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FRIDAY, JANUARY 30, 2004

NATIONAL REPORT CRITICIZES HAWAII

FOR LOSING PUBLIC HEALTH SCHOOL

WASHINGTON, D.C. (January 30, 2004) – An assessment of health care in the 50 states, released here today, finds that Hawaii is lagging in the field of public health. The report, which faults Hawaii’s loss of accreditation for its school of public health and its inability to revive the school, appears in the February 2004 issue of Governing magazine.

“Experts agree that schools of public health are vital to building the public health workforce of the future,” says Michele Mariani, co-author of the special issue of Governing. “It’s already difficult to find well-trained public health workers, and state health officers aren’t sure where they’ll find the next generation, if not in public health schools. Hawaii’s ability to cultivate its own public health employees is hurt by its lack of an accredited school.”

Just as several other states were creating much-needed schools of public health, the University of Hawaii’s school was stripped of its accreditation in 2000 after struggling with insufficient funds, lagging enrollment and high turnover rates among faculty and administration positions. As Governing’s report notes, the university’s medical school absorbed some public health programs, while officials worked to rebuild the separate public health school. But that effort has been halted, and officials now say they do not expect a stand-alone school to reopen.

The report emphasizes the labor shortage facing public health. About 500,000 people work in the field, but experts estimate between another 10,000 and 30,000 employees are needed, and large numbers of current employees are expected to retire during the next decade. Schools of public health serve as crucial training grounds for workers entering public health disciplines, and 33 are accredited nationwide.

On the positive side, the report praises Hawaii’s Prepaid Health Care Act, passed in 1974, which makes it the only one of the fifty states that is able to compel its businesses to offer insurance to all employees who work more than 20 hours a week. Other states have been unable to follow Hawaii’s lead here because a federal law called the Employee Retirement Income Security Act (ERISA) was passed in 1974 and placed all employee benefits under the jurisdiction of the federal government and not the states. Hawaii’s law was grandfathered in, but other states no longer had the legal ability to regulate employee health coverage. The mandated coverage has worked well, according to the report’s authors, and is accepted by big businesses, although small businesses continue to complain about the costs.

Governing’s analysis of state-funded health care is part of the Government Performance Project, a six-year-old effort, funded by the Pew Charitable Trusts, to evaluate a wide range of state government management and policy functions. This year’s special report focuses on six critical health care problems facing states: long-term care, public health, mental health, prescription drugs, access to care for the uninsured, and care for children.

The Government Performance Project found and documented the inability of the 50 states’ health care system to deliver improvements in medicine fairly and consistently to many of their citizens. Health care in most states is not just inadequate, the study concluded--it’s deteriorating. “After exhaustive analysis and hundreds of interviews,” says Peter Harkness, Governing’s publisher and editor, “it became clear that there is a health care crisis in America. But it is in no way a medical crisis. It is a fiscal crisis.”

Governing is a policy and management magazine aimed at high-level state and local government officials. An online version of this report will be available at http://www.governing.com/gpp/2004/intro.htm as of January 29. Press releases for each of the 50 states can be found at http://www.governing.com/gpp/2004/press.htm.