G-2206-17477

The Hawai’i Public Health Institute (HIPHI) is the state's public health and policy leader. HIPHI also operates the Hawai’i Oral Health Coalition (HOHC). Together, these organizations maintain a platform that provides training, organizing, and other resources to strengthen community voice and enable meaningful change through policy advocacy.

In 2021, after participating in a multifaceted, multi-year campaign that engaged a broad base of community and health leaders across the state, the Hawai’i legislature passed a comprehensive Medicaid adult dental benefit. Diagnostic, preventative, and restorative coverage will now be available to an additional 280,000 low-income Hawai’ians who did not have coverage before. Given the lack of oral health infrastructure in the state, there is a unique opportunity for HIPHI and the HOHC to lead the benefit implementation process and capitalize on the opportunity to explore new models of integrated, person-centered care.

This proposal falls under the Advancing Equity portfolio and the Strengthen Community Voice and State Advocacy subprogram. Given the window of opportunity, the momentum that was built and sustained through the passage of expanded Medicaid benefits, there are three key areas around which HIPHI wants to focus its work this coming year.

First, at the request of the state Medicaid program, HIPHI will step into a facilitative role in which the organization will lead the planning, design, and roll out of the new Medicaid adult dental benefit. This includes assessing fee schedules, reimbursement rates, and communication strategies, as well as creating an opportunity for HIPHI to bring low-income Hawai’ians to the policy table to inform how the benefit should be structured.

Building on its facilitative role, the second area of work involves HIPHI leading an extensive environmental scan that will, for the first time in Hawai’i, assess the network adequacy of Medicaid providers in the state. A report will then be developed and will highlight current and potential workforce capacity and development, policy, community-based services, Medicaid provider infrastructure, access barriers, and utilization. A core part of this environmental scan process will be to spend time with low income and rural communities to ensure their lived experience is being weighed proportionally to the perspective of providers and organizations.

Lastly, in looking towards strengthening future oral health and health systems, HIPHI aims to advance equity in oral health data across the state. In 2021, HIPHI and the HOHC partnered with the state Medicaid agency to develop a statewide oral health data tracker that prioritized 40 indicators. Through this process, it was discovered that Native Hawaiian and Pacific Islander communities are being represented inconsistently, which is impacting data outputs. As a result of this finding, HIPHI will organize and build a platform to bring local cultural organizations together with the state to build a strategy around authentic data representation and data sovereignty that will drive more equitably policy and program decisions.