated by the fact that the cumulative case reporting from 1984-2013 indicates that 60.6% of new cases are reported among males and 38.1% females (1.3% unknown). In response to the growing epidemic, the country quickly scaled up its national HIV/AIDS program in 2004. While care and treatment remains a high priority, St. Vincent and the Grenadines has devoted significant resources to preventative activities, including HIV counseling and rapid testing, education and workplace programs, and other behavioral interventions.
Despite a marked decline in HIV and AIDS cases, significant challenges for the country’s response remain. Close to 20% of persons with advanced HIV infection discontinue treatment within 12 months of initiation, suggesting the need to reinforce adherence and retention to care. The country also faces an imminent decline in donor funding and domestic reprioritization of chronic and non-communicable diseases; without renewed sources of external funding or greater domestic resources allocated to HIV/AIDS, progress made since 2004 could regress.
In response to these challenges, key priorities outlined in the country’s strategic framework (2014-2025) include: 1) institutionalizing HIV education through collaborative programs with different sectors, 2) targeting high risk groups, 3) strengthening HIV testing and counseling, including routine testing for pregnant women and, 4) ensuring access and retention to care and treatment for those with HIV and AIDS and TB. St. Vincent and the Grenadines has also taken steps to integrate HIV and AIDS services into the broader health system and included the HIV and AIDS program as part of the Ministry of Health, Environment and Wellness’ overall health framework. These actions are the beginning of efforts to improve access to care, reduce costs, and improve efficiencies.
This document discusses behavioral health patient boarding in emergency departments. It defines boarding as patients staying in the ED after being admitted until an inpatient bed becomes available. Boarding can last over 24 hours and negatively impacts both patients and hospital resources. The document provides statistics on the increasing rates of psychiatric boarding in US EDs and safety concerns for healthcare workers from violent patients. It examines reasons for boarding like capacity constraints, limited outpatient services, lack of funding, and legal issues. The document also discusses the ill effects of boarding and factors exacerbating wait times. It concludes with recommendations to improve care and safety for psychiatric patients boarding in the ED.
Fighting Health Security Threats Requires a Cross-Border ApproachHFG Project
This document discusses how health security threats like Ebola and Zika require a cross-border approach. It summarizes efforts taken in the Caribbean region to strengthen health security through regional cooperation. Key steps included conducting a regional self-assessment using Global Health Security Agenda tools, developing a Caribbean Region GHSA Roadmap with input from over 70 stakeholders, and reinvigorating the Regional Coordinating Mechanism for Health Security. The roadmap establishes targets and plans for 19 health security capacities across Caribbean countries and aims to improve regional communication, coordination, and cooperation to address health threats.
Integrating HIV/AIDS in Vietnam’s Social Health Insurance Scheme: Experience ...HFG Project
The document describes lessons learned from integrating HIV/AIDS services into Vietnam's social health insurance scheme from 2014-2017. It discusses challenges such as HIV services originally being provided through donor funding and separate from the insurance scheme. The Health Finance and Governance project worked with Vietnamese government agencies to address barriers through technical assistance. This included integrating HIV treatment facilities into the public system funded by insurance, expanding insurance coverage, and shifting to local drug procurement. The project aligned with government policies and created evidence to advocate for sustainable HIV financing as donors transitioned support. Major lessons were the importance of working within complex adaptive systems and existing policy frameworks.
The VA healthcare system is inefficient due to policies that resulted in veterans dying while waiting for appointments. An investigation found VA employees were falsifying appointment times. The VA's goal of seeing patients within 30 days is unacceptable compared to Medicare patients seeing doctors within 3 days. Two alternative policies are proposed to increase efficiency: 1) A hybrid system using Medicare for non-service related care and the VA for service-related care. 2) Removing priority groups 7 and 8 from VA healthcare to reduce wait times by 50% for service-disabled veterans in groups 1-6.
Reaching the Missing Middle: Ensuring Health Coverage for India’s Urban PoorHFG Project
This document discusses health coverage challenges facing India's urban poor population and opportunities to expand coverage through the new National Health Protection Scheme (NHPS). It notes that India's urban poor, estimated at 27% of the urban population, have been excluded from existing public health insurance schemes that target those below the poverty line. The NHPS, announced in 2018, aims to provide health insurance of up to 500,000 rupees per family annually. The document argues that integrating primary health care benefits into insurance schemes could help manage population health and reduce costs by keeping people healthy and out of hospitals. There is no single solution, but the NHPS could play a major role in expanding safety nets for the urban poor through financial protection and investing in
Extending health insurance coverage to the informal sector: Lessons from a pr...HFG Project
As a growing number of low‐ and middle-income countries commit to achieving universal health coverage, one key challenge is how to extend coverage to informal sector workers. Micro health insurance (MHI) provides a potential model to finance health services for this population. This study presents lessons from a pilot study of a mandatory MHI plan offered by a private insurance company and distributed through a microfinance bank to urban, informal sector workers in Lagos, Nigeria.
Sustaining the HIV and AIDS Response in St. Vincent and the Grenadines: Inves...HFG Project
National surveillance reports estimate that there were about 649 persons living with HIV in St. Vincent and the Grenadines at the end of 2011, which translates to 1.2% of the adult population (15-49 years) or 0.7% of the total population. The epidemic is male-dominant, illustrated by the fact that the cumulative case reporting from 1984-2013 indicates that 60.6% of new cases are reported among males and 38.1% females (1.3% unknown). In response to the growing epidemic, the country quickly scaled up its national HIV/AIDS program in 2004. While care and treatment remains a high priority, St. Vincent and the Grenadines has devoted significant resources to preventative activities, including HIV counseling and rapid testing, education and workplace programs, and other behavioral interventions.
Despite a marked decline in HIV and AIDS cases, significant challenges for the country’s response remain. Close to 20% of persons with advanced HIV infection discontinue treatment within 12 months of initiation, suggesting the need to reinforce adherence and retention to care. The country also faces an imminent decline in donor funding and domestic reprioritization of chronic and non-communicable diseases; without renewed sources of external funding or greater domestic resources allocated to HIV/AIDS, progress made since 2004 could regress.
In response to these challenges, key priorities outlined in the country’s strategic framework (2014-2025) include: 1) institutionalizing HIV education through collaborative programs with different sectors, 2) targeting high risk groups, 3) strengthening HIV testing and counseling, including routine testing for pregnant women and, 4) ensuring access and retention to care and treatment for those with HIV and AIDS and TB. St. Vincent and the Grenadines has also taken steps to integrate HIV and AIDS services into the broader health system and included the HIV and AIDS program as part of the Ministry of Health, Environment and Wellness’ overall health framework. These actions are the beginning of efforts to improve access to care, reduce costs, and improve efficiencies.
This document discusses behavioral health patient boarding in emergency departments. It defines boarding as patients staying in the ED after being admitted until an inpatient bed becomes available. Boarding can last over 24 hours and negatively impacts both patients and hospital resources. The document provides statistics on the increasing rates of psychiatric boarding in US EDs and safety concerns for healthcare workers from violent patients. It examines reasons for boarding like capacity constraints, limited outpatient services, lack of funding, and legal issues. The document also discusses the ill effects of boarding and factors exacerbating wait times. It concludes with recommendations to improve care and safety for psychiatric patients boarding in the ED.
Fighting Health Security Threats Requires a Cross-Border ApproachHFG Project
This document discusses how health security threats like Ebola and Zika require a cross-border approach. It summarizes efforts taken in the Caribbean region to strengthen health security through regional cooperation. Key steps included conducting a regional self-assessment using Global Health Security Agenda tools, developing a Caribbean Region GHSA Roadmap with input from over 70 stakeholders, and reinvigorating the Regional Coordinating Mechanism for Health Security. The roadmap establishes targets and plans for 19 health security capacities across Caribbean countries and aims to improve regional communication, coordination, and cooperation to address health threats.
Integrating HIV/AIDS in Vietnam’s Social Health Insurance Scheme: Experience ...HFG Project
The document describes lessons learned from integrating HIV/AIDS services into Vietnam's social health insurance scheme from 2014-2017. It discusses challenges such as HIV services originally being provided through donor funding and separate from the insurance scheme. The Health Finance and Governance project worked with Vietnamese government agencies to address barriers through technical assistance. This included integrating HIV treatment facilities into the public system funded by insurance, expanding insurance coverage, and shifting to local drug procurement. The project aligned with government policies and created evidence to advocate for sustainable HIV financing as donors transitioned support. Major lessons were the importance of working within complex adaptive systems and existing policy frameworks.
STRATEGIC_PLANNING_FOR_THE_VANDERBURGH_COUNTY_HEALTH_DEPARTMENTChristina Miller
The strategic plan document provides an overview of the Vanderburgh County Health Department, including its organizational structure, mission and vision, SWOT analysis, and recommendations to address strategic issues related to adult smoking, obesity/diabetes, sexually transmitted diseases, meth use, and lead poisoning. It summarizes county health data and rankings, identifies areas for improvement in essential public health services, and analyzes challenges and opportunities for the health department.
A poll found that while almost half of metro area residents take supplements to prevent colds and flu, 39% of those supplement takers have not received the flu shot. The flu shot is considered the best preventive method against flu, whereas benefits of supplements have not been proven. Vitamin C is the most popular supplement taken, with 85% of supplement takers reporting its use to prevent colds and flu. However, nearly a third of supplement takers do not inform their doctors about supplement use.
A single-payer healthcare system would cause further inefficiencies and be an economic burden for the United States. While increasing access to care, a single-payer system would lead to longer wait times like in Canada where 27% of people wait over 4 months for procedures compared to only 5% in the US. It would also decrease quality of care as seen in Canada where doctors are overworked and underpaid. Implementing such a system would require a tax increase of over 150% which would cripple the US economy, as seen when Vermont explored a single-payer plan. Competition in healthcare markets leads to lower costs and higher quality unlike a single-payer system, making it a step backwards for US healthcare.
Global Medical Cures™ | Community Strategies for Preventing CHRONIC DISEASESGlobal Medical Cures™
Global Medical Cures™ | Community Strategies for Preventing CHRONIC DISEASES
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
Bayhealth, the second largest healthcare system in Delaware, lacks mental health services despite mental illness being a major driver of healthcare costs in the state. A strategic plan is proposed to address this unmet need and increase Bayhealth's market share. The strategic plan would leverage Bayhealth's size and location in central and southern Delaware to expand into the mental health market, where over 50% of those with mental illness do not receive treatment currently. The plan aims to strengthen Bayhealth's position relative to its main competitor, Christiana Healthcare, while improving access to care for Delaware residents and fulfilling Bayhealth's mission.
The document discusses emerging home health monitoring technologies that promise to enhance care for aging patients and reduce healthcare costs through remote patient monitoring. However, reimbursement from Medicare and other payers has not kept pace, posing financial challenges for healthcare providers looking to adopt these technologies. Some states have begun reimbursing for telehealth services, but widespread reimbursement will be necessary for these technologies to truly transform home healthcare. The future of home health monitoring depends on resolving the conflict between providers wanting to invest in new technologies and payers refusing to pay until technologies are proven effective.
This report summarizes findings and recommendations from a leadership panel on traumatic brain injury (TBI) among current and former U.S. military personnel. The panel was formed in response to legislation requiring the CDC, NIH, DoD, and VA to improve data collection on TBI prevalence and incidence in the military. The report aims to raise awareness of military-related TBI as a public health issue, improve TBI surveillance efforts, and strengthen collaboration between agencies on diagnostic tools, treatments and rehabilitation. It provides an overview of TBI-related programs and research at each agency and makes recommendations on better measuring the health and socioeconomic impact of TBI in this population.
Syn cing chronic disease advocacy greewaldhealthhiv
The document discusses health care reform opportunities and challenges for people living with HIV/AIDS. It outlines the current access to care crisis, including high rates of uninsured individuals with HIV/AIDS and limited Medicaid access in most states. It then describes major opportunities created by health care reform, such as expanded Medicaid eligibility, enhanced Medicaid care coordination, increased access to Medicare prescription drugs, private insurance market reforms, and new investments in prevention and care delivery. Finally, it discusses key challenges in ensuring these opportunities translate into real benefits for people with HIV/AIDS.
Socio economic differentials in health care seeking behaviour and out-of-pock...Alexander Decker
This study examined health care utilization patterns and out-of-pocket expenditures for outpatient services in Madina Township, Ghana. The study found that only 27.5% of households were enrolled in Ghana's National Health Insurance Scheme. Insured patients experienced longer wait times at facilities compared to non-insured patients. Despite the financial protection of insurance, poorer households still incurred significant costs for health care. Household characteristics such as perceived quality, illness severity, and proximity influenced choice of health services used. Socioeconomic status continued to impact health care choices even with the introduction of health insurance. Efforts are needed to improve enrollment in insurance as well as address other barriers to access in order to maximize the benefits of Ghana's health insurance
Entry Point Mapping: A Tool to Promote Civil Society Engagement on Health Fin...HFG Project
ivil society organizations (CSOs), particularly those working in the health sector, frequently seek opportunities to influence public health policy or share feedback on the quality or accessibility of health services. While these organizations may have important contributions to make, they often are not aware of the most effective and accessible entry points to use. Entry Point Mapping provides a methodology for systemic review and identification of mechanisms, forums and public platforms by which civil society organizations can participate in health sector policy formulation, program implementation, and oversight.
This paper presents an Entry Point Mapping Tool designed for CSOs with advocacy experience and public health officials seeking to expand civil society participation and contains a step-by-step guide for researching and analyzing legal entry points for civil society participation in governance of public health care facilities. Because CSOs have varied interests, the tool includes a series of steps for individual CSOs to determine the level of government at which to pursue their specific advocacy interest and the process of collecting targeted information on legally required points of entry for their civic engagement.
In addition, the Entry Point Mapping Tool offers guidance on analyzing the effectiveness on these entry points and coaches CSOs through the negotiation process of activating or expanding existing entry points, creating new ones, and winning overall collaboration with health officials on improving health policy and service delivery. This tool also documents the experience of CSOs implementing the entry point mapping methodology in Bangladesh and Cote d’Ivoire to demonstrate how the tool can promote increased civil society engagement on issues of health finance and governance.
This document describes a research project to develop an emergency data collection system to track humanitarian needs during natural disasters and complex emergencies. The research was conducted during an emergency response to the 2015 Nepal earthquake. The project involved: (1) analyzing patient diagnoses to understand health conditions, (2) studying existing reporting mechanisms to identify improvements for informing decision-makers, and (3) exploring how collected data can create a more complete picture of the situation on the ground. The goal is to enable data-driven humanitarian interventions through comprehensive data collection, analysis and dissemination across all response phases.
Reimagining care ensuring access to care during a pandemic and beyondCompliatric
This webinar from NACHC provided information and resources for health centers to ensure access to coverage during the COVID-19 pandemic and beyond. Speakers from health centers in Kentucky, Pennsylvania, and Massachusetts discussed their experiences transitioning outreach and enrollment efforts to virtual platforms in response to the pandemic. They shared workflows for conducting remote assistance by phone and strategies for effective communication, documentation, and follow up. The webinar also provided an overview of Medicaid policy changes in response to COVID-19 and information on upcoming learning opportunities from NACHC.
The document discusses a compliance review initiative conducted by the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) at 12 hospitals in cities most impacted by HIV/AIDS. The review examined how the hospitals ensure equal access, language access, and privacy of health information for people living with HIV/AIDS. OCR found that while all hospitals had some policies to promote access and protect privacy, some opportunities for improvement existed. OCR provided technical assistance and the report identifies additional steps hospitals can take to protect civil rights and privacy for people living with HIV/AIDS.
This document summarizes key points from a policy briefing about the Affordable Care Act and Ryan White program. It discusses ACA milestones including Medicaid expansion and health insurance exchanges. It notes that some states like Pennsylvania may not expand Medicaid. The briefing also covers the potential impacts of sequestration cuts and upcoming advocacy events regarding appropriations for HIV/AIDS programs.
The USAID Health Finance and Governance project, led by Abt Associates, works with developing countries to expand access to healthcare. It helps countries increase domestic health funding, manage resources effectively, and make wise purchasing decisions. The project provides technical assistance in over 40 countries on improving health financing, governance, management systems, and measuring universal health coverage progress.
Presentation - The Future of Home HealthC Sam Smith
"Instead of it being described as home healthcare, in a few years the services performed by home health care agencies will simply be known as "modern healthcare".
-Dr. Steve Landers, VNA Health Group, New Jersey
This qualitative overview of the Open Health Data initiatives is meant to showcase the importance of open health data, social as well as economic impacts across US, UK and a select set of Western European countries. This overview is not meant to be a comprehensive report on all the global initiatives, funding models and tracking of open health data. There are tremendous efforts across the globe to change our global healthcare system and we believe that open health data is one of the keys to bridge the gap between digital citizens & governments. Also, please note that if your country, initiative or product was not mentioned, it is in no way meant to diminish the impact of the efforts. Please feel free to share, discuss and contribute to the list of ongoing efforts and initiatives on one of our global communities or on openhealthdata.org.
The 2021 Guide to Fully Integrating Telehealth and Eliminating No-ShowsMichael Dillon
Telehealth is here to stay! Easily integrate it with your practice and reduce administrative overhead and patient no-shows.
A Must Read Guide to Eliminating No Shows in Healthcare Organizations.
Us Helping Us is a nonprofit organization committed to improving health and well-being of Black gay men and reducing HIV/AIDS impact in the Black community. It began as a self-help group for HIV+ Black gay men and has expanded to serve gay/bisexual men, heterosexual men and women, transgender persons, and youth. Services include mental health, HIV testing, health screenings, case management, support groups, and HIV prevention. Opportunities exist to expand volunteer programs, attract physician volunteers, pursue new funding sources, and strengthen collaborations to further serve clients.
There are two kinds of fools: those who can't change their opinions and those who won't.
- Josh Billings
Never tell a fool that he is a fool. All you'll have is an angry fool.
- The Talmud
STRATEGIC_PLANNING_FOR_THE_VANDERBURGH_COUNTY_HEALTH_DEPARTMENTChristina Miller
The strategic plan document provides an overview of the Vanderburgh County Health Department, including its organizational structure, mission and vision, SWOT analysis, and recommendations to address strategic issues related to adult smoking, obesity/diabetes, sexually transmitted diseases, meth use, and lead poisoning. It summarizes county health data and rankings, identifies areas for improvement in essential public health services, and analyzes challenges and opportunities for the health department.
A poll found that while almost half of metro area residents take supplements to prevent colds and flu, 39% of those supplement takers have not received the flu shot. The flu shot is considered the best preventive method against flu, whereas benefits of supplements have not been proven. Vitamin C is the most popular supplement taken, with 85% of supplement takers reporting its use to prevent colds and flu. However, nearly a third of supplement takers do not inform their doctors about supplement use.
A single-payer healthcare system would cause further inefficiencies and be an economic burden for the United States. While increasing access to care, a single-payer system would lead to longer wait times like in Canada where 27% of people wait over 4 months for procedures compared to only 5% in the US. It would also decrease quality of care as seen in Canada where doctors are overworked and underpaid. Implementing such a system would require a tax increase of over 150% which would cripple the US economy, as seen when Vermont explored a single-payer plan. Competition in healthcare markets leads to lower costs and higher quality unlike a single-payer system, making it a step backwards for US healthcare.
Global Medical Cures™ | Community Strategies for Preventing CHRONIC DISEASESGlobal Medical Cures™
Global Medical Cures™ | Community Strategies for Preventing CHRONIC DISEASES
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
Bayhealth, the second largest healthcare system in Delaware, lacks mental health services despite mental illness being a major driver of healthcare costs in the state. A strategic plan is proposed to address this unmet need and increase Bayhealth's market share. The strategic plan would leverage Bayhealth's size and location in central and southern Delaware to expand into the mental health market, where over 50% of those with mental illness do not receive treatment currently. The plan aims to strengthen Bayhealth's position relative to its main competitor, Christiana Healthcare, while improving access to care for Delaware residents and fulfilling Bayhealth's mission.
The document discusses emerging home health monitoring technologies that promise to enhance care for aging patients and reduce healthcare costs through remote patient monitoring. However, reimbursement from Medicare and other payers has not kept pace, posing financial challenges for healthcare providers looking to adopt these technologies. Some states have begun reimbursing for telehealth services, but widespread reimbursement will be necessary for these technologies to truly transform home healthcare. The future of home health monitoring depends on resolving the conflict between providers wanting to invest in new technologies and payers refusing to pay until technologies are proven effective.
This report summarizes findings and recommendations from a leadership panel on traumatic brain injury (TBI) among current and former U.S. military personnel. The panel was formed in response to legislation requiring the CDC, NIH, DoD, and VA to improve data collection on TBI prevalence and incidence in the military. The report aims to raise awareness of military-related TBI as a public health issue, improve TBI surveillance efforts, and strengthen collaboration between agencies on diagnostic tools, treatments and rehabilitation. It provides an overview of TBI-related programs and research at each agency and makes recommendations on better measuring the health and socioeconomic impact of TBI in this population.
Syn cing chronic disease advocacy greewaldhealthhiv
The document discusses health care reform opportunities and challenges for people living with HIV/AIDS. It outlines the current access to care crisis, including high rates of uninsured individuals with HIV/AIDS and limited Medicaid access in most states. It then describes major opportunities created by health care reform, such as expanded Medicaid eligibility, enhanced Medicaid care coordination, increased access to Medicare prescription drugs, private insurance market reforms, and new investments in prevention and care delivery. Finally, it discusses key challenges in ensuring these opportunities translate into real benefits for people with HIV/AIDS.
Socio economic differentials in health care seeking behaviour and out-of-pock...Alexander Decker
This study examined health care utilization patterns and out-of-pocket expenditures for outpatient services in Madina Township, Ghana. The study found that only 27.5% of households were enrolled in Ghana's National Health Insurance Scheme. Insured patients experienced longer wait times at facilities compared to non-insured patients. Despite the financial protection of insurance, poorer households still incurred significant costs for health care. Household characteristics such as perceived quality, illness severity, and proximity influenced choice of health services used. Socioeconomic status continued to impact health care choices even with the introduction of health insurance. Efforts are needed to improve enrollment in insurance as well as address other barriers to access in order to maximize the benefits of Ghana's health insurance
Entry Point Mapping: A Tool to Promote Civil Society Engagement on Health Fin...HFG Project
ivil society organizations (CSOs), particularly those working in the health sector, frequently seek opportunities to influence public health policy or share feedback on the quality or accessibility of health services. While these organizations may have important contributions to make, they often are not aware of the most effective and accessible entry points to use. Entry Point Mapping provides a methodology for systemic review and identification of mechanisms, forums and public platforms by which civil society organizations can participate in health sector policy formulation, program implementation, and oversight.
This paper presents an Entry Point Mapping Tool designed for CSOs with advocacy experience and public health officials seeking to expand civil society participation and contains a step-by-step guide for researching and analyzing legal entry points for civil society participation in governance of public health care facilities. Because CSOs have varied interests, the tool includes a series of steps for individual CSOs to determine the level of government at which to pursue their specific advocacy interest and the process of collecting targeted information on legally required points of entry for their civic engagement.
In addition, the Entry Point Mapping Tool offers guidance on analyzing the effectiveness on these entry points and coaches CSOs through the negotiation process of activating or expanding existing entry points, creating new ones, and winning overall collaboration with health officials on improving health policy and service delivery. This tool also documents the experience of CSOs implementing the entry point mapping methodology in Bangladesh and Cote d’Ivoire to demonstrate how the tool can promote increased civil society engagement on issues of health finance and governance.
This document describes a research project to develop an emergency data collection system to track humanitarian needs during natural disasters and complex emergencies. The research was conducted during an emergency response to the 2015 Nepal earthquake. The project involved: (1) analyzing patient diagnoses to understand health conditions, (2) studying existing reporting mechanisms to identify improvements for informing decision-makers, and (3) exploring how collected data can create a more complete picture of the situation on the ground. The goal is to enable data-driven humanitarian interventions through comprehensive data collection, analysis and dissemination across all response phases.
Reimagining care ensuring access to care during a pandemic and beyondCompliatric
This webinar from NACHC provided information and resources for health centers to ensure access to coverage during the COVID-19 pandemic and beyond. Speakers from health centers in Kentucky, Pennsylvania, and Massachusetts discussed their experiences transitioning outreach and enrollment efforts to virtual platforms in response to the pandemic. They shared workflows for conducting remote assistance by phone and strategies for effective communication, documentation, and follow up. The webinar also provided an overview of Medicaid policy changes in response to COVID-19 and information on upcoming learning opportunities from NACHC.
The document discusses a compliance review initiative conducted by the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) at 12 hospitals in cities most impacted by HIV/AIDS. The review examined how the hospitals ensure equal access, language access, and privacy of health information for people living with HIV/AIDS. OCR found that while all hospitals had some policies to promote access and protect privacy, some opportunities for improvement existed. OCR provided technical assistance and the report identifies additional steps hospitals can take to protect civil rights and privacy for people living with HIV/AIDS.
This document summarizes key points from a policy briefing about the Affordable Care Act and Ryan White program. It discusses ACA milestones including Medicaid expansion and health insurance exchanges. It notes that some states like Pennsylvania may not expand Medicaid. The briefing also covers the potential impacts of sequestration cuts and upcoming advocacy events regarding appropriations for HIV/AIDS programs.
The USAID Health Finance and Governance project, led by Abt Associates, works with developing countries to expand access to healthcare. It helps countries increase domestic health funding, manage resources effectively, and make wise purchasing decisions. The project provides technical assistance in over 40 countries on improving health financing, governance, management systems, and measuring universal health coverage progress.
Presentation - The Future of Home HealthC Sam Smith
"Instead of it being described as home healthcare, in a few years the services performed by home health care agencies will simply be known as "modern healthcare".
-Dr. Steve Landers, VNA Health Group, New Jersey
This qualitative overview of the Open Health Data initiatives is meant to showcase the importance of open health data, social as well as economic impacts across US, UK and a select set of Western European countries. This overview is not meant to be a comprehensive report on all the global initiatives, funding models and tracking of open health data. There are tremendous efforts across the globe to change our global healthcare system and we believe that open health data is one of the keys to bridge the gap between digital citizens & governments. Also, please note that if your country, initiative or product was not mentioned, it is in no way meant to diminish the impact of the efforts. Please feel free to share, discuss and contribute to the list of ongoing efforts and initiatives on one of our global communities or on openhealthdata.org.
The 2021 Guide to Fully Integrating Telehealth and Eliminating No-ShowsMichael Dillon
Telehealth is here to stay! Easily integrate it with your practice and reduce administrative overhead and patient no-shows.
A Must Read Guide to Eliminating No Shows in Healthcare Organizations.
Us Helping Us is a nonprofit organization committed to improving health and well-being of Black gay men and reducing HIV/AIDS impact in the Black community. It began as a self-help group for HIV+ Black gay men and has expanded to serve gay/bisexual men, heterosexual men and women, transgender persons, and youth. Services include mental health, HIV testing, health screenings, case management, support groups, and HIV prevention. Opportunities exist to expand volunteer programs, attract physician volunteers, pursue new funding sources, and strengthen collaborations to further serve clients.
There are two kinds of fools: those who can't change their opinions and those who won't.
- Josh Billings
Never tell a fool that he is a fool. All you'll have is an angry fool.
- The Talmud
The Office of Hawaiian Affairs (OHA) requests that the State of Hawaii prioritize collecting and reporting disaggregated data on Native Hawaiians relating to the COVID-19 pandemic. Specifically, OHA asks for disaggregated data from the Departments of Health, Labor and Industrial Relations, and Human Services on topics like COVID-19 cases, unemployment claims, and applications for assistance programs. Disaggregated data is critical to understand how the pandemic is impacting Native Hawaiians and to direct resources most effectively. OHA also requests information on how race data is currently collected by these agencies.
LION ROARS CULTURE - WE ARE A PRIDE
We learn from example, and we can carve out great territories if we keep our pride in mind
Quite simply, to us this means:
- We work as a team and support each other
- We own the problem and solve it
- We value character and each other
- We're a family - together we are strong
Lion Roars Hotels and Lodges
Cape Town, South Africa
Nursing Shortage as a National Healthcare.docx4934bk
The document discusses the issue of nursing shortage as a national healthcare stressor. It describes how nursing shortages negatively impact healthcare organizations by increasing burnout among existing nurses and potentially leading to negligence and malpractice suits. The document also reviews two articles discussing strategies that organizations have implemented to address nursing shortages, such as increasing pay competitiveness. It concludes by discussing the potential positive and negative impacts that further strategies like legislation around nurse staffing could have on healthcare organizations.
The document summarizes several topics related to public health in Iowa:
1) The Iowa Department of Public Health Director Dr. Mary Mincer Hansen recently returned from a trip to China where she formed partnerships with Chinese public health departments to begin collaborating on public health issues.
2) Workgroups have formed following a symposium on preventing obesity to develop a statewide "Iowans Fit for Life" plan targeting nutrition and physical activity for Iowans of all ages.
3) The Iowa Immunization Registry Information System recently marked entering the one millionth patient record, providing immunization histories to share among health care providers.
Barbados 2012-13 Health Accounts ReportHFG Project
This report presents the findings and policy implications of Barbados’ first Health Accounts estimation, conducted for the year April 2012 to March 2013. It captures spending from all sources: the government, non-governmental organizations, external donors, private employers, private insurance companies and households. The analysis presented breaks down spending to the standard classifications, as defined by the System of Health Accounts 2011 framework, namely sources of financing, financing schemes, type of provider, type of activity and disease/health condition.
A house built on a shaky foundation will eventually collapse.
- Toni Payne
The foundation stones for a balanced success are honesty, character, integrity, faith, love and loyalty.
- Zig Ziglar
Think of your local community. What health-related issue current.docxirened6
Think of your local community. What health-related issue currently affects a large number of people within your community? How could research help address this issue? How would you go about obtaining more data on the health-related issue you identified?
This is an opportunity for you to explore the practical application of how to create a plan to obtain data on a health-related topic, specifically in your community. Please respond in first person, share personal experiences to further develop your understanding of how evidence-based practice can affect health-related issues at the community level.
Use as references:
National Center for Health Statistics (NCHS)
- National and state data sets as well as statistic reports. Information about ordering data sets that cannot be downloaded.
CDC Data and Statistics page
- much more than NCHS
CDC WONDER
- WONDER provides a single point of access to a wide variety of reports and numeric public health data.
Agency for Healthcare Research and Quality
- Data and Surveys
Statewide Planning and Research Cooperative System (SPARCS)
- Data dictionaries, documentation and request forms. No searchable data online.
U.S. Census Bureau
,
Current census data including information broken down by state, city, and region.
WHOSIS
-- WHO Statistical Information System
In two different paragraph give your personal opinion to Valencia Matilus and Malika Nelson, them do not need a different referents use the same as them.
Valencia Matilus
In the community in Florida many people are infected by the chronic illness hypertension is a common disease cholesterol, fatigues, and stress. Patients are major risks cardiovascular, stokes, and leading causes of death, respectively in the community. In 2016, 80,722 deaths were caused by high blood pressures. In 2014, high blood pressures were five times more deaths than it was in 2016. Hypertension has referred to high blood pressures. Hypertension is a big major cause of premature death worldwide (Benjamin, 2016).
Hypertension very often had no signs or symptoms. Once the primary care doctor has diagnosed the patient had high blood pressures as a medication. Patients can lower their blood pressures by changing their diet, and exercises. In 2015-2016, in the communities 1/3 patients have controlled high blood pressures. 2017, recent revised guidelines more than one patient have unknown or undiagnosed if they have high blood pressures. In 2016, the total costs directed for high blood pressures were $54.8 billion. It’s projected for the year 2035, the total costs will be reach $221.8 billion. I’ll suggest implementing public health to have more programs to help to reduce the hypertension problems. Healthcare providers have provided more information, have classes for the patient, and show them how to eat, have nutrition in the clinic or private doctor offices to reduce mortality. (Benjanmin, 2016).Florida, adults ages 18-39; 45 to 79, nearly half of patients can .
Côte d’Ivoire Stronger Health Governance to Fight Emerging Health EmergenciesHFG Project
Cote d'Ivoire's Institute National d'Hygiene Publique (INHP) coordinates the country's Ebola response and oversees the prevention, detection, and response to other emerging disease threats. Recently, INHP and the Ministry of Health identified financial control and audit tools as critical components in health emergency preparedness.
Hawaii- Leadership Under Fire - Balancing Governor's Emergency Powers and Gov...CliftonHasegawa1
The summary discusses Hawaii's emergency management laws and the governor's suspension of the public records law during the COVID-19 pandemic. It notes that while lawmakers opposed the suspension, they have not taken direct action to address it. Some lawmakers want to examine the governor's emergency powers more broadly next legislative session. Experts argue Hawaii's laws allow unchecked emergency power and need reforms like legislative checks on indefinite emergency extensions to balance public health responses with civil liberties.
Read the article on the following 2 pages, Fighting HIV a Commu.docxcatheryncouper
Read the article on the following 2 pages, “Fighting HIV a Community at a Time.” , answer the following questions. Please type your answers…complete and thoughtful responses…1/2 page, single spaced minimum.
1. Statistically as many as 20-25% of people who are HIV positive do not know they are infected. Why do people not get tested if they engage in risky behaviors (unprotected sex and/or IV drug use with used needles)? Give reasons and rationales for their decision not to get tested.
2. In 2006 only about half of Washington D.C. residents who were tested positive for HIV saw a doctor about it within 6 months. They are contagious during that time. Again, why would someone who receives a positive diagnosis, not get treatment? Is a diagnosis of HIV different from other STDs? Why or why not?
3. The “test and treat” program in D.C. and the Bronx improved the follow-up of prompt medical care. What are the statistics?
4. At the end of the article, it states the profile of who is most resistant to being tested and treated. What is it about that particular group of people that would make them resistant?
Fighting HIV a Community at a Time Susan Okie, New York Times, Oct. 27, 2009
WASHINGTON- Federal health officials are preparing a plan to study a bold new strategy to stop the spread of the AIDS virus: routinely testing virtually every adult in a community, and promptly treating those found to be infected. The strategy is called “test and treat,” and officials say the two sites for the three-year study will be the District of Columbia and the Bronx--locales with some of the nation’s highest rates of infection with HIV.
The officials emphasize that this is just a first step. The goal is not to measure whether “test and treat” actually works to slow and epidemic, but whether such a strategy can even be carried out, given the many barriers to being tested and getting medical care.
On the path from infection to treatment, “we lose people at every single step,” said Dr. Shannon L. Hader, director of the HIV/AIDS administration at this city’s Department of Health.
As many as 5 percent of the adults in the District of Columbia are infected--a rate Dr. Hader says is comparable with those in West Africa--and one-third to one-half do not even know they harbor the virus. (Nationwide, 20 percent to 25 percent of people who are HIV positive do not know of their infections, according to the federal Centers for Disease Control and Prevention.)
And even when infection is diagnosed, “getting people from the field to the doctor is the hardest component,” said Angela Fulwood Wood, deputy director of Family and Medical Counseling Service, and agency that operates a mobile HIV testing clinic here. Often, she added, someone who has just tested positive “can walk off that day and decide, ‘I’m going to pretend that never happened.’ In 2006, only about half of D.C. reside ...
SAMHSA administrator Pam Hyde outlined plans to dramatically change the agency and the Substance Abuse Prevention and Treatment Block Grant in preparation for health care reform taking full effect in 2014. Key points include:
1) Medicaid will cover many people currently relying on the block grant for treatment, reducing its role. However, an estimated 15 million people will still be uninsured.
2) The block grant will focus more on non-treatment services not covered by Medicaid/insurance, like services for the criminal justice population.
3) SAMHSA is working with CMS and states to determine what each system (block grant, Medicaid, private insurance) should cover for the estimated 6-10 million people newly eligible
SAFEASSIGNCHECKTEST - CSU SAFEASSIGN PLAGIARISM CHECK TOOL
SafeAssign Originality Report Generator III
Shaundreka Lowery
on Sun, Sep 08 2019, 12:04 PM
48% highest match
Submission ID: 5466e2eb-99a4-44e3-9624-2e95c4bca988
Attachments (1)
Case Study 7.docx
1 DESCRIBE A SOCIAL DETERMINANT OF HEALTH IN YOUR
COMMUNITY THAT HAS PRODUCED HEALTH RISKS AND
OUTCOMES.
Addressing the Determinant AIDS
1 DESCRIBE A SOCIAL DETERMINANT OF HEALTH IN YOUR
COMMUNITY THAT HAS PRODUCED HEALTH RISKS AND
OUTCOMES.
Stillwaggon (2000) shows that “HIV/AIDS has developed below diverse conditions
around the world”. For instance, in the industrialized countries, ‘what commenced as
an epidemic amongst guys who have intercourse with men and then needle sharing
drug users, is now increasingly concentrated in negative and marginalized sectors of
the population’. In Africa and South Asia, ‘the AIDS epidemic is nearly entirely
among heterosexual non-drug users. Latin America represents a composite of the
(http://safeassign.blackboard.com/)
Case Study 7.docx
Word Count: 1,194
Attachment ID: 2097172046
48%
Page 1 of 13SafeAssign Originality Report
9/8/2019https://online.columbiasouthern.edu/webapps/mdb-sa-bb_bb60/originalityReportPrint?cours...
industrial and growing worlds both in its monetary overall performance and its HIV
epidemics’. While it is acknowledged that “social determinants of fitness have an
effect on a person’s risk of HIV infection, the velocity with which HIV contamination
will growth to AIDS and a person’s capability to control and live with
HIV/AIDS” (Public Health Agency of Canada, 2006), these social determinants can
be categorized in a wide variety of ways. For instance, as counseled through Pound
stone et al. (2004), these can focus on structural factors, social factors, character
factors and HIV transmission dynamics. To be useful for research, programmatic
and coverage purposes, the categorizations need to add explanatory power to the
conceivable pathways between factors and outcomes, and no longer certainly be a
laundry list of societal aspects. Furthermore, the meaning and relevance of these
determinants may additionally range notably relying on the regional context as. For
this cause we will at the beginning evaluation the social determinants of HIV/AIDS
from a North American (Canada and the USA) unique perspective, and then from an
emerging markets nations perspective.
1 DESCRIBE HOW THE COMMUNITY IS PRESENTLY TACKLING THE
PROBLEM THROUGH THE LOCAL PUBLIC HEALTH DEPARTMENT.
Local health department in our society is a non profit organization. And along with
this local organization some organizations are working same for the prevention of
AIDS and their roles are as follows:
Because of their capacity to more effortlessly provide services to high-risk groups,
non-governmental agencies (NGOs) will play a quintessential function in any
profitable AIDS prevention program.
This webinar discussed how to educate Nurse Practitioners who have completed Community Health Center. Inc’s NP Residency or NPs who have significant experience as a Primary Care Provider on the integration of specialty care for key populations, including:
• HIV care
• Hepatitis C management
• Medication-assisted treatment for opioid use and other substance use disorders
• Sexually transmitted disease (STI) screening and management
• Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex, Asexual (LGBTQIA+) health, including hormone replacement therapy and gender affirming care.
Panelists:
• Charise Corsino, MA, Program Director, Nurse Practitioner Residency Programs, Community Health Center, Inc.
• Marwan Haddad, MD, MPH, AAHIVS, Medical Director, Center for Key Populations, Community Health Center, Inc.
• Jeannie McIntosh, APRN, FNP-C, AAHIVS, Family Nurse Practitioner, Center for Key Populations, Community Health Center, Inc.
This document discusses HIV/AIDS as a global epidemic, providing statistics on infections and deaths. It introduces HATS, an HIV screening software created by Medwiser to increase access to testing through automated processes. HATS streamlines screening, treatment, reporting and can be used on various devices. New York state passed a law requiring routine HIV testing that will help identify infections earlier and improve outcomes. The document argues for increased HIV prevention funding and addresses barriers to testing in emergency rooms. It outlines how partnerships between Medwiser's HATS and other organizations can mutually benefit patients, physicians, payers and public health efforts to address HIV/AIDS.
DHS Analysis of healthcsare sector cyber interdependeciesDavid Sweigert
The document discusses cyber threats facing the healthcare and public health sector. It notes that stolen health data is highly valuable on black markets, selling for 10-20 times more than stolen credit card data. As medical devices become more connected, cyber incidents targeting devices are expected to increase because manufacturers do not prioritize security. The sector faces risks of ransomware, distributed denial of service attacks, and theft of personally identifiable data that could enable medical identity theft.
This document provides an overview of open health data initiatives in the United States, United Kingdom, Austria, Belgium, and France. It highlights several projects in each country that utilize open government health data to create applications, tools, and services. These initiatives aim to improve transparency, spur innovation, and empower citizens and patients. The document also discusses some of the economic and social impacts and challenges of open health data.
Similar to State of Hawaii - COVID-19 Response - Beneath the Tip of the Iceberg - Accountabilty and Responsibility (20)
Excuses kill solutions and dilute passion. Kill excuses before it kills you. Focus is key! Obstacles will always exist on your path, but it's important to remember that it is not these challenges that stop us from becoming the amazing people we can be, it is often our own excuses that stop us. - Vijay Eswaran
Audit success comes from service, not from status. The true standards of audit practice are found within the auditor's character: honesty, integrity, self control and high ethical values. The printed standards are merely guidelines for trying to make the art of auditing into a profession. - Michael L. Piazza
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The rodeo ain't over till the bull riders ride. - Ralph Carpenter
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Two roads diverged in a wood and I - I took the one less traveled by, and that has made all the difference.
- Robert Frost
Sometimes the right path is not the easiest.
- Grandmother Willow
LEADership is the ability to translate vision into reality.
- Warren Bennis
Realize that if a door closed, it's because what was behind it wasn't meant for you.
- Mandy Hale
Hawaii has emerged as a global leader in clean energy policy by being the first state to adopt a 100% renewable energy requirement and commit to the Paris Climate Agreement after the US withdrew. Other states and countries are now following Hawaii's lead on clean energy and climate solutions. Through making Hawaii a model of clean energy progress, it can inspire climate action worldwide to address the global challenges of climate change and COVID-19.
I believe each of us has a mission in life, and that one cannot truly be living their most fulfilled life until they recognize this mission and dedicate their life to pursuing it. - Blake Mycoskie
A mission statement is not something you write overnight. But fundamentally, your mission statement becomes your constitution, the solid expression of your vision and values. It becomes the criterion by which you measure everything else in your life. - Stephen Covey
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Success seems to be connected with action. Successful people keep moving. They make mistakes, but they don't quit.
- Conrad Hilton
The document discusses Hawaii County Mayor Mitch Roth's proposal to publish a list of travelers who are supposed to be quarantining upon arrival to Hawaii Island. The ACLU of Hawaii has concerns about privacy and potential unintended consequences. Roth believes transparency is important for government, but privacy during a health crisis must be balanced. The document provides background on Roth and cites his experience as a former prosecutor.
The Law is a mighty machine. Woe to the unfortunate man who, wholly or in part innocent, becomes entangled in its mighty wheels, unless his innocence is patent or his rescue planned and executed by able counsel. The machine will grind on relentlessly and ruthlessly, and blindfolded justice does not see that the grist is sometimes stained with blood.
- Edward Johnes, Esq.
Inner harmony means knowing yourself, accepting yourself and delighting yourself. Make your body and mind the best friends to give your best, effortlessly, in any area of your life.
- Savitha Hosamane
Michael Jordan:
Some people want it to happen, some wish it would happen, others make it happen.
I've always believed that if you put in the work, the results will come. I don't do things half-heartedly. Because I know if I do, then I can expect half-hearted results.
Talent wins games, but teamwork and intelligence wins championships.
Write your own book instead of reading someone else's book about success. Great moments are born from great opportunities. This is your time. Their time is done. It's over. This is your time. Now go out there and take it!
- Herb Brooks
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To do what nobody else will do, a way that nobody else can do, in spite of all we go through; that is to be a nurse.
- Rawsi Williams
Nurses dispense comfort, compassion, and caring without even a prescription. - Val Saintsbury
The document discusses the issue of graffiti and whether it should be considered art or vandalism. It describes an event at the University of Hawaii where the campus newspaper encouraged students to draw on newsstands, but this led to other objects being tagged as well. While some see graffiti as a form of artistic expression, under Hawaii law it is considered illegal vandalism to mark public or private property without permission. Reports from 2020-2021 indicate the mobile medical clinic van from the University of Hawaii medical school was vandalized multiple times, showing graffiti continues to be a problem. Understanding the root causes and different types of graffiti may help address the issue more effectively.
The document discusses the need for vaccines and exit strategies to end the COVID-19 crisis. It highlights research at the University of Hawaii that shows promise for a COVID-19 vaccine. The vaccine candidate developed by Dr. Axel Lehrer and his team successfully stimulated antibody and immune responses in mice, demonstrating potential to provide protection against SARS-CoV-2. If further research is successful, this could provide a path towards resolving the global pandemic.
It's no secret that the healthcare system needs some work. In fact, it's not really a system at all. It's confusing, it's difficult to navigate, and it's too expensive. When you combine that with some of the demographic trends that you see in our country — the population is getting older, we're experiencing more chronic disease — it gets even more complicated and more expensive. And consumer expectations are changing dramatically as well. So, this creates an opportunity for an organization like ours to lead this digital transformation.
Steve Nelson, CEO
UnitedHealthcare
When a man becomes a fireman his greatest act of bravery has been accomplished. What he does after that is all in the line of work.
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State of Hawaii - COVID-19 Response - Beneath the Tip of the Iceberg - Accountabilty and Responsibility
1. STATE OF HAWAII
COVID-19 SURVEILLANCE - OUTBREAK MANAGEMENT - CONTACT TRACING
BREACH OF THE PUBLIC TRUST
DECEPTION, DECEIT, DERELICTION OF DUTY
DEPRIVATION OF RIGHTS UNDER COLOR OF LAW
_____________________
PREFACE
Lieutenant Governor Josh Green stated to the Senate Special Committee on Covid-19 at an
Informational Meeting, “We can either Contact Trace or Lockdown”. Governor David Ige sided
with Dr. Sarah Park, State Epidemiologist and Dr. Bruce Anderson, Hawaii Department of
Health Director - Lockdown. The following chronology is shared for your review and
evaluation. Given the severity of the situation and pending Congressional Inquiry, information
from the Department of Justice is included.
_____________________
HOW HAWAII BOTCHED CONTACT TRACING AND WHAT IT WILL TAKE TO FIX IT
By Ashley Mizuo, Hawaii Public Radio, AUGUST 11, 2020
<https://www.hawaiipublicradio.org/post/how-hawaii-botched-contact-tracing-and-what-it-will-take-fix-it#stream/0>
CALLING FOR PARK'S RESIGNATION
The state's lack of robust contact tracing is one reason Lt. Gov. Josh Green, an emergency room
physician, called for Park to step down.
“Dr. Park has other priorities and a different philosophy. Her philosophy is very smart as far as
social distancing and decreasing large gatherings. She's very firm on the high risk behaviors in
state,” he said.
But while blaming public behavior for the surging cases and downplaying the importance of
contact tracing, Park at times appeared to be throwing in the towel when it comes to contact
tracing, noting that colleagues in other states have abandoned contact tracing.
“I know what we're capable of and what we're not capable of socially, as far as preventing spread,”
Green said. “She doesn't have that kind of commitment to a program that is necessary to trace and
test everyone.”
The senators and Green want the health department to set up a contact tracing hub at the Hawaii
Convention Center to house the contact tracers.
__________________
STATE DEBATES CONTACT TRACER WORKFORCE TO TRACK CORONAVIRUS
By West Hawaii Today, First Published by Associated Press, AUGUST 12, 2020
<https://www.westhawaiitoday.com/2020/08/12/hawaii-news/state-debates-contact-tracer-workforce-to-track-coronavirus/>
Hawaii is in the midst of a debate over the number of contact tracers needed to locate people who
have had close contact with people who tested positive for the coronavirus, while Democratic Lt.
Gov. Josh Green called for new oversight for the program. Green called for State Epidemiologist
Sarah Park to be removed from management of the state's contact tracing effort.
2. Green said he wants to employ 400 to 500 contact tracers, while estimating the state needs hundreds
more, The Honolulu Star-Advertiser reported Monday.
“WE CAN EITHER CONTACT TRACE OR LOCK DOWN” Green said last Friday
[Emphasis Supplied]
Park did not respond directly to Green's statement. A spokesperson said Park and state Health
Director Bruce Anderson would only answer questions during scheduled news briefings as a result
of their workload, Hawaii Public Radio reported Tuesday.
The State of Hawaii COVID-19 Joint Information Center responded to a request for comment from
the Associated Press with a statement by Democratic Gov. David Ige, which said in part, “I am in
ongoing discussions with DOH leadership on ways to improve our testing and contact tracing
systems and capacity. And we are confident that plans and resources are being put in place to meet
the needs of our community.”
__________________
HAWAII'S CONTACT TRACING EFFORT FALLS SHORT OF NATIONAL STANDARDS
By Stewart Yerton, The Honolulu Civil Beat, AUGUST 12, 2020
<https://www.civilbeat.org/2020/08/hawaiis-contact-tracing-effort-falls-short-of-national-standards/>
In the middle of April, roughly three weeks into stay-at-home orders that eventually would nearly
stop the spread of COVID-19 in Hawaii, public officials, economists and community leaders were
identifying contact tracing as a key element in the state's plan to contain the virus as the economy
reopened.
“This contact tracing is really where the action is,” Hawaii Department of Health Director Bruce
Anderson said at the time.
Now, nearly four months later, with the virus spreading out of control on Oahu, Anderson and State
Epidemiologist Dr. Sarah Park are being increasingly criticized for failing to provide enough
staffing to conduct the tracing necessary to quickly track down and isolate the people who had been
close to those infected with the virus.
Late Monday, the union that represents the public health investigators joined a growing number of
critics when it said it had filed a grievance on behalf of overwhelmed health department workers
who have said there aren’t enough of them to do the job.
That complaint came after a surprise visit to the health department on Friday by Hawaii senators
trying to fact check statements made the previous day by Park. During testimony before the Senate
Special Committee on COVID-19, Park downplayed the importance of contact tracing as a cause of
recent spreading and said the department has 105 active contact tracers and planning to bring on
about 20 more.
Park and Anderson blame the recent surge in cases on the public and the fact that people have
been attending large gatherings and engaging in other risky behavior.
3. But critics including lawmakers and health professionals are increasingly concerned that Park
and Anderson — as well as Gov. David Ige — are dismissing the importance of contact tracers
and haven't acted as quickly as they should have — and said they would — to get that leg of
the response effort solidly in place.
[Emphasis Supplied]
__________________
WE NEED AN ARMY
HIRING OF CORONAVIRUS TRACKERS SEEN AS KEY TO CURBING DISEASE SPREAD
By Maggie Fox, STAT (The Boston Globe), APRIL 13, 2020
<https://www.statnews.com/2020/04/13/coronavirus-health-agencies-need-army-of-contact-tracers/>
Combined with more widespread testing, contact tracing is seen as an essential part of the
strategy for keeping the coronavirus in check after the first wave recedes and the economy
reopens.
Hong Kong and South Korea “didn't do so much of physical distancing by shutting down
whole cities and whole regions. They did more in the way of using testing data and contact
tracing data to see who should be quarantining themselves or isolating themselves”
Dr. David R. Holtgrave, Dean of the School of Public Health, University at Albany
__________________
IGE URGED TO ORDER DOH TO ACCEPT MORE PANDEMIC HELP
Some think the Hawaii Department of Health is woefully short of people doing contact tracing,
but the department says it has enough staff to handle the short term
By Stewart Yerton and Eleni Avendaño, The Honolulu Civil Beat, MAY 4, 2020
<https://www.civilbeat.org/2020/05/ige-urged-to-order-doh-to-accept-more-pandemic-help/>
When it comes to reopening Hawaii's economy, there's little argument Hawaii's ability to
conduct contact tracing is key.
It's one of the four pillars – along with screening, testing and isolating – that officials have identified
as a prerequisite to lifting stay-at-home orders and eventually opening Hawaii’s economy.
But now there's a growing dispute over whether the state has enough people to do the tracing.
Maj. Gen. Kenneth Hara, who is leading the state's response to the COVID-19 outbreak, said he
would ask Gov. David Ige to order the Department of Health to accept help.
Bruce Anderson, the director of the Hawaii Department of Health, says the department currently has
about 50 staff and 30 volunteers conducting contact tracing — enough, he said, given the relatively
low number of active cases in Hawaii.
“I'm comfortable they can handle the volume of cases today,” Anderson said. “We are training and
have recruited volunteers to help with surge capacity. I'm comfortable with existing staff, at least in
the near term.”
The state official leading the recovery, meanwhile, said he's going to ask Gov. David Ige to
intervene and accept help that’s being offered to boost the department’s ranks.
4. During the weekly meeting of the House Select Committee on COVID-19 Economic and Financial
Preparedness, Maj. Gen. Kenneth Hara, the official in charge of the state's response, said he would
ask the governor to order the health department to accept help from the Hawaii Emergency
Management Agency, which Hara heads. Hara wasn't the only one pointing out that there are
hundreds if not thousands of people available to get training and help, including people with health
care experience.
Dr. Mark Mugiishi, the chief executive of Hawaii Medical Service Association who is on the House
Select Committee, said the head of the University of Hawaii's nursing school had offered several
hundred nursing students to help.
Carl Bonham, executive director of the University of Hawaii Economic Research Organization, said
there are thousands of out-of-work health care workers with at least some medical training who
could be hired to help.
“We just have to take it to the Department of Health to see if they’ll accept the help,” Mugiishi said.
In a news conference following the House meeting, Ige downplayed any tensions between
Hara's agency and the health department. He said health officials were not “pushing back.” “I
think it’s a misunderstanding. It's not pushing back as much as the acknowledgment that we
do have the personnel we need to handle the current case count,” Ige said. “General Hara has
been very active in planning for the worst case scenario.
__________
HEAD OF STATE EMERGENCY RESPONSE SAYS HEALTH DEPARTMENT
DRAGGING FEET ON EXPANDING CONTACT TRACING
By Ryan Finnerty, Hawaii Public Radio, May 5, 2020
<https://www.hawaiipublicradio.org/post/head-state-emergency-response-says-health-department-dragging-feet-expanding-contact-tracing#stream/0>
Contact tracing is universally regarded as critical in safely relaxing pandemic-induced lockdowns.
But Hawaii officials publicly disagree over how much tracing capacity is needed.
The process of contact tracking involves identifying and reaching anyone who may have come into
close proximity with a COVID-19 positive individual. The goal is to locate others who may have
become infected and either test or direct them to isolate.
Some senior officials in the Hawaii's recovery task force are now publicly agitating for the state
health department to significantly expand the number of tracers available. Major General Kenneth
Hara, Adjutant General of the Hawaii National Guard and head of the Hawaii Emergency
Manangement Agency, serves as the governor's emergency response lead. He says authorities need
to build that tracing capacity now, rather than waiting for a spike in cases.
“To be responsive, we need to anticipate needs. We need to organize, equip, and train the people, so
that when we need it, we're there,” Hara said.
Hara told a state House of Representative committee on Monday that he is frustrated by the health
department's lack of action to further expand the contact tracing program.
5. Hara offered to provide National Guard soldiers, many of whom are trained doctors, nurses, and
EMTs to help, but the health departmrnt has apparently not taken up on his offer. “We're all aligned.
It's just kind frustrating trying to convince DOH that its important,” Hara said to the committee.
Hara added that he had spoken with Gov. David Ige over the weekend and asked the governor to
personally intervene, possibly with an official order. But at a press conference later in the day, Ige
said the situation was a misunderstanding. When asked about Hara's comments, Ige stated that there
are adequate resources to handle the current outbreak.
“We do have the personnel we need for the current case count. General [Hara] has been very active
in planning for the worst case scenario, where we see hundreds of cases [per day], rather than the
one or two or 10 we're seeing now,” Ige said.
__________
COVID-19 CASE INVESTIGATION AND CONTACT TRACING
CONSIDERATIONS FOR USING DIGITAL TECHNOLOGIES
ASTHO and In-Q-Tel, Inc. (IQT), JULY 2020
<https://www.astho.org/ASTHOReports/COVID-19-Case-Investigation-and-Contact-Tracing-Considerations-for-Using-Digital-Technologies/07-16-20/>
As communities relax stay-at-home orders and ramp up testing, the public health system is seeing
increases in COVID-19 cases.
Until vaccines are broadly available, the primary ways of preventing transmission of COVID-19
include interventions such as case investigation, contact tracing, social distancing, and isolation and
quarantine.
Case investigation and contact tracing are well-established public health functions that have been
implemented for many diseases like Ebola, sexually transmitted infections (STIs), and tuberculosis.
However, the scale and speed needed for COVID-19 is unprecedented.
An extensive and swift expansion of the case investigation and contact tracing workforce—paired
with continuous evaluation to ensure effectiveness—is needed to adequately respond to rising
caseloads and rapid investigation cycles. To complement this time-tested, workforce-based solution,
technology companies have been engaging with various public health experts to develop new tools
that could aid in COVID-19 response efforts. Public health officials may choose to incorporate
solutions that can augment and support case investigation and contact tracing while also protecting
privacy.
There are a wide range of technology options that can be used to support discrete steps involved in
case investigation and contact tracing, including those that provide capabilities for exposure
notification, digital surveys, telemedicine, symptom tracking, testing and care coordination options,
and “customer” relationship management.
However, no single technology solution covers all functions required for case investigation and
contact tracing. Taking full advantage of technology options may require layering and linking
multiple technologies across the case investigation and contact tracing workflows.
6. State public health governance structures vary across the nation, with over half of states reporting
decentralized governance, meaning local government employees hold primary authority over local
health units. Close to 30 percent of states report a centralized structure in which state employees
primarily lead local health units, with the remainder of states reporting shared and mixed
governance structures.
The range of governance structures can influence or dictate how public health decisions are made
and services delivered—the impact of which is evident during the domestic response to COVID-19.
Traditional case investigation and contact tracing can take weeks to carry out. COVID-19 modeling
studies, however, have shown that faster contact tracing is needed to curb the spread of infection.
Transmission models suggest that contact tracing must be highly effective (i.e., more than 70% of
contacts traced) and leverage technology to facilitate instant contact notification in order to contain
the epidemic.
Data technologies, advanced analytics, and mobile devices can potentially be leveraged as force
multipliers for speed and scale in case investigation and contact tracing. As seen in South Korea,
Singapore, and China, technology tools can be deployed to facilitate contact tracing with varying
outcomes. Several other countries are exploring the use of a range of technologies with a strong
focus on proximity sensing and exposure notification capabilities.
There is a range of technology that can be used to support the steps involved in case investigation
and contact tracing. Notably, no single technology option spans across the full range of steps
involved in case investigation, contact tracing, care coordination, or team coordination. Rather,
taking full advantage of technology options may require layering multiple technologies across the
full range of work functions.
Though a wide array of technology options are being developed and piloted across jurisdictions,
models of technology enabled contact tracing are nascent, and decision-makers must consider issues
related to privacy and consent, stakeholder and community engagement, and operational issues.
Because no single technology option addresses the full arc of functionalities required for rapid and
scaled up case investigation and contact tracing, layering multiple technologies may be required to
take full advantage of digital options to support this work.
To improve effectiveness and outcomes, standards for evaluating data technologies should be
established and evolved based on lessons learned. Case investigation and contact tracing
technologies should be assessed to ensure they accomplish their intended function and protect data
appropriately.
The CDC has developed preliminary criteria for evaluating digital contact tracing tools,15 and
ongoing engagement from the public and private sector is required to develop and refine evaluation
standards.
* ASTHO is the national nonprofit organization representing the public health agencies of the
United States, the U.S. territories and freely associated states, and the District of Columbia, as well
as the more than 100,000 public health professionals these agencies employ. ASTHO members, the
chief health officials of these jurisdictions, are dedicated to formulating and influencing sound
public health policy and to ensuring excellence in public health practice.
7. * In-Q-Tel, Inc. (IQT) is the not-for-profit strategic investor that accelerates the development and
delivery of cutting-edge technologies to U.S. government agencies that keep our nation safe. IQT
was established in 1999 with a distinct mission: to identify and partner with startup companies
developing innovative technologies that protect and preserve our nation's security
__________
CONTACT TRACING FOR COVID-19
SUMMARY OF COVID-19 SPECIFIC PRACTICES
National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases
UPDATED JULY 22, 2020
<https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/contact-tracing.html>
Contact tracing will be conducted for close contacts (any individual within 6 feet of an infected
person for at least 15 minutes) of laboratory-confirmed or probable COVID-19 patients.
Remote communications for the purposes of case investigation and contact tracing should be
prioritized; in-person communication may be considered only after remote options have been
exhausted.
Testing is recommended for all close contacts of confirmed or probable COVID-19 patients.
Those contacts who test positive (symptomatic or asymptomatic) should be managed as a
confirmed COVID-19 case.
Asymptomatic contacts testing negative should self-quarantine for 14 days from their last
exposure (i.e., close encounter with confirmed or probable COVID-19 case).
__________
HAWAII GOV. DAVID IGE CALLS OUT SENATORS
FOLLOWING DEPARTMENT OF HEALTH
CONTACT TRACING TOUR
By Dan Nakaso, The Honolulu Star Advertiser, AUGUST 16, 2020
<https://www.staradvertiser.com/2020/08/16/hawaii-news/ige-calls-out-senators-following-doh-contact-tracing-tour/>
Gov. David Ige has admonished Senate President Ron Kouchi after members of the Senate
Special Committee on COVID-19 toured the Health Department on Aug. 7 to review contact tracing
operations at the invitation of the state epidemiologist — but apparently without enough advance
notice. Ige wrote to Kouchi on Tuesday. “Committee members ignored the security protocols
and made their way into an area where contact tracing activities involving sensitive, protective
health information were ongoing.”
State Sen. Jarrett Keohokalole, a member of the Senate Special Committee on COVID-19,
called Ige's letter both inaccurate and “petty”. “People are dying and the governor's response
speaks for itself,” Keohokalole said Saturday. “This is a crisis and this is where his (Ige's)
focus is?”
8. In his response to Ige, Kouchi wrote: “Your demand that I 'ensure' that legislators 'should
never again' appear unannounced at another 'state department' in order to ‘protect and
support our public servants' rings hollow because your administration has previously
condoned unannounced department visits by legislators, i.e., when members of the House of
Representatives, including Speaker Scott Saiki, Representatives Sylvia Luke and news media, went
to the Department of Labor and Industrial Relations (DLIR) unannounced, toured DLIR and spoke
with employees and Director Scott Murakami about DLIR's inability to timely address and process
unemployment claims.”
In a phone interview with the Honolulu Star-Advertiser on Saturday, Kouchi said some of the
concerns expressed in Ige's letter “simply weren't true” based on multiple reports from members
of the Senate COVID-19 committee.
Ige gave the impression “they were wandering around unsupervised and interacting with employees,
which would have been inappropriate,” Kouchi said. “They were escorted by Dr. Park and they were
simply going where they were directed.”
Repeatedly pressed to describe the tenor of the exchange between himself and the governor, Kouchi
said: “I would refer to the last paragraph, which is the least interesting: I still stand committed to
work with the governor in the best interest of the people of Hawaii.”
[Emphasis Supplied]
__________
CALIFORNIA CONGRESSWOMAN WANTS ANSWERS ON HAWAII’S VIRUS RESPONSE
EFFORT - THE CHAIRWOMAN OF A CONGRESSIONAL SUBCOMMITTEE ON HEALTH
WANTS TO KNOW DETAILS ABOUT HOW THE STATE SPENT $50 MILLION IN CARES
ACT MONEY AIMED AT TESTING AND TRACING.
By Stewart Yerton, The Honolulu Civil Beat, AUGUST 19, 2020
<https://www.civilbeat.org/2020/08/california-congresswoman-wants-answers-on-hawaiis-virus-response-effort/>
U.S. Rep. Anna Eshoo, who chairs the House Health subcommittee of the Energy and Commerce
Committee, asked Ige for more information on the Hawaii Department of Health's testing and
contact tracing program, including things like how many contact tracing personnel the state has had
on staff each week since the outbreak began.
“As you know, less than two months ago, Hawaii had the lowest number of COVID-19 cases per
capita of any state in the nation,” wrote Eshoo, a California Democrat whose district includes
Silicon Valley. “However, this trend has reversed and now Hawaii has the highest infection rate in
the United States.”
Eshoo's criticisms and demands for transparency echoed those of U.S. Rep. Tulsi Gabbard, who last
week called for the resignations of Hawaii Department of Health Director Bruce Anderson and Dr.
Sarah Park, the state epidemiologist.
“The crisis we face today is a direct result of our state's failed leadership,” Gabbard said in a press
release that cited Eshoo’s letter. “Governor Ige and his team had months to hire, train and deploy a
robust contact tracing team to prevent the very situation we face today.
9. “Months ago we worked in Congress to deliver over $50 million in funding to the state so that they
had the resources to trace, test, and contain future COVID-19 cases. Yet, we have around a dozen
people doing contact tracing today, who are so overwhelmed that they can only reach a small
number of individuals who have contracted COVID-19.”
Gabbard blamed Ige and his staff for dropping the ball on contact tracing and testing and
suggested the state's inaction led to the outbreak Hawaii is currently experiencing.
“If Governor Ige and his team had done what they were supposed to do, we could have prevented
the major outbreak we are experiencing today that has taken more lives and resulted in so many of
our kupuna, families and keiki getting infected and sick,” she said in the statement. “This is a punch
in the gut to Hawaii residents who have sacrificed so much to try to prevent the spread of this virus,
only to see our state leaders failing the people.”
Last week, in a joint press conference with a DOH whistleblower, Gabbard accused Anderson and
Park of lying about the state's capacity to do contact tracing after Jennifer Smith, a Ph.D. virologist
and case investigator for the Department of Health, came forward to say the department's lack of
tracing capacity contributed to a recent surge in cases.
After Smith last week said the department recently had only nine people doing contact tracing on
Oahu, the department in a statement responded that it has about 100 for the state, and continues to
add more. The statement did not respond directly to Gabbard’s statement that Anderson and Park
lied.
Asked about Eshoo's letter at a news conference on Wednesday, Ige said he had not had time to
formulate a full response to the letter but said of the $50 million in CARES Act money, some $2.5
million was being used to train contact tracers from the University of Hawaii and $10 million to
increase testing and surveillance capacity, including systems for data management and lab testing
equipment.
Although public health officials have shifted the blame onto the public for participating in
gatherings that let the virus spread, it appears a lack of contact tracing contributed to
Hawaii's recent surge in cases. For much of May, it appeared the state had all but eliminated the
virus, as the weekly average of new cases hovered at less than two.
The plan was to use extensive testing and tracing to keep the virus in clusters as the economy
opened. As the state prepared to open the local economy in early June, Anderson rebuffed attempts
to provide extra contact tracers and vowed the department would be able to “surge from within” to
ramp up tracing capacity to trace and contain the expected surge in cases.
But that didn't happen. And as Eshoo noted, “From early June through the end of July, your state’s
cases more than tripled to 2,111 confirmed infections, and from July 31 through August 14, the
state’s cases doubled and now stand at 5,042 positive cases.”
Eshoo, whose committee has oversight over public health and quarantine among other health-related
issues, wants detailed information from the Ige administration about the contact tracing program that
has been in place since the COVID-19 outbreak was declared an emergency more than five months
ago.
10. She also wants to know how the state has used federal money aimed at the coronavirus response,
including how much the state has received for testing and contact tracing and how much remains
unspent.
Eshoo also wants the state to provide a plan and timeline for bringing Hawaii's testing and tracing
effort up to national standards.
“Due to the numerous instances of conflicting and false information being released to the
public by your Department of Health regarding the number of contact tracers employed and their
capabilities, what specific actions will you take to restore the integrity of the Department of
Health?” Eshoo asked.
__________
CONGRESS SEEKS ANSWERS ABOUT HAWAII'S CONTACT TRACING, USE OF
FEDERAL FUNDS - HAWAII'S SURGE IN COVID-19 CASES THIS MONTH IS RAISING
QUESTIONS AT THE CONGRESS OF THE UNITED STATES.
THE CHAIRWOMAN OF THE SUBCOMMITTEE OF HEALTH, U.S.
REPRESENTATIVE ANNA ESHOO, WANTS ANSWERS
KITV NEWS, AUGUST 19, 2020
<https://www.kitv.com/story/42518350/congress-seeks-answers-about-hawaiis-contact-tracing-use-of-federal-funds>
Hawaii's surge in COVID-19 cases this month is raising questions at the Congress of the United
States.
The chairwoman of the Subcommittee of Health, U.S. Representative Anna Eshoo, wants answers.
In a letter addressed to Governor David Ige, she says she is concerned over the coronavirus outbreak
and the way Hawaii is handling contact tracing and testing.
She includes questions to “bring greater clarity regarding these issues.” Eshoo questions the
amount of contact tracers and exactly how much of the federal funds was used since receiving the
grant in March.
Hawaii received over $50 million from the CDC solely for the purpose of contact tracing,
purchasing of COVID-19 tests, administration costs and other operations needed to stop the
spread of the virus. Eshoo also wants a response to the Department of Health's whistle
blower's allegations of reporting false information about active contact tracers.
Eshoo requests the governor's complete response by August 28, along with “specific actions” to
“restore the integrity of the Department of Health”.
__________
U.S. HOUSE SUBCOMMITTEE CHAIR QUESTIONS GOVERNOR IGE
ON CONTACT TRACING
By Big Island Video News, AUGUST 19, 2020
<https://www.bigislandvideonews.com/2020/08/19/house-subcommittee-chair-questions-governor-ige-on-contact-tracing/>
U.S. Congresswoman Tulsi Gabbard (D-Hawaii) says another Democratic member of the U.S.
House – California Representative Anna Eshoo, who chairs the House Energy and Commerce
Committee’' Subcomittee on Health – is “demanding answers and transparency from Governor
David Ige about how federal funds designated for contact tracing and testing have been used in
Hawaii.”
11. Gabbard held a news conference last Friday, in which she criticized the Hawaii Department of
Health for its response to the COVID-19 pandemic, and introduced a DOH employee whistleblower
who revealed what is really going on with the State’s contact tracing effort.
__________
MAYOR AGAIN WARNS OF COUNTY RESTRAINTS
HOSPITAL COVID-19 CASES CLIMB TO 45
By Kehaulani Cerizo, The Maui News, AUGUST 20, 2020
<https://www.mauinews.com/news/local-news/2020/08/mayor-again-warns-of-county-restraints/>
As Maui hit a single-day record for COVID-19 cases, Maui County Mayor Michael Victorino again
warned that he will reinstate emergency restrictions if numbers don't improve — this time by
Monday.
“I'm going to say that unless this changes quite drastically quite quickly, rollback will start,”
Victorino said during a news conference Wednesday afternoon. “And we're looking probably at
announcing something no later than Monday.”
Maui recorded a record 20 new cases Wednesday, according to state Department of Health officials.
The state also recorded two more Oahu deaths related to COVID-19. All the while, cases at Maui's
main hospital continued to creep up, with Maui Memorial Medical Center reporting 45 COVID-19
cases — 24 patients and 21 health care workers — on Wednesday, up from 36 on Tuesday.
The hospital surge triggered mass testing of all patients, employees and providers. Tracy Dallarda,
hospital spokeswoman, said Wednesday that the HOSPITAL SO FAR HAS PERFORMED 637
TESTS ON EMPLOYEES, with 602 negative results, 21 positive and 14 pending.
“The purpose of this testing is to understand the prevalence of the virus in our hospital,” Dallarda
said in a statement. “Because our patients, employees and providers are a direct reflection of our
community, it will also provide a valuable estimate of viral incidence on Maui and help identify
symptomatic and asymptomatic individuals and allow us to further isolate, quarantine and limit
further transmission.”
Dallarda has said the surge at the hospital is a reflection of spikes around the state and that
many MMMC cases are community spread.
Dr. Lorrin Pang, state Department of Health Maui District health officer, said at the news
conference, that because the virus is prevalent throughout the community, it's difficult to tell
whether MMMC health care workers contracted COVID-19 outside or inside of the hospital.
When clusters have popped up on Maui, such as at a hot yoga class, a bachelor party or out-of-state
travel for a funeral, officials make pleas to the public to change behavior, Pang added. “We say stop
it, change things, don't travel so much,” he said. “But sometimes you can’t quite shut it down. You
can't say shut down the hospital, you can't do that.” He discussed the importance of individual
responsibility and prevention measures, such as physical distancing, wearing face masks and
sanitizing.
12. The Health Department reported that as of late Tuesday afternoon there were 16 people hospitalized
at Maui Memorial with COVID-19. The hospitalization counts on other islands were 163 on Oahu,
six on Hawaii island and two on Kauai. In light of triple-digit surges sweeping over Oahu for weeks,
Gov. David Ige signed the City and County of Honolulu's “Act Now Honolulu” order Wednesday,
which will restrict social indoor and outdoor gatherings to no larger than five people effective at
12:01 a.m. today.
“We can only be successful when we each take personal responsibility . . . stay home, wash hands,
wear masks,” Ige said during a state news conference. “We're focused on unstructured social
gatherings, and the surge we’re seeing is because people let their guard down.” He said that the
Neighbor Islands will remain in the “Act with Care” phase of reopening due to lower case counts.
However, Victorino has cautioned for weeks that rollbacks may be coming if cases average double-
digits over a consistent period of time. He upgraded his warning Wednesday, saying that he will
decide over the next few days whether restrictions are coming.
Asked by The Maui News what rollbacks he's considering, Victorino declined to lay out specifics
but added that he is eyeing uncontrolled social gatherings, such as sporting activities with large
families not wearing masks or social distancing. “I will say if you are in modem of gatherings where
you have large groups of people that are coming together . . . these are the kind of things that make
it really difficult to monitor,” he said. “These are areas I'm looking at first because these seem to be
where many of the outbreaks have begun, in activities where people gather . . . they congregate, they
are not wearing masks, and they're not physical distancing,” Victorino added.
“Beaches? Beach parks? Who knows? “Those are areas that are rising to the top as far as priorities
to be shut down.”
MAUI HOSPITAL CONFIRMS TWO MORE COVID-19 CASES
By Wendy Osher, Maui Now, AUGUST 21, 2020
<https://mauinow.com/2020/08/21/maui-hospital-confirms-two-more-covid-19-cases/>
Maui Health identified two additional positive COVID-19 patients on Thursday, bringing the total
number of infections at the facility since last week Thursday, Aug. 13, to 47. Total infections over
the past eight days include 26 patients and 21 health care workers.
Tracy Dallarda, Communications for Maui Health / Maui Memorial Medical Center said one-
time testing of all patients, employees and providers continues.
“As a reminder the purpose of this testing is to understand the prevalence of the virus in our
hospital. Because our patients, employees, and providers are a direct reflection of our community, it
will also provide a valuable estimate of viral incidence on Maui and help identify symptomatic and
asymptomatic individuals and allow us to further isolate, quarantine, and limit further transmission,”
said Dallarda. Hospital administrators have said the suspected source of infection are index cases of
an employee and a patient, with both appearing to have come from the community.
The newly reported cases since Aug. 13, 2020 are separate from an initial cluster reported earlier
this year.
13. During the first wave of infection, the cluster of individuals linked to the initial Maui Health
outbreak totaled 52 including 38 health care workers and 14 patients who had tested positive,
according to previous reports. That cluster was declared “closed” on May 19, 2020.
The state has reported 236 new COVID-19 cases on Thursday including 230 on Oahu, one on Maui
and five on Hawaii Island. More than 96% of the active cases statewide are on the island of Oahu.
The death of a Lanai man was also reported yesterday by the state Department of Health. He was
40-59 years old with underlying health conditions, and had been hospitalized on Maui. So far there
have been seven COVID-19 related deaths on Maui and 45 in the state over the course of the
pandemic.
Of the 263 cases in Maui County, at least 166 have been released from isolation, and 31 have
required hospitalization. Based on Thursday's numbers, there are 90 active cases in Maui County.
__________
20 AT ROSELANI PLACE TEST POSITIVE HOSPITAL OUTBREAK
GROWS TO 31 PATIENTS, 35 STAFF
By Colleen Uechi, Assistant City Editor, The Maui News, AUGUST 25, 2020
<https://www.mauinews.com/news/local-news/2020/08/20-at-roselani-place-test-positive/>
Eight residents and 12 staff have tested positive for COVID-19 at a senior independent and assisted
living community that’s largely escaped the pandemic until now.
The outbreak at Roselani Place in Kahului that began with a resident in the memory support area
and three staffers had grown to 20 on Monday after a round of testing over the weekend.
Karl Drucks of Paradigm Senior Living, the management company for Roselani Place, said that the
first resident confirmed with the virus had been discharged from Maui Memorial Medical Center
earlier this month. However, because of possible exposure from a family member, it was unclear
where the resident had actually contracted the virus.
Drucks explained that the resident had been admitted to Maui Memorial on JULY 28 for other
medical issues. The patient tested negative upon admission to the hospital and was tested again
on AUG. 12 and AUG. 14, both with negative results.
On AUG. 15, the patient was discharged to Roselani Place. On AUG. 17, a nurse at Roselani
Place was notified of possible exposure from the resident's son; the nurse and the general
manager immediately contacted the state epidemiologist. After the resident's primary physician and
family members were informed, the resident was immediately isolated in a private apartment at
Roselani, with limited staff entry and recommendations to retest the resident every five to six days.
On Wednesday, Maui Memorial informed Roselani's general manager that the resident may
have been exposed as of AUG. 12. Contact tracing and testing found that three of the staff who
had interacted with the resident had caught the virus. Roselani arranged for testing of
remaining staff Sunday.
14. Maui Health spokeswoman Tracy Dallarda said Monday that the patient who left Maui Memorial
for Roselani did not have COVID while in the hospital and tested negative twice upon discharge, a
requirement for placement at another care facility.
The hospital outbreak had grown from 26 patients and 21 workers on Thursday to 31 patients and 35
workers on Monday; the 66 cases have now outpaced the first cluster in April that reached 57 at one
point. Dallarda said that no new cases were reported Monday and that Maui Memorial was currently
caring for 25 positive patients.
Nearly 1,500 COVID-19 TESTS HAVE BEEN CONDUCTED ON MAUI HEALTH
WORKERS since mass testing began AUG. 12.
“Maui Health continues to conduct mass testing and our team of physicians, nurses and other leaders
are committed to doing all we can to prevent viral spread for the health and safety of our patients,
employees, providers and our community,” Dallarda said in a statement.
__________
UNITED STATES DEPARTMENT OF JUSTICE
DEPRIVATION OF RIGHTS UNDER COLOR OF LAW
<https://www.justice.gov/crt/deprivation-rights-under-color-law>
[Emphasis Supplied]
SUMMARY:
Section 242 of Title 18 makes it a crime for a person acting under color of any law to willfully
deprive a person of a right or privilege protected by the Constitution or laws of the United
States.
For the purpose of Section 242, acts under “color of law” include acts not only done by federal,
state, or local officials within their lawful authority, but also acts done beyond the bounds of
that official's lawful authority, if the acts are done while the official is purporting to or
pretending to act in the performance of his/her official duties.
Persons acting under color of law within the meaning of this statute include police officers, prisons
guards and other law enforcement officials, as well as judges, care providers in public health
facilities, and others who are acting as public officials. It is not necessary that the crime be
motivated by animus toward the race, color, religion, sex, handicap, familial status or national origin
of the victim.
The offense is punishable by a range of imprisonment up to a life term, or the death penalty,
depending upon the circumstances of the crime, and the resulting injury, if any.