Tag Archives: hawaii

Primary care physicians find value-based payments fail to cover their costs

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health reform. He welcomes questions and suggestions and tip sheets at joseph@healthjournalism.org.

It’s hard to imagine any physician starting an online fundraising effort to keep her practice open. But for Michelle Mitchell, M.D., a solo physician who runs Hawaii Family Health, the business model for primary care in her state is unsustainable otherwise.

She wants to raise $250,000 via a GoFundMe page that explains many of the financial problems she and her 15-member staff face running a practice that serves 2,500 patients in Hilo, the capital of the Big Island.   Continue reading

Mother, legislators advocate for more regulation of pediatric dentistry

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

On Jan. 4, Ashley Boyle returned to Kailua Beach to remember her lost child.

The date marked a year and a day since 3-year-old Finley Boyle died. The little girl lapsed into a coma after undergoing a dental procedure, reporter Ben Gutierrez reminded viewers of Hawaii News Now.

A medical examiner’s report found that Finley suffered cardiac arrest after she was given sedatives during a procedure at Island Dentistry for Children in December 2013. She died a month later, on Jan 3, 2014. Continue reading

For Hawaii reporter, scarce nursing home inspections become the story

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The Honolulu Star Advertiser‘s Rob Perez reports that, thanks to cutbacks, Hawaii has failed to meet federal standards for “evaluating the severity” of nursing home complaints in four of the past five years. His two-part investigation (Part 1 | Part 2) is built in part on the back (or, in this case, “lack”) of documents that should be familiar to many AHCJ members: Nursing home inspection reports. For more on how to use these, and related documents, check out AHCJ’s slim guide, Covering the Health of Local Nursing Homes.Covering the Health of Local Nursing Homes

The Centers for Medicare and Medicaid Services, the federal agency that oversees most nursing homes nationally, imposed only one sanction against a Hawaii facility last year, the lowest number among the 50 states, according to CMS data. North Dakota also had just one sanction.

Over the past six years, the agency took enforcement actions against 4 percent of Hawaii institutions that were cited for a certain level of deficiencies, compared with a national average of 30 percent, the data show. Only North Dakota, at 3.5 percent, had a lower percentage. In 2006 and 2007, no Hawaii nursing homes were penalized.

In the first installment, “Hobbled oversight,” Perez shows how far behind the state has fallen when it comes to inspections. The story has already attracted nearly 150 comments. In the second piece, “Abuse goes unpunished at Hawaii’s care homes,” Perez takes a look at the real-world impact of these administrative failures.

Honolulu Advertiser examines nursing homes

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The Honolulu Advertiser put together a multimedia package about nursing home deficiencies that includes text, video,  a questionnaire to help patients and families choose homes, a nursing home databases and inspection reports.kupuna

The package’s second day, which focuses on sanctioning flawed nursing homes, is anchored by Rob Perez’ story on lax enforcement, reinforced by their daily collection of case studies and supplemented by a number of other stories and videos.

Other days focus on flaws in the system, how lobbyists prevail over advocates for the elderly and help in finding a care facility.

Covering the Health of Local Nursing HomesSlim guide: Covering the Health of Local Nursing Homes

This reporting guide gives a head start to journalists who want to pursue stories about one of the most vulnerable populations – nursing home residents. It offers advice about Web sites, datasets, research and other resources. After reading this book, journalists can have more confidence in deciphering nursing home inspection reports, interviewing advocacy groups on all sides of an issue, locating key data, and more. The book includes story examples and ideas.AHCJ publishes these reporting guides, with the support of the Robert Wood Johnson Foundation, to help journalists understand and accurately report on specific subjects.

AHCJ resources

Untold stories remain in nursing homes
More investigations of nursing homes
Aging Nation: Troublesome Health Care Issues
Headlines an advocate for seniors would like to see
The impact of aging upon health care
Covering nursing homes and other issues of aging
How will retiring boomers affect the national health agenda?
You Can Run, but You Can’t Hide: Policy and Problems in Long-Term Care
Biology of Aging: Sources and Resources

Islanders, sick from fallout, are political hot potato

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Writing for the Associated Press, Mark Niesse digs into a dispute between the state of Hawaii, the federal government and chronically ill immigrants from three Pacific nations over who should foot the bill for their health care. At issue is a 1986 treaty that guarantees migration rights and assistance to folks from Micronesia, the Marshall Islands, and Palau and to help compensate for Cold War-era nuclear testing in the Pacific.

Under the treaty, many ill islanders have relocated to Hawaii, which offers better health care and quality of life than they could find in their homelands. They come from populations with “high rates of leukemia and thyroid, lung, stomach, skin and brain cancers,” at least some of which is linked to radioactive fallout from nuclear testing.

Nobody is yet sure where the debate will lead, but Niesse maps out where the battle lines are drawn:

The state of Hawaii sought to save $15 million by cutting health services to more than 7,000 migrants, who are treated as legal residents lacking citizenship. Their ambiguous status, as well as their cost to taxpayers, led to the state’s proposed health reductions.

Both the Hawaii government and the migrants argue that the U.S. government should take responsibility for their health treatments.

But federal Medicaid funding to the migrant islanders was slashed when welfare reform passed in 1996, resulting in Hawaii picking up the tab. U.S. Rep. Neil Abercrombie, a Democrat representing Hawaii, said he is trying to reinstate Medicaid benefits for compact migrants as part of the pending health care legislation.