The state is planning how it will spend hundreds of millions of dollars from a new federal Rural Health Transformation Program, and it wants public input.
The program was a compromise in President Donald Trump’s megabill, as the Medicaid cuts are expected to negatively impact rural health systems.
Starting next year, $50 billion will be distributed to states over five years. The funds can be used on different initiatives like improving technology, boosting the health care workforce and increasing preventative care.
Healthcare Association of Hawaiʻi President Hilton Raethel explained that it’s a unique opportunity for the state that will benefit from its smaller population.
"Normally, when money gets allocated, it gets allocated on a per capita basis. So in other words, the more people you have in a state, the higher proportion of the dollars you would get. This particular program doesn't do that," he said.
"So look at Texas, for example, or California, which are both way bigger than Hawaiʻi; they will get the same amount of money or are eligible for the same amount of money that Hawaiʻi is. So that means that, per capita, we in Hawaiʻi get a lot more money."
Although the state is expecting a large amount of money, Raethel explained that it takes a significant amount of administrative work to actually spend it.
That’s why they are considering expanding existing programs like the already established health care worker student loan forgiveness initiative.
" We already have an infrastructure. We already have the contracts. We already have a lot of the pieces in place, and we could just expand that. So that's one of the things we're looking at: are there existing programs that could be expanded or added to? We may have to add some additional staff, buy some equipment, things like that, but it's much easier to do that generally than to start up a program just from scratch," he said.
"We have to find the people to run these programs and do all this work. So the administration and infrastructure involved is a significant challenge when it comes to money of this size and all the requirements that go with this program."
In a written statement, Gov. Josh Green emphasized the need for the federal funds.
"Hawaiʻi’s rural and neighbor island communities deserve access to the same high-quality healthcare as the rest of the nation," Green said.
"By pursuing this federal funding, we have the chance to modernize our rural health infrastructure, expand primary and behavioral health services and support the workforce that cares for our people."
The funds cannot be used to help hospitals pay off debt or help with day-to-day operations.
Hawaiʻi has until Nov. 5 to submit its application to the Centers for Medicare & Medicaid Services. In the meantime, the state is asking for public feedback on projects and needs that could be supported by the funds.
