Maui County
Budget & Finance Committee
Chair Keani Rawlins-Fernandez
Aloha Chair & Council,
I would like to first apologize for an item I spoke on yesterday, April 7, 2021 in which I was not completely informed. I get excited when I see and hear spaces and places and that have Hawaiian connection and I believe I spoke too quickly on this specific item. I would like to retract my support for the change in 3.38.020 and how it relates to improvements of Kamehameha Iki park until I learn more. I have inquiries out and will speak to it before your Budget deliberations come to an end.
First speaking to Fire & Public Safety Budget items, I would like to speak to the appropriation to FEMA in item a.) for $700,000 and b.) for $750,000. I just want to mention that I truly hope these funds have the trickle down effect wherein it reaches the community residents who are in need of aid. As you all are aware, I've been data mining in attempts to understand who is first to lend aid to our residents who are struggling with secure housing. I've unsuccessfully tried to continue conversations on this subject with Mr. Andaya of MEMA. I recently reached out to Red Cross Maui and had learned that 100 tents were generously being sent over from O‘ahu Red Cross. As I inquired further to Red Cross I learned that “the County has decided on a change of distribution”. When I hit this roadblock I again returned to try to find out more from MEMA to no avail. I will state again that I truly hope the appropriated FEMA monies have an honest reach.
I would also like to advantage this agenda item to speak to the emergency needs of the remote most area of Kahikinui. They have had nine serious fires in the last ten years and it must be understood the serious needs of this area. When you call 911 from Hana, Kipahulu, Kaupo and Kahikinui you reach Hawaii island 91 operateors because we dont have a repeater on top of Mauna Kea to correctly direct these calls. It also takes 40 minutes for fire safety officers and trucks to reach Kahikinui from the Kula Fire Station 13. I have learned that a partner organization of the Kahikinui Hawaiian Homelands Association has applied for outside funding to support an 'Adopt A Firebreak'. I would just like to impress that anything the Fire & Public Safety Division can do to support these efforts would bode well for this area that has been lacking services for a long time. This is particularly imporatnt as homesteaders are steadily retuning this area because the Dept. of Hawaiian Homelands sent out strong message to homesteaders that if they do not begin homesteading they may lose their land award. While it has been found that this is actually illegal as it implies an adhesion contract that is not within Prince Kuhio's 1920 Hawaiian Homestead Act, it still has put undue pressure on beneficiaries and there is in fact a growing population in the southwestern area of Kahikinui.
Moving on to Dept. of Housing and Human Concerns budget concerns, I first want to request that page 309 needs a complete rewrite The goals are too vague and reads as though “sweeps” or what has been defined by DHHC and Maui Police Department as “Compassionate Disruption” , are an acceptable goal because it favors the general public in feeling safe that those areas where houseless, homeless, those living in their cars and struggling with safe parking and those struggling with secure housing have had to congregate, are periodically “cleaned”. As I mentioned in Yuki Lei's Upcountry Town Hall, I find this section completely offensive. I won't regurgitate my lengthly testimonies since COVID has started but this section does need a re-approach.
I question item f. Family Self-Sufficiency Coordinator Grant , is this a new position. I'd like to know and understand the exacting job descrition.
In item K. Wherein the Mason Foundation has a $1000 contribution, might I take this opportunity to tell the Department that there is a strong mechanism within the Matson Foundation to secure containers that can be used as tiny homes, might you include this on an inter departmental agenda to perhaps expand upon considering the dier needs of your County.
I would alsolke to better understand DHHC budget item w. Volunteer Center Program. Is this a new position, what does the job description read.
Keani N. W. Rawlins-Fernandez, Chair
Budget and Finance Committee
Aloha Chair Rawlins-Fernandez,
Re: Letter of Support for continued funding from County of Maui for Maui Economic Development Board (MEDB) Programs
I am writing in support of funding that MEDB receives from the County. These funds provide MEDB with the ability to deliver quality programs and services in business and workforce development that seek to improve the quality of life for all our residents. These funds also leverage the other state, federal, and private funding we raise to increase our community reach.
LCHC has worked with MEDB for many years — most recently participating in the Aloha Connects Innovation program. This program and others they provide are critical to expanding opportunities within our community. We encourage the County to continue this funding.
Mahalo,
D M V Shaw, PhD, MPH, MBA, FACMPE
Executive Director
Keani N. W. Rawlins-Fernandez, Chair
Budget and Finance Committee
Aloha Chair Rawlins-Fernandez,
Re: Letter of Support for continued funding from County of Maui, DHHC for Behavioral Health Services
We are in strong Support of the funding allocation for Lanai Community Health Center Behavioral Health Program: $82,610
LCHC thanks County of Maui, Mayor, and Council for continued support of the Lāna’i Community Health Center’s (LCHC) programs. For the past several years, our Health Center has been the recipient of a DHHC line-item award. These funds have made it possible for our Health Center to provide services to all community members seeking health care, especially the un– and under-insured. We continue to utilize DHHC Grant funds to support our behavioral health (BH) program by providing support for our clinical psychologist’s salary—leveraging funds we have received from insurance payments and other grants. We continue to struggle with inadequate insurance payments to cover the full cost of this program. At the same time, we have had to hire additional behavioral health providers to manage the patient load and associated needs.
Our behavioral health (BH) program continues to be heavily utilized by community members — patients of LCHC and also those of Straub — as we provide the only such services on island. A number of our patients do not have coverage for behavioral health services — or the annual number of visits is severely limited. And COVID has erected another barrier — however, LCHC has addressed this barrier by providing BH services via telehealth. We are therefore continuing to reach more patients who are in need of help. And with per capita income for Lāna’i families being $23,826, 29% of the island’s population (42% of LCHC’s patients) at or below 200% poverty level, and 11% of LCHC patients being uninsured, County funding remains a critical component of our program.
In FY2020 we provided services to 110 patients, though somewhat constricted by COVID if patients did not feel comfortable with telemedicine. In FY 2021 (still with COVID restrictions) we have seen 82 patients YTD, and are on track to service at least 123, and continue to see increased service requests. We started with 1.0 FTE BH post-doc fellow; today we have 1.5 FTE BY post-doc fellow and .5 FTE licensed clinical psychologist. While we continue to juggle increased cost associated with our behavioral health FTE complement, we continue to be able to only collect reduced reimbursement from insurance companies for most of our BH providers, as the insurance companies pay less for services provided by post-doc fellows: continued support from the County will be required to support this program.
LCHC continues to supplement its BH program with our University of Hawaii Psychiatry relationship—which utilizes telehealth for psychiatric consultation. With Aloha House no longer providing services on our island (except through a new contract with LCHC), Behavioral Health services provided by LCHC are critical and needed more now than ever. Indeed, LCHC has accepted the State Judiciary contract to provide substance abuse services for adults. And, we also continue to work to establish a relationship with a Psychology training program to develop a workforce pool for our program — as we feel we see the need for additional manpower — pretty much on a continuous basis for the foreseeable future.
Our request for FY2022 is for the County to continue to provide funding for our Behavioral Health Program — paying for direct services — a portion of our BH providers compensation. In addition to providing psychological counseling, our BH providers also support our medical and dental patients by providing integrated behavioral health services and playing an integral part in our wellness and lifestyle program development and management. We continue to seek additional funding streams that we can use to leverage the County’s funding—and have been successful in obtain a bit more federal funding. However, our program’s growth has been faster than our funding growth— which is why we continue to need County funding.
These services continue to be badly needed on our island—and with County support, these services will continue, in spite of all the challenges we face. We ask that you continue to support our program at its current level, $82,610.
Mahalo,
Diana V. Shaw, PhD, MPH, MBA, FACMPE
Executive Director
SUBJ: Lana’i Community Health Center, Behavioral Health Program
I’m a member of the Health Center Board and thank you for the County’s support of the subject Program. As we’ve seen nationwide, this has been a truly stressful year so the Behavioral Health Program has been especially needed.
The community was just fully recovering from the long hotel shutdowns due to renovations when the pandemic hit. Luckily, we’ve only had one large but short-lived COVID outbreak and appreciate the County opening up vaccinations to the community very early. We were also fortunate that our two largest employers continued to pay employees for several months though they weren’t working. Thereafter, people experienced the same problems that were faced elsewhere as incomes shrank and people lined up for food.
Although our isolation helped protect us from COVID, it has cut us off from outlets like seeing friends and relatives in Hawaii and elsewhere, traveling, and spending time on Maui shopping, attending events and eating out. On island, even seeing a movie at the theater is no longer an entertainment option. People worry about health needs, skipping appointments on Oahu due to their fear of COVID and the logistics of traveling.
Like elsewhere, families have had to cope with having the entire family home at once. In many cases, this means several families in a small house due to our housing shortage. (Unrelated to Behavioral Health, we really need money for infrastructure for our affordable housing project.)
So we try to cope, but many are “bust up”. We hope to see the end of the pandemic soon, but I think we will continue to see the increased need for the Behavioral Health Program and would appreciate the County’s support.
Faith Chase
faith@planetserver.com
Maui County
Budget & Finance Committee
Chair Keani Rawlins-Fernandez
Aloha Chair & Council,
I would like to first apologize for an item I spoke on yesterday, April 7, 2021 in which I was not completely informed. I get excited when I see and hear spaces and places and that have Hawaiian connection and I believe I spoke too quickly on this specific item. I would like to retract my support for the change in 3.38.020 and how it relates to improvements of Kamehameha Iki park until I learn more. I have inquiries out and will speak to it before your Budget deliberations come to an end.
First speaking to Fire & Public Safety Budget items, I would like to speak to the appropriation to FEMA in item a.) for $700,000 and b.) for $750,000. I just want to mention that I truly hope these funds have the trickle down effect wherein it reaches the community residents who are in need of aid. As you all are aware, I've been data mining in attempts to understand who is first to lend aid to our residents who are struggling with secure housing. I've unsuccessfully tried to continue conversations on this subject with Mr. Andaya of MEMA. I recently reached out to Red Cross Maui and had learned that 100 tents were generously being sent over from O‘ahu Red Cross. As I inquired further to Red Cross I learned that “the County has decided on a change of distribution”. When I hit this roadblock I again returned to try to find out more from MEMA to no avail. I will state again that I truly hope the appropriated FEMA monies have an honest reach.
I would also like to advantage this agenda item to speak to the emergency needs of the remote most area of Kahikinui. They have had nine serious fires in the last ten years and it must be understood the serious needs of this area. When you call 911 from Hana, Kipahulu, Kaupo and Kahikinui you reach Hawaii island 91 operateors because we dont have a repeater on top of Mauna Kea to correctly direct these calls. It also takes 40 minutes for fire safety officers and trucks to reach Kahikinui from the Kula Fire Station 13. I have learned that a partner organization of the Kahikinui Hawaiian Homelands Association has applied for outside funding to support an 'Adopt A Firebreak'. I would just like to impress that anything the Fire & Public Safety Division can do to support these efforts would bode well for this area that has been lacking services for a long time. This is particularly imporatnt as homesteaders are steadily retuning this area because the Dept. of Hawaiian Homelands sent out strong message to homesteaders that if they do not begin homesteading they may lose their land award. While it has been found that this is actually illegal as it implies an adhesion contract that is not within Prince Kuhio's 1920 Hawaiian Homestead Act, it still has put undue pressure on beneficiaries and there is in fact a growing population in the southwestern area of Kahikinui.
Moving on to Dept. of Housing and Human Concerns budget concerns, I first want to request that page 309 needs a complete rewrite The goals are too vague and reads as though “sweeps” or what has been defined by DHHC and Maui Police Department as “Compassionate Disruption” , are an acceptable goal because it favors the general public in feeling safe that those areas where houseless, homeless, those living in their cars and struggling with safe parking and those struggling with secure housing have had to congregate, are periodically “cleaned”. As I mentioned in Yuki Lei's Upcountry Town Hall, I find this section completely offensive. I won't regurgitate my lengthly testimonies since COVID has started but this section does need a re-approach.
I question item f. Family Self-Sufficiency Coordinator Grant , is this a new position. I'd like to know and understand the exacting job descrition.
In item K. Wherein the Mason Foundation has a $1000 contribution, might I take this opportunity to tell the Department that there is a strong mechanism within the Matson Foundation to secure containers that can be used as tiny homes, might you include this on an inter departmental agenda to perhaps expand upon considering the dier needs of your County.
I would alsolke to better understand DHHC budget item w. Volunteer Center Program. Is this a new position, what does the job description read.
Mahalo for hearing my concerns today,
Faith Chase
Testimony received from BFED Committee.
Keani N. W. Rawlins-Fernandez, Chair
Budget and Finance Committee
Aloha Chair Rawlins-Fernandez,
Re: Letter of Support for continued funding from County of Maui for Maui Economic Development Board (MEDB) Programs
I am writing in support of funding that MEDB receives from the County. These funds provide MEDB with the ability to deliver quality programs and services in business and workforce development that seek to improve the quality of life for all our residents. These funds also leverage the other state, federal, and private funding we raise to increase our community reach.
LCHC has worked with MEDB for many years — most recently participating in the Aloha Connects Innovation program. This program and others they provide are critical to expanding opportunities within our community. We encourage the County to continue this funding.
Mahalo,
D M V Shaw, PhD, MPH, MBA, FACMPE
Executive Director
I support continued funding of Lanai Community Health Center.
Keani N. W. Rawlins-Fernandez, Chair
Budget and Finance Committee
Aloha Chair Rawlins-Fernandez,
Re: Letter of Support for continued funding from County of Maui, DHHC for Behavioral Health Services
We are in strong Support of the funding allocation for Lanai Community Health Center Behavioral Health Program: $82,610
LCHC thanks County of Maui, Mayor, and Council for continued support of the Lāna’i Community Health Center’s (LCHC) programs. For the past several years, our Health Center has been the recipient of a DHHC line-item award. These funds have made it possible for our Health Center to provide services to all community members seeking health care, especially the un– and under-insured. We continue to utilize DHHC Grant funds to support our behavioral health (BH) program by providing support for our clinical psychologist’s salary—leveraging funds we have received from insurance payments and other grants. We continue to struggle with inadequate insurance payments to cover the full cost of this program. At the same time, we have had to hire additional behavioral health providers to manage the patient load and associated needs.
Our behavioral health (BH) program continues to be heavily utilized by community members — patients of LCHC and also those of Straub — as we provide the only such services on island. A number of our patients do not have coverage for behavioral health services — or the annual number of visits is severely limited. And COVID has erected another barrier — however, LCHC has addressed this barrier by providing BH services via telehealth. We are therefore continuing to reach more patients who are in need of help. And with per capita income for Lāna’i families being $23,826, 29% of the island’s population (42% of LCHC’s patients) at or below 200% poverty level, and 11% of LCHC patients being uninsured, County funding remains a critical component of our program.
In FY2020 we provided services to 110 patients, though somewhat constricted by COVID if patients did not feel comfortable with telemedicine. In FY 2021 (still with COVID restrictions) we have seen 82 patients YTD, and are on track to service at least 123, and continue to see increased service requests. We started with 1.0 FTE BH post-doc fellow; today we have 1.5 FTE BY post-doc fellow and .5 FTE licensed clinical psychologist. While we continue to juggle increased cost associated with our behavioral health FTE complement, we continue to be able to only collect reduced reimbursement from insurance companies for most of our BH providers, as the insurance companies pay less for services provided by post-doc fellows: continued support from the County will be required to support this program.
LCHC continues to supplement its BH program with our University of Hawaii Psychiatry relationship—which utilizes telehealth for psychiatric consultation. With Aloha House no longer providing services on our island (except through a new contract with LCHC), Behavioral Health services provided by LCHC are critical and needed more now than ever. Indeed, LCHC has accepted the State Judiciary contract to provide substance abuse services for adults. And, we also continue to work to establish a relationship with a Psychology training program to develop a workforce pool for our program — as we feel we see the need for additional manpower — pretty much on a continuous basis for the foreseeable future.
Our request for FY2022 is for the County to continue to provide funding for our Behavioral Health Program — paying for direct services — a portion of our BH providers compensation. In addition to providing psychological counseling, our BH providers also support our medical and dental patients by providing integrated behavioral health services and playing an integral part in our wellness and lifestyle program development and management. We continue to seek additional funding streams that we can use to leverage the County’s funding—and have been successful in obtain a bit more federal funding. However, our program’s growth has been faster than our funding growth— which is why we continue to need County funding.
These services continue to be badly needed on our island—and with County support, these services will continue, in spite of all the challenges we face. We ask that you continue to support our program at its current level, $82,610.
Mahalo,
Diana V. Shaw, PhD, MPH, MBA, FACMPE
Executive Director
SUBJ: Lana’i Community Health Center, Behavioral Health Program
I’m a member of the Health Center Board and thank you for the County’s support of the subject Program. As we’ve seen nationwide, this has been a truly stressful year so the Behavioral Health Program has been especially needed.
The community was just fully recovering from the long hotel shutdowns due to renovations when the pandemic hit. Luckily, we’ve only had one large but short-lived COVID outbreak and appreciate the County opening up vaccinations to the community very early. We were also fortunate that our two largest employers continued to pay employees for several months though they weren’t working. Thereafter, people experienced the same problems that were faced elsewhere as incomes shrank and people lined up for food.
Although our isolation helped protect us from COVID, it has cut us off from outlets like seeing friends and relatives in Hawaii and elsewhere, traveling, and spending time on Maui shopping, attending events and eating out. On island, even seeing a movie at the theater is no longer an entertainment option. People worry about health needs, skipping appointments on Oahu due to their fear of COVID and the logistics of traveling.
Like elsewhere, families have had to cope with having the entire family home at once. In many cases, this means several families in a small house due to our housing shortage. (Unrelated to Behavioral Health, we really need money for infrastructure for our affordable housing project.)
So we try to cope, but many are “bust up”. We hope to see the end of the pandemic soon, but I think we will continue to see the increased need for the Behavioral Health Program and would appreciate the County’s support.
Thank you for considering this request.