Change will happen when all citizens are involved, including leaders and employees from government, businesses and nonprofits

This report is one of six reports on CHANGE because Hawai‘i must change its path.

CHANGE stands for six interconnected major issues identified by the Hawai‘i Community Foundation and explored in-depth by Hawaii Business Magazine. Those issues are:

Illustration: Shar Tuiasoa

• Community & Economy
• Health & Wellness
• Arts & Culture
• Natural Environment
• Government & Civic Engagement
• Education

Government leaders, civic-minded citizens and business and nonprofit executives all must help initiate the changes needed in each of these areas. This report focuses on how government and our civic community must improve to help lead those changes.

Like the previous reports, this report is not intended to cover everything about government and civics in Hawai‘i. It examines key issues in-depth and focuses on possible solutions and ways forward.

Why is this business magazine doing these reports? One reason is because businesses and business leaders must be part of the solutions. Government and nonprofits have not been able to solve these problems, so businesses must help.

These reports are part of a multifaced approach to change that was launched at the annual Hawai‘i Executive Conference in October 2018. The conference was led by Hawaii Business Magazine’s owner, Duane Kurisu, and the committees formed there are bringing together business leaders, nonprofit executives and politicians to focus on the major challenges facing our Islands. This is not a one-year effort but a long-term commitment to change from many people.

The six reports published in Hawaii Business Magazine and at hawaiibusiness.com are part of that multifaceted approach. We welcome your feedback on any of the reports: Use the tag #HawaiiforChange on Facebook, Twitter, LinkedIn and Instagram.

Disclosure: Hawaii Business Magazine got support from the aio Foundation, HCF and other organizations, and input from many people, but no one outside our editorial team had any control over the content of these reports. —Steve Petranik

QUICKLINKS

Part 1: Five Ways to Make Government More Effective
Part 2: How to Increase Hawaiʻi’s Low Voter Turnout
The Kākou App: Designed to Increase Civic Engagement
Part 3: Three Change Agents

The Hawaiian Language Surges: New generations are learning the language at school and home and introducing it into tourism, media, science and beyond.

This is the fifth of Hawaii Business Magazine’s six CHANGE Reports on major issues facing Hawaiʻi.

The CHANGE Reports are based on a framework created by the Hawaiʻi Community Foundation.

CHANGE stands for:

• Community & Economy
• Health & Wellness
• Arts & Culture
• Natural Environment
• Government & Civic Engagement
• Education

Artist John Koga in his home studio | Photo: Aaron Yoshino

“The CHANGE framework acknowledges the interconnected nature of community issues and zeroes in on six essential areas that constitute the overall well-being of these islands and people,” HCF says.

All of the contents from reports already published are at hawaiibusiness.com. We welcome your feedback on any of the reports: Use the tag #HawaiiforChange on Facebook, Twitter, LinkedIn and Instagram.

Disclosure: Hawaii Business Magazine got support from the aio Foundation, HCF and other organizations, and input from many people, but no one outside the Hawaii Business Magazine editorial team had any control over the content of these reports.

—Steve Petranik

Like three previous CHANGE Reports and two still to come, this report on Hawaii’s natural environment focuses on important problems and possible solutions. It does not cover every major environmental challenge.

We welcome your feedback and suggestions on this and all the CHANGE Reports, on Facebook, Twitter, LinkedIn and Instagram using the tag #HawaiiforChange.

The six CHANGE Reports from Hawaii Business Magazine are based on a framework created by the Hawaii Community Foundation and adopted by the Hawaii CHANGE Initiative. “The CHANGE framework acknowledges the interconnected nature of community issues and zeroes in on six essential areas that constitute the overall well-being of these islands and people,” HCF says.

“By examining critical community indicators by sector, we can identify gaps where help is specifically needed and opportunities where help will do the most good.”

CHANGE stands for:

• Community & Economy
• Health & Wellness
• Arts & Culture
• Natural Environment
• Government & Civic Engagement
• Education

All of the content from reports already published is at hawaiibusiness.com.

Disclosure: Hawaii Business got support from the aio Foundation, HCF and other organizations, and input from many people, but no one outside the Hawaii Business editorial team had any control over the content of these reports.  —Steve Petranik

Overall, the Islands are often ranked as the healthiest state in America.

But diabetes, excessive drinking, vaping and other problems are on the rise and health outcomes are worse than average for some local groups, including Native Hawaiians, other Pacific Islanders, the mentally ill and the poor.

Table of Contents

Part 1: The Challenge
Part 2: We’re No. 1
Part 3A: Diabetes Epidemic Keeps Spreading
Part 3B: How to Beat Diabetes Before it Starts
Part 4: Helping Children with Mental Illness
Part 5: The Micronesian Struggle for Health Care
Part 6: Employee Wellness

Like the other CHANGE Reports, this one on health does not try to be comprehensive. Senior Writer Beverly Creamer writes about major problems and the ways local leaders, government agencies, nonprofits and companies  are trying to deal with them. We welcome your feedback and suggestions on this and all the CHANGE Reports on Facebook, Twitter, LinkedIn and Instagram using the tag #HawaiiforChange.

The six CHANGE Reports from Hawaii Business Magazine are based on a framework created by the Hawaii Community Foundation. “The CHANGE framework acknowledges the interconnected nature of community issues and zeroes in on six essential areas that constitute the overall well-being of these islands and people,” HCF says.

“By examining critical community indicators by sector, we can identify gaps where help is specifically needed and opportunities where help will do the most good.”

CHANGE stands for:

• Community & Economy
• Health & Wellness
• Arts & Culture
• Natural Environment
• Government & Civic Engagement
• Education

Disclosure: Hawaii Business got support from the aio Foundation, HCF and other organizations, and input from many people, but no one outside the Hawaii Business editorial team had any control over the content of these reports. —Steve Petranik

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Part 1: The Challenge

Taking a Good Health Care System and Making it Better

Hawaii is often called one of the healthiest states in the nation and that’s partly the result of Hawaii’s Prepaid Health Care Act.

The 1974 law was the first in the country to mandate all full-time workers be covered by health insurance; the employer must pay at least 50 percent of the premium, with employee contributions not exceeding 1.5 percent of monthly wages. Many businesses also voluntarily cover at least part of the premium for dependents.

Before the law was passed, only 70 percent of local residents had health insurance; afterward, with the help of federal and state government programs for gap groups like the poor and children, coverage peaked at 98 percent.

The percentage of uninsured increased over time but the federal Affordable Care Act, nicknamed Obamacare, reduced the rate again and the latest data show only 3.7 percent of the local residents lack health insurance.

Robert Harrison, chairman and CEO of First Hawaiian Bank and chair of the Hawaii CHANGE Project’s Health Committee, says Hawaii has been fortunate. “We have very high-quality health care, and the cost has been reasonable. Certainly we can always do better on both quality and cost, but overall Hawaii is in a good place now,” Harrison says.

Nonetheless, he says, the state “has the opportunity to take a very good system and make it better. Some of the issues we need to address are how to better care for our homeless population, as well as continuing to deliver quality care at an affordable price.”

Here are some other challenges:

• About 15 percent of Native Hawaiians lack health insurance – three times the average rate of uninsured statewide.
• As many as half of Hawaii’s residents are either at a higher risk of developing diabetes or already have it.
• Youth and children with mental illnesses often fail to get the help they need.

Dr. Virginia Pressler, former state health director, believes the biggest factors harming the health of Hawaii’s people are inadequate access to mental health services, tobacco and vaping, too little physical activity, and fast foods and sugary beverages.

“These lead to substance abuse, kidney failure, dialysis, cancer and heart disease,” Pressler says.

Bruce Anderson, who succeeded Pressler as state health director in May, provides a similar list. “Currently, some of my highest concerns are the increases in e-cigarette use by our youth, climate change and its impacts on public health, and the need for more mental health services in our communities,” Anderson says.

A report last year from the Pew Charitable Trusts provided fodder for critics of the state government. The Pew report ranked states on the percentage of the state revenue that came from federal funds; Hawaii ranked second last among the states, with only 22.7 percent of state revenue coming from the federal government. Much of that revenue funds health programs.

Six states got more than 40 percent of their revenue from the federal government, the Pew report said. Even some states which have relatively high state taxes like Hawaii do much better on that measure: For instance, California and New York each got more than 32 percent of state revenue from the federal government, the Pew report said.

Pressler acknowledges the state government’s problems in that area but says the situation is complex. State programs work hard to apply for those federal funds “only to be frustrated by administrative and legislative policies restricting their expenditure. And then they expire and cannot be used,” she says

Anderson actually disputes the report’s claims. “Over the decades that I have worked in the Department of Health, we have been very aggressive in applying for and receiving federal grant awards to support the health and environmental management programs. During the current fiscal year, the department received $141,369,958 in federal funds, which support health and environmental management programs statewide.”     

Another Hawaii health issue centers on Hawaii’s Micronesian community – citizens from the Republic of Palau, the Federated States of Micronesia and the Republic of the Marshall Islands. Most adults in that community don’t have health insurance. U.S. agreements with the Micronesian states once included access to Medicaid or other health care benefits but Congress ended that in 1996. In 2013, the latest year for which data are available, nearly 25 percent of non-Hawaiian Pacific Islanders did not have health insurance.

Harrison says he and a group of state health care leaders that includes Dave Underriner from Kaiser Permanente, Ray Vara from Hawaii Pacific Health,  Art Ushijima from The Queen’s Health Systems, and Mike Stollar and Dr. Mark Mugiishi from HMSA, will address key health issues and work with the Legislature and Gov. David Ige’s administration to look for solutions.

Pressler sees the Honolulu rail system as a bright light on the horizon.

“Transit-oriented development allows people to live without cars and consequently walk and bike more, as well as the ability to have easier access to healthy food and employment,” she says.

What Determines How Healthy You Are?

The single largest set of influences on a person’s health are social and economic factors. That means you can tell more about a person’s health by knowing their ZIP code than by knowing their genetics.

An analysis from the federal Centers for Disease Control and Prevention found a more than 10-year difference in average life span in Hawaii, based on what ZIP code people live in. The longest average life spans are usually found in high-income ZIP codes and the shortest in low-income ZIP codes.

A map showing all Hawaii ZIP codes can be found here.
View the report.

Source: “Public policy frameworks for improving population health,” a 1999 report in the Annals of the New York Academy of Sciences.

58% of Hawaii residents who get health insurance coverage through employers. Average annual employee premium after employer contribution: $703.

$2,349 a day: Average cost for an inpatient day in a Hawaii hospital before insurance payment.

Source: eHealth, a national online marketplace for health insurance.

More People Get Food Stamps in Hawaii

Hawaii has increased access to the Supplemental Nutrition Assistance Program, SNAP, the program still widely called food stamps, according to the national Food Research and Action Center. SNAP is designed to give low-income people money to buy food.

Hawaii earned a $724,000 performance bonus from the federal Food and Nutrition Service in 2013 because of major improvements in processing food stamp applications faster. In 2011, 61 percent of eligible local households participated, placing Hawaii 49th in the nation for participation. The latest available data shows 84 percent of eligible households participated in 2015, 26th in the nation.

Some Ethnic Groups Live Longer

A study of life expectancy among five ethnic groups in Hawaii found that Chinese live the longest on average and Native Hawaiians the shortest. And women in Hawaii, on average, live 6.1 years longer than men.

The 2017 study from a research team at UH also found that in 2010 the average life span for Hawaii residents was 82.4 years, 3.7 years longer than the national average.

This graphic from the study shows the difference in life expectancies among the five major ethnic groups:

Read the Full Study

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Hawaii’s Health Leader

Interview with Bruce Anderson,
director of the state Department of Health since May

Anderson has worked in the Department of Health for more than 20 years, including a previous term as director during Gov. Ben Cayetano’s administration. He has also served as administrator of the Department of Land and Natural Resources’ Division of Aquatic Resources and CEO of Hawaii Health Systems Corp.

Q: What do you see as the three or four biggest health challenges in Hawaii?

A: Hawaii is ranked as the healthiest state in the nation today. We are fortunate to live in the middle of the Pacific with clean air and water and few industrial sources of pollution. One of the important factors in achieving that No. 1 ranking was the relatively low percentage of smokers here. That ranking is now in jeopardy. The epidemic of e-cigarette use among high school students and young adults will undoubtedly translate to higher smoking rates. And studies have shown that e-cigarette use often leads to smoking tobacco later in life as individuals become addicted to nicotine.

Preparedness and resiliency to hurricanes, flooding and other events associated with climate change is critically important. Hawaii experienced devastating rains and two near misses from hurricanes last year. We can expect these extreme weather events to increase in frequency and magnitude in years to come.

The need for more community-based behavioral health services is obvious to those who recognize the need for a continuum of care for those who live with severe mental illness. One glaring deficiency is the lack of detox facilities where those who have drug- and alcohol-related disorders can recover and receive treatment services. Too many times these individuals end up in emergency rooms or on the streets, repeatedly.

Q: How do we deal with these challenges?

A: Gov. Ige has introduced a bill to ban the sale of flavored tobacco products, which will help discourage their use. The flavors and advertisements are obviously targeted to attract middle and high school students as well as young adults. If it passes, Hawaii would be the first state in the nation to ban flavored tobacco products.

Our executive budget request includes funds and staffing for a new psychiatric facility at the Hawaii State Hospital in Kaneohe to provide secure, state-of-the-art treatment for those with serious mental illness. However, building the infrastructure and making available transitional housing and other community-based support services for those with behavioral health challenges will be an ongoing challenge.

Certainly legislation and policy changes can lead the way to changing our attitudes and actions in dealing with these issues. These are long-term battles that require commitment and a strong mindset toward physical, behavioral and environmental health in creating systemic changes.

These efforts also require strong collaborative partnerships. For example, we are working closely with the Department of Education to reduce e-cigarette use in schools.

Q: Are we winning in any of these challenging areas?

A: We have been making progress in expanding community-based mental health services, and the construction of a new state psychiatric facility at the Hawaii State Hospital in Kaneohe is underway.

We are also making systemic changes. For example, we are developing a comprehensive and seamless case management system for children and adults served by both our behavioral health and developmental disabilities programs. When fully operational, this will result in the delivery of more effective and efficient services for the thousands of individuals we serve daily. Additionally, it will dramatically improve reimbursement for those services.

Q: What about the future?

A: Lack of affordable housing, traffic congestion and the overall cost of living in Hawaii are certainly major challenges we need to overcome. Health must be a primary consideration when planning communities, schools, social services, prisons and other community needs. Bringing healthy lifestyle options to the areas where we live, work, play and worship will improve health outcomes and reduce health care costs. In addition, investing in healthy babies and families will provide the right trajectory toward healthier communities and generations to come.

Fortunately, the opioid crisis is not as widespread in Hawaii as it is in most states. We recently received $8 million in federal funds to deal with the epidemic over the next two years. Nevertheless, more people die of drug overdoses than from traffic accidents and the abuse of alcohol and the use of crystal meth and other drugs continues to be a serious problem.

Childhood obesity, the root cause of diabetes and other serious chronic disease problems later in life, is also a growing problem. We need to help children – and their parents – reduce their intake of sugary beverages, increase physical activity, and make healthy choices in life.

Q: What about health coverage for Micronesians?

A: Historically, Hawaii has been the major provider of health care of Pacific Islanders from the U.S.-associated jurisdictions under the Compact of Free Association, without receiving adequate federal compensation. In fact, tens of millions of dollars of uncompensated care are delivered to those in need every year. We believe that federal Medicaid and Medicare support should be extended to those jurisdictions, just as it is to U.S. citizens living in Hawaii. We don’t turn people away from our emergency rooms who need health care based on their ability to pay. Our hospitals are covering those unreimbursed costs now, which are indirectly passed on to residents and others utilizing our health care system.

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Part 2: We’re No. 1

National experts are the ones that often rank Hawaii as the healthiest state overall in America. For instance, Hawaii is ranked No. 1 by the United Health Foundation’s latest annual ranking issued in December 2018. The foundation had also ranked Hawaii No. 1 in five of the past six years.

The Commonwealth Fund also ranked Hawaii No. 1 in its 2018 national Scorecard on State Health System Performance.

The Gallup-Sharecare Well-Being Index, which Gallup says is based on more than 2.5 million surveys, explores how people experience their daily lives. Hawaii was ranked third among the states in the latest report after placing first the previous year.

Here are some highlights from the United Health Foundation’s 2018 ranking.

Hawaii Among the Top 10 States

Hawaii ranked among the 10 best states in each of these measures (brackets explains the criteria used by the United Health Foundation):

Behaviors:

• Drug deaths (12.3 a year per 100,000 population; nationally 16.9)
• Obesity (23.8% of all adults; nationally 31.3%)
• Physically inactive (23.5% of all adults; nationally 25.6%)
• Smoking (in the past six years, smokers in Hawaii decreased from 16.8% to 12.8% of all adults; nationally 17.1%)

Community and environment:

• Air pollution (micrograms of fine particles per cubic meter)
• Children in poverty (11.5% of all children; however, this measure does not fully account for the high cost of living in Hawaii; nationally 18.4%)

Policy:

• Vaccination of young females against human papillomavirus (62.7% of females aged 13 to 17 years; nationally 53.1%)
• Public health funding ($226 per person; nationally $86)
• Uninsured people (in the past five years, the percentage of uninsured decreased from 7.8% to 3.7% of the local population; nationally 8.7%)

Clinical Care:

• Dentists (75.8 per 100,000 population; nationally 60.9)
• Preventable hospitalizations (23.3 discharges per 1,000 Medicare enrollees; nationally 49.4)
• Primary care physicians (In the past two years, primary care physicians in Hawaii increased from 172.6 to 187.6 per 100,000 population; nationally 156.7. However, local experts believe nonetheless that Hawaii has too few primary care doctors.)

Clinical Care:

• Cancer deaths (161.1 per 100,000; nationally 189.8)
• Cardiovascular deaths (208.1 per 100,000; nationally 256.8)
• Disparity in health status (Difference between the percentage of adults aged 25 and older with at least a high school education compared with those without a high school education who reported their health is very good or excellent. A 13% difference in Hawaii; 29.9% nationally)
• Frequent mental distress (9.5% of adults; nationally 12.0%)
• Frequent physical distress (10.7% of adults; nationally 12.0%)
• Premature death (6,104 years lost before age 75 per 100,000 population; nationally 7,432)

Source: United Health Foundation 2018 Report.

Read the full Hawaii report

Lowest Rankings

Hawaii ranked among the 10 worst states in only two categories:

• Excessive drinking (in the past five years, excessive drinking increased from 19.7% of the local adult population to 21.1%: nationally 19.0%)
• Tdap immunization (84.8%% of adolescents aged 13 to 17 years immunized; nationally 88.7%)

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Part 3A: Diabetes Epidemic Keeps Spreading

Fighting back against a growing health threat – and one of the most costly

Hawaii’s largest health insurer is launching a major survey of the medical histories of 150,000 of its members in the hopes of pinpointing key health indicators that could lead to developing diabetes later in life.

HMSA’s pilot study aims to identify early on those people who are at-risk for a disease that’s not just a public health crisis, but an economic crisis. Diabetes is one of the most common and expensive diseases to treat.

With that information, says Dr. Mark Mugiishi, executive VP and chief health officer for HMSA, the nonprofit will implement early intervention programs and strategies for at-risk groups, with the hope of preventing the disease. 

Mugiishi said HMSA is working with employer groups and their employees to see if the approach works to identify groups in order of most risk to least risk. HMSA covers 750,000 people or about half the state’s population.

“We’re taking a lot of big data and running through it and seeing what kinds of things appear in people’s medical history that allow us to project who in the future would be likely to get it so we can intervene early,” Mugiishi says. “When we identify these different (at-risk) groups, then we’ll work with the employers to offer education, including places to go to work on lifestyle changes.”

While poor diets and too little exercise early in life often plant the first seeds of diabetes, those bad habits can be overcome.

“The most common things you can do is adjust your lifestyle so you move more and eat better – meaning fewer processed sugars and carbohydrates – and monitor your weight by making sure you don’t get too overweight or by staying at an ideal body weight,” Mugiishi says.

“If you do those three things, it’s going to help a lot. As well, it’s been shown with many other diseases that it’s easier to stick with making changes if you do it in a group. That has worked in breaking addictions and in cardiac rehab programs. So if you have a support system around you to encourage you, you will be more successful.”

Diabetes is a severe health problem in Hawaii and getting worse. HMSA went from 30,000 members with diabetes in 2015 to about 50,000 today. Statewide, there are as many as 100,000 people with diabetes, and as many as 25,000 don’t know it.

”It’s so important for people who might be at risk to start incorporating a healthy lifestyle.” – Doreen Nakamura, Director of clinical care, UHA

Wait, it gets scarier: Some medical experts estimate that as much as 30 percent of Hawaii residents have prediabetes, Mugiishi says, based on risk factors and early onset symptoms. You’re at risk if there’s a history of the disease in your family, if you’re overweight, sedentary or just don’t feel good.

“Those are four things that should make you worried,” he says.

Heart disease is a more common affliction in Hawaii, but diabetes comes close, and it strikes Native Hawaiians, Pacific Islanders and Asians in greater numbers than other groups, although no group is immune. It can lead to strokes, vascular diseases that risk amputation, chronic kidney disease that may require dialysis, and retinal disease that can cause blindness. All require additional care.

All of that pushes up the costs of care – costs that almost always are shared by others within a health insurance network or by government programs.

“The cost of treating diabetes is extremely high,” Mugiishi says. “The average diabetic will spend two times more than the average person (on) health care. In 2012-13 we passed the threshold where more than $1 billion in Hawaii went to treating diabetics. That’s just the total cost of medical care and doesn’t even include the loss of productivity and the cost to society. That’s going to be more hundreds of millions of dollars.”

HMSA and other Hawaii health insurance carriers are constantly reappraising treatment and intervention options, and some of those initiatives are showing promise. In 2015 HMSA hired a large group of care managers and care coordinators to specifically work with patients with severe forms of diabetes.

“They manage the sickest people who have really, really bad disease to make sure they stay on their medications, go to specialists and enroll in community programs that help them manage the disease,” Mugiishi says. That includes up to 4,000 HMSA patients.

UHA, another Hawaii health insurance provider, offers its own staff onsite exercise programs that make it easy for employees to finish work and then work out.

Doris Villorente | Photo: Elyse Butler

Doris Villorente, UHA’s RN care specialist, does that often. She was diagnosed with diabetes almost 18 years ago but has learned to control it – and now works one-on-one with clients who are referred for case management.

“I didn’t really know what diabetes was about until I became a member of UHA and got involved with various programs here,” Villorente says. “For me it was important to understand what the disease was because you just hear everything and it’s scary. Just understanding how it affects my body was a realization, as well as seeing some of the worst outcomes of other people. That’s what pushed me forward. I want to be well. I became more aware of what I was eating and cut down on the sweets, the white rice, the carbs. I didn’t eliminate them but now I know how to balance them out.”

Vegetables became a key ingredient, says Villorente. “I wasn’t really a fan of salads and vegetables but now I really like squash, broccoli, carrots. My meals used to be grab and go (in her former job) and I think that’s one of the problems – that grab and go mentality. I was just so busy at work that I was eating fast foods maybe three times a week. And when I cooked dinner it was Filipino dishes with high sodium. Diabetes is a metabolic process. It’s not just the breakdown of carbs, but of everything else, including the breakdown of fats. And it’s important to watch your salt.”

UHA tracks its members diagnosed with diabetes and prediabetes. “About 9.4 percent of our membership has diabetes and about 11 percent have been diagnosed with prediabetes,” says Doreen Nakamura, director of clinical care at UHA. “The prediabetes population is a much larger group. But this group still has the opportunity to prevent the disease. That’s why it’s so important for people who might be at risk to start incorporating a healthy lifestyle. That’s why we partnered with the YMCA and their Diabetes Prevention Program. It’s a comprehensive lifestyle program that includes diet, nutrition, mental health, exercise, stress relief, all of which impact the disease.”

”It was the behavior of people decades ago that’s causing diabetes today. Still, you have to start working on it now.” – Dr. Mark Mugiishi, Executive VP and chief health officer, HMSA

It’s also important that once patients are diagnosed with diabetes that they are connected to an endocrinologist or certified diabetes educator who will focus on treatment and lifestyle adjustment that will keep the disease from getting worse, with added complications.

HMSA has additional initiatives, Mugiishi says. One is its latest model for paying health care providers.

“We pay for outcomes now. And one of the big outcome measures is diabetes care. Physicians get paid to monitor and lower hemoglobin A1c levels. That’s a blood test of molecules in your blood that’s a good measure of the risk that someone has for complications of diabetes. If it’s kept low, under 7, the risk of having complications is low. That’s one of the things we pay doctors to manage.”

Payment is also made according to how frequently patients go for eye exams, how often they are checked for kidney disease, and how their weight is being managed. 

All of that specific, supervised care is making a difference, says Mugiishi. “We have really good data that the hemoglobin A1c level (overall) is coming down.”

There’s also some good news for those who have already developed diabetes: There are easier ways to monitor blood sugar levels than daily finger-prick tests.

“They have Bluetooth-enabled glucose monitoring,” explains Mugiishi. “It will send your information into a central command center to monitor how you are doing. It’s a personal device that has been around for a while, but the wireless component that sends the information to a central command center where someone is monitoring it is relatively new. A lot of these get the blood composition and glucose off sweat, but there are different degrees of accuracy.”

Mugiishi likens diabetes to climate change. “You kind of reap the harm today that was done 10, 20, 30 years ago,” he said. “It was the behavior of people decades ago that’s causing diabetes today. Still, you have to start working on it now.”

And whose job is it to stem the tide?

“People still feel it’s the doctors’ job, but we’re sophisticated enough today to know that in the provider community it’s everyone’s job,” Mugiishi says.

High Blood Pressure

Almost a third of Hawaii’s population (32%) has high blood pressure – higher than the U.S. rate of 31%. Two local populations have high-blood pressure rates of more than 40%: Japanese and Blacks. Only 60% of Hawaii residents with high blood pressure have it under control.

Source: hawaiihealthmatters.org

Doctor Shortage in Hawaii (2017)

Biggest Shortages in Specialists

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Part 3B: How to beat diabetes before it starts

Marilyn “Mel” Billingsley has been a hiker, backpacker, swimmer and enthusiastic Jazzerciser much of her life. “I’ve always been aware of the importance of being healthy,” says the retired speech and language pathologist.

That’s why it came as a surprise when her doctor said she was prediabetic – a condition suffered by 30 to 50 percent of Americans – and suggested she lose a little weight to stop herself from getting the disease.

“What motivated me the most was being healthy so I could live a long time to enjoy my grandchildren, children and my time with my spouse,” she says.

Through a news bulletin at her church, Billingsley learned about the YMCA’s yearlong Diabetes Prevention Program that helped her change eating habits, lose weight and get support from others going through the same health challenges. She even gave up Spam musubi.

“Our group was incredible. Over time we became close and shared many ideas and spoke openly about our struggles and successes. I stopped eating so much cheese, nuts, fast foods and pizza in order to follow the program,” says Billingsley. 

That prediabetic diagnosis and the Y’s program may have saved Billingsley from a potentially debilitating disease, just as it has been saving people at YMCAs all across the nation.

Marilyn “Mel” Billingsley | Photos: Marie Eriel Hobro

Kristen Chin, health care service clinical coordinator for health insurance company UHA, notes that programs like the one at the Y that are approved by the federal Centers for Disease Control and Prevention in Atlanta are preventing the onset of diabetes.

“Programs approved by the CDC have been shown to reduce the number of new cases of diabetes by 58 percent in adults under 60, and as much as 71 percent in those over the age of 60,” Chin says.

That’s good news for about 110 people who joined the latest classes offered at Hawaii YMCAs. 2019 began with the launch of 11 new groups with 10 participants each. For the first four months there are weekly meetings, which gradually taper down during the year.

Insurance carriers like UHA pay the full price of $690 per person for the program, and other carriers are considering covering it partially or fully once people have a diagnosis of prediabetes.

The program was developed over the past decade and a half, says Christina Simmons, the YMCA of Honolulu’s chronic disease program director.

“The Y has tried to be very community-oriented, and one of the things they look at is what are the big issues of our time in health and wellness. About 10 or 15 years ago we started looking at diabetes rates, which were beginning to skyrocket around the country. We said, ‘Wow, we’ve really got a problem,’ and started doing research, hooking up with the CDC and Indiana University, and started looking at what works to prevent diabetes.”

The first research involved clinical trials with medications, says Simmons. But soon they were evaluating medications vs. lifestyle change, and discovered that “lifestyle change works so much better.”

Christina Simmons | Photo: Marie Eriel Hobro

“At the time it was more of a medical lifestyle change model, but it’s very cost-prohibitive to have a physician do lifestyle change. So we started looking at a medical vs. community model and tra-la, the community model worked much better.”

The Y’s program was born.

Much of the Diabetes Prevention Program’s success comes from the built-in support system that nurtures participants without telling them exactly what to do, says Simmons. “A physician will tell you what to do. At the Y, we don’t tell you what to do. We guide you to the goal, and there are two goals: one is 7 percent body weight loss, and the other is adding 150 minutes of activity to your week.

“In other words, we don’t say you have to do this or that. We work in a group, so it’s a group dynamic. And we use the power of the group to move the group forward. The positive behaviors come from the group and they support each other. That’s very important, because you can really have empathy with other people struggling with the same things you are.”

Simmons emphasizes that people have to be ready for the program. Otherwise, it may not work or they may quit.

But it will work “if you’re ready to really learn and think of the long-term lifestyle change,” she says.

The weekly meetings are a time to talk story, share insights and ideas, and support each other. From those group meetings come partnerships within the group as people exercise together, share healthy eating tips, and otherwise encourage one another.

“We always have a topic,” Simmons says of the group meetings. “For example, one is cues in your environment – either external or internal – that are helping you to exercise, and those stopping you from exercising. What’s your internal justification for eating 12 cookies? We talk about problem-solving skills and we talk a lot about nutrition. A lot of people don’t have a good relationship with food.”

Each group’s coordinator gradually adds new subjects into the meetings, including the expectation that participants will log everything they eat as well as their daily and weekly activities.

“We really pay attention to what you put in your mouth, and your activity log,” says Simmons. “That becomes your frenemy – both a friend and enemy. It’s not about prevention, it’s really about holding yourself accountable to yourself.”

Simmons says the Y is happy to take the program into business offices. “We can do the program outside of the Y. All we need is a meeting room. If there’s a business with 10 or more interested people, we’ll come to you.”

Chris Chow | Photo: Marie Eriel Hobro

Group facilitator Chris Chow says the gradual and realistic steps of the program help participants understand that they can control whether they develop the disease.

“By empowering participants with personalized tools needed to achieve and maintain a healthy lifestyle, they’re reminded that Type 2 diabetes can be prevented in steps that are not as out of reach as one may think.,” says Chow. “By having participants find something they enjoy doing, their journey toward weight loss and healthy eating is likely translated into long-term healthy habits. It works!”

Billingsley can attest to that. As the program progressed, her physical stamina increased and her attitude toward life improved. “It’s amazing to be able to do things with my very young children, and not be out of breath, walking with an ache in my joints or breathing hard,” she says.

While she knows she may still be at risk for disease because of her family history, Billingsley says: “This has been a life-changing program for me. Every day presents a challenge, but when one has learned the right tools to meet these challenges, you can be successful at anything.”

How to Enroll: Call 548-0951 and ask to speak to the staff in the YMCA chronic disease program

Fighting Back Against Diabetes: The Ekahi Solution

There is no single cause of diabetes, so combating the disease requires multiple strategies, says Dr. Kevin Lum.

Lum is the director of the Ekahi Health Center at Honolulu’s Waterfront Plaza, which offers a comprehensive program to lessen the effects of the disease on the body. Specialists in the year-old program include registered dietitians, a medical social worker, behavioral health specialist, pharmacist and nurse practitioner, as well as an exercise physiologist, stress management specialist and mental health experts.

“We have referrals from primary care physicians, but we also have self-referral,” says Lum, who is also a specialist in emergency medicine. “We participate with all insurances, and while Medicaid is not accredited yet, we expect it to happen.

“The difference with our program is that others may just have six classes and you’re done, but what we want to do is create a partnership with our clients. We want you to come to the program and experience all facets, and we’re there to support you in a long-term way – hopefully reversing it or being successful with management,” Lum says.

“Lifestyle factors are probably the biggest things to address. Eating habits are one of them, but there are also a lot of psychosocial barriers to success. For instance, maybe you live in a house that doesn’t promote healthy eating. As well, stress is also a big contributor to diabetes. Any kind of stressor can increase your cortisone, and when that goes up, it increases your sugar. When you’re in a constant state of stress, you have high cortisol levels running through your body. So we incorporate stress management to learn what is causing those stresses and how to decrease them. Is it your job? Your home life? Do you stress eat? So how can you learn to manage those things?”

Treatment at the Ekahi center begins with a care navigator who looks at the reasons that may keep a person from successfully managing the disease. “The navigator gets to know the person so they can set up appointments with other elements of the program depending on particular needs,” Lum says.

“Hopefully we can knock down their barriers and identify what has been hampering their success in the past.”

As well, says Lum, “we want to encourage them to move to a plant-based diet. We have had so much success at the clinic with the Ornish diet that we want to incorporate it into a wellness diet. Maybe they don’t want to jump into the deep end of the pool at first, but to migrate them over to a plant-based diet.”

The Ekahi clinic also builds resilience in participants with group classes that address diet, stress management and exercise.

“The whole idea around creating these classes is forming a community of people who support one another. Being socially isolated has a negative impact on their health,” says Lum. “This sense of community helps people realize they’re not alone. Becoming friends with others who also want to get better can help people with their own care.”

The facility includes a small gym where participants learn to exercise safely. The exercise program includes aerobic activity along with strength training and weightlifting.

“One of the big issues for people is time management,” Lum says. “People say, ‘I don’t have time to do it.’ We’re always in a rush, so instead of planning my meal I’m going to rush off and make a bad food choice.  So our behavioral specialist will work in some of the tools to manage time better. For instance, meal prepping, or planning your day is important. Book 15 minutes to prepare a lunch or on Sunday night make sure you have lunch for the week. Those are the common changes to make but for each person it’s going to be different.”

When participants adopt a plant-based diet, says Lum, they tend to see changes in their blood sugar in the first two to three weeks. “We do see rapid changes. We see people coming off medications as well.”

Lum says Type 2 diabetes is generally considered to be reversible. “And so far we’ve had pretty good success with that. When people are highly motivated, we can see changes within the first month or so. On average, it’s three to four months.”

While the program is typically nine weeks, it can last longer. It can also lead to lifelong friendships among people who now have a common commitment to themselves and their health.

Learn More: For further information about the program or to register, call 777-4001, ext.1

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Part 4: Helping Children with Mental Illness

Taking a Good Health Care System and Making it Better

An estimated 2,000 children in Hawaii deal with serious emotional problems. Some are as young as 4.

Mental illness is rarely their only problem. Many are homeless, or have been physically or sexually abused. Often they are poor or come from fractured families or chaotic homes or all of the above. And far too often, there is no adult at home they can talk with.

The state Department of Health’s Child and Adolescent Mental Health Division tries to care for these children. Their average age has fallen to 13 as they’re being referred at younger and younger ages because the sooner they get help, the more effective the treatment.

“Ten years ago, it was essentially all teenagers,” says the division’s administrator, Dr. M. Stanton Michels. “But if we’re going to impact kids, we need to reach them earlier in their lives, and hopefully we’ll have better outcomes. When a kid is 16, 17, 18 years old, the outcomes aren’t that good. So we need to get into the picture earlier, when kids are more malleable.”

In many cases the children aren’t dealt with at all because they are not diagnosed or a lack of resources.

As they get older, they can end up behind closed doors, in residential programs, in juvenile justice courtrooms, sometimes in locked hospital units.

The picture is especially bleak for Native Hawaiian youth. In 2013, the latest year for which data was available, 32 percent of Native Hawaiian high school students surveyed said they experienced depression; one-fifth said they had suicidal thoughts within the past year.

In addition to the 2,000 young people with severe issues, many of whom get help from the Child and Adolescent Mental Health Division, another 4,500 receive specialized services from therapists in their schools. And overall, 12,000 Hawaii children and adolescents receive some level of services for non-academic issues through their schools, according to data from the state departments of Health and Education.

When he took the lead at the state’s Child and Adolescent Mental Health Division a decade ago, Michels was appalled to discover that one of the children in state care had spent nine months in a hospital setting. He says that no longer happens. The focus has been to reduce the time children spend in institutional therapy in favor of treatment in their homes whenever possible.

“When you have a kid in a certain level of treatment, they can get better, and then they plateau,” says Michels. Keeping them in an institutional setting means just spending money without seeing advances, he says.

“You just don’t keep pouring money at the problem. You have to make sure your money is doing something.”

Reducing long hospital stays saved the division $3 million in Michels’ first year, and improved care for children who were able to return to a normal environment.

When possible, children are increasingly being served in their homes – or in a safe alternative environment – by telemedicine, often using Skype or FaceTime. The technology is especially useful if they live in rural or other difficult to reach areas, helping stretch limited mental health resources a bit further.

“This is the future, not just of mental health, but physical health,” says Michels, “with the current care coordinator going to the home with her laptop. We’re providing the care and we’re keeping the costs way down. The next step is the cellphone.”

Therapeutic care from private institutions is needed to supplement state resources, but residential treatment programs at Castle Medical Center and Leahi Hospital on Oahu have closed in recent years. The Queen’s Medical Center offers acute care for mental illness but no long-term care. Sutter Health Kahi Mohala has stepped into the breach with its 88 licensed beds and a staff of about 200; about half of the patients under its care are young people.

“Six out of 10 Hawaii adolescents who need help aren’t getting it,” says Quin Ogawa, interim CEO at Sutter Health Kahi Mohala. “Mental health issues impact everyone, and our patients come from all income levels. Forty percent are from Neighbor Islands, up from 27 percent in 2017.”

Illustrations: Kimberlie Clinthorne-Wong

The Child and Adolescent Mental Health Division has pushed for two new residential programs for disturbed children: one each on Oahu and Hawaii Island, the state’s poorest county, whose economic struggles were exacerbated last year by Kilauea’s eruption and tropical storms.

The proposed Hawaii Island treatment program would have onsite schooling; the Oahu program would be a 30-day short-term crisis center that could accept eight young people at a time for up to a month of intervention and services.

“These would be young people with substance abuse on top of behavior issues. We need a place to stabilize those kids and provide joint programs,” says Michels of the Oahu program.

“This would give us 30 days to identify a safe environment for the child. The common denominator (among these children) is they need a safe place to be.”

There is a growing recognition of the link between poverty and poor health – particularly long-range physical health and mental health.

“The single largest set of influences on a person’s health are social and economic factors. That means you can tell more about a person’s health by knowing their zip code than by knowing their genetics,” says a CHANGE Report from the Hawaii Community Foundation.

UH Public Health Professor Kathryn Braun, who has studied disease and disability in minority populations for more than 40 years, agrees that geographic zip codes are a closer match to determine health and longevity than cultural or racial backgrounds.

“Health and longevity are inextricably tied to income,” Braun says. “The groups with the highest income in Hawaii are the Japanese and Chinese, followed by the Caucasians. At the lowest end are Filipinos, Native Hawaiians and Pacific Islanders.

“Disease and longevity patterns follow wealth patterns. The zip codes with the worst outcomes are on Molokai, and what is that but Native Hawaiian and Filipino, very high poverty, low household incomes, and very high Medicaid for the blind and disabled. So you have a population with a lot of poverty, and with that come diseases and disability and lower life expectancy. So it’s not genetic, it’s poverty. And poverty is due in many cases to underlying racism in our system.”

The ALICE Report says that 48 percent of Hawaii’s households are either living in poverty or have working adults yet are barely able to get by. “So we have half of the population that can’t make it. And that spells doom for our healthcare system.,” says Braun. “We are just going to get more and more sick people. People go into healthcare because they don’t have stable housing, or are homeless. Then they can’t manage their disease because they don’t have air-conditioning or electricity.” The more that happens, says Braun, the more those people are going to be going in and out of the healthcare system.

Poverty often leads to depression. In its 2017 report “The State of Mental Health in America,” the nonprofit Mental Health America, formerly the National Mental Health Association, ranks the states according to the prevalence of mental illness among both youth and adults, as well as each individual state’s access to care.

The MHA report, as well as other findings, shows Hawaii lagging far behind other states. Hawaii was:

• 44th among the states with 70.9 percent of youth with depression not receiving treatment.
• 22nd among the states with 4.97 percent of youths reporting a substance or alcohol problem.
• 14th among the states, with 6.4 percent of youths reporting a severe depressive episode.
• 38th in the nation with only 19 percent of youth with severe depression receiving some consistent treatment.

These low percentages demonstrate Hawaii has a way to go to provide needed services, says Leonard Licina, the former long-time CEO of Sutter Health Kahi Mohala.

“Mental illness touches all social classes,” Licina says. “Many of Kahi Mohala’s patients come from good supportive families.” He pointed out that in addition to sexual or physical abuse, trauma, and homelessness, such things as family dysfunction can lead to serious behavioral problems as well as mental illness in the young.

The most recent 2017 Hawaii Youth Risk Behavior Survey by the Department of Health in cooperation with the Department of Education, also gives a telling glimpse into the lives of young teens. Data from the report shows that from 2015 to 2017 marijuana use increased almost two percentage points among middle school students, going from 10.2 percent to 11.9 percent. That amounts to 3,300 middle schoolers who have used pot.

The Behavior Risk Survey also shows that use of all illegal drugs among middle schoolers – with drugs offered at school, sold at school or received at school – increased from 8.2 percent in 2013 to 9.1 percent in 2015. Even with that increase, the numbers are lower than they were in 2011 when 9.3 percent of middle school students were able to find drugs at school.

Michels says the way forward is for state departments and agencies to collaborate – both in their work with patients and through changes in funding – to increase their effectiveness for their patients.

With the division’s new call for additional treatment centers, Michels visualizes agencies working far more closely together and pooling resources in some way so that funding is available to respond to whatever the needs may be. This could be through earmarking special funds for these specific purposes, or by other means.

“You will never break down the silos until you break down the funding by pooling agencies, resources and treatment,” he says.

UH’s Braun has spent four decades studying, counseling and developing strategies to fight poor health outcomes. She offers three economic reforms to improve the health of Hawaii’s people.

“No. 1, I would just say raise the minimum wage. Secondly, do something about housing. Increase property taxes so the government has enough money to create low and moderate-income housing that they control, not developers.

“And third, deal with the food system to make food more affordable. Healthy foods are more expensive. If we can do those things, we can see reductions in healthcare costs. And an increase in overall community health.”

Mental Health Issues in Hawaii

32% of Native Hawaiian high school students statewide have experienced depression. One-fifth of all Native Hawaiian students surveyed said they had suicidal thoughts within the past year.

Mental health services are increasingly difficult to access, especially for low-income people with Medicaid coverage. The number of adults served by public outpatient mental health services dropped 36% from 2001 to 2017.

On average in Hawaii, someone commits suicide every two days. Suicide is the second-leading cause of death among people aged 15 to 34.

Efforts Underway:

Prevent Suicide Hawaii Task Force
National Alliance on Mental Illness Hawaii
Hawaii Tobacco Quitline

Hawaii’s keiki

• Almost 2,600 children are in Hawaii’s foster care system – the highest number since 2010.
• One in 4 children in Hawaii live in households receiving federal assistance.
• Hawaii ranks 49th in the nation for participation in the federal school breakfast program, which provides free and reduced-price breakfasts to low-income students. Only 42% of eligible students participate.
• Most of the 65,000 children who receive free and reduced-price school meals do not get free summer meals. Only 1 out of every 9 children in Hawaii eligible for the federal summer meals program access it.
• Bright Spot: 2016 saw the fewest number of Hawaii’s children living in poverty since the 2008 recession – 31,000 children or 10% of all local children.

Sources: Hawaii Department of Human Services Data Book, Food Research and Action Center, KidsCount.org

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Part 5: The Micronesian Struggle for Health Care

There’s profound hopelessness in Hawaii’s Micronesian community, largely around a lack of health care coverage, says Micronesian community activist Jocelyn “Josie” Howard. But there is also hope that the next generation of Micronesians will rise up and take their place as other immigrant groups to Hawaii have done.

The state’s Med-Quest program for low-income people covers Micronesian children 18 and under, elders 65 and above, pregnant women, and those who are blind or have other disabilities. But other Micronesians without U.S. citizenship are not eligible for the state-sponsored health insurance; those who do not get coverage through an employer can buy health insurance but many can’t afford it.

As a result, only 1 in 4 Micronesian households has health insurance, according to data collected by Michael Levin, a consultant with PacificWeb LLC, whose career as a demographer has taken him to the U.S Census Bureau, Harvard University and, most recently, the East-West Center. Levin tracked the Micronesian experience in Hawaii through surveys in 1997, 1999, 2003 and 2012.

Even Howard is fearful, though she has worked in Hawaii for 30 years and has medical coverage through her job.

“If I lose my job I will not qualify for Med-Quest,” says Howard, who is program director for We Are Oceania, an organization assisting Pacific Islanders, including Native Hawaiians. “And the Healthcare.gov option is not affordable for me.”

With the Compact of Free Association created in 1986, the U.S. entered into agreements with three Micronesian states: the Republic of Palau, the Federated States of Micronesia and the Republic of the Marshall Islands. COFA allowed Micronesians easy immigration to America and included eligibility for Medicaid or low-income health care benefits in the U.S., but 10 years later Congress withdrew the health care benefits.

That placed an enormous burden on the more than 15,000 Micronesians in Hawaii and on the state health care system, as uninsured Micronesians often use hospital emergency rooms for their health care needs.

Jocelyn “Josie” Howard | Photo: Elyse Butler

“Most people when sick go to the ER. They can’t help it,” says Howard. “Some people are accessing urgent care services. And some tried to come to We Are Oceania to apply for any health coverage available to them, but most of the times there was none. We established partnerships with Hoola Health and Urgent Care Clinic, and have been referring people without health coverage there for medical treatment.”

Researchers point out that Hawaii has long been a popular draw for Micronesians because of the quality of the state’s medical care compared to the care offered on their home islands.

“The medical situation in Micronesia is so bad that they are generally glad just to be in a place where they can be reasonably confident that they will get adequate, if not superior, care,” says Levin. He cites the example of a Micronesian woman who gave birth to a healthy daughter 10 years ago while studying at UH Hilo. “When she and her husband moved back to Pohnpei, she had three miscarriages before becoming pregnant again,” he says.

During that latest pregnancy, “She came to Hawaii on the health insurance provided to Micronesians. She had pregnancy related diabetes, which was measured several times a day and precautions taken. And she was on bed rest for the last month of her pregnancy. She had a very healthy daughter who is now 3 years old. Obviously each pregnancy is different, (but) it is unlikely that the result would have been the same in Micronesia.”

Levin notes that many Micronesians come to Hawaii specifically because of medical issues like a need for dialysis or other “machine-related” treatments and diseases. Their move from a traditional diet and lifestyle to Western food and a more sedentary life has led to conditions like hypertension, diabetes and high cholesterol.

A Hawaii-based study published in the American Journal of Public Health in 2016 noted that Micronesians were “significantly younger at admission (to hospital) than were comparison racial/ethnic groups” and the severity of cardiac and infectious diseases was also significantly higher than that of all comparison racial/ethnic groups. As well, it was higher than that of Caucasians and Japanese for cancer and endocrine hospitalizations, and higher than that of Native Hawaiians for substance abuse hospitalizations.

A Micronesian Youth Summit was held at the East-West Center in March. | Photo: Elyse Butler

Researchers Megan Kiyomi, Inada Hagiwara, Jill Miyamura, Seiji Yamada and Tetine Sentell concluded that “Micronesians were hospitalized significantly younger and often sicker than comparison populations” and that they are a particularly vulnerable group.

The study also pointed out that Micronesians have experienced “a variety of historical events that have contributed to poor health, including U.S. nuclear testing in the region, and the disruption of traditional economics, cultures and diets.”

Lack of health care coverage is just one issue facing the Micronesian community in Hawaii. As Micronesians moved to Hawaii from the mid-1990s and into the early 2000s, they also faced the difficulties of finding housing and jobs with a living wage, and racial prejudice. A disproportionate share of the state’s homeless population is Micronesian.

For Josie Howard, hope lies with the next generation of young Micronesians and their ability to make their voices count at the ballot box.

“Our children are U.S. citizens and they are voting now,” Howard says. “So, just like every immigrant group that came to Hawaii before us, and are policymakers in Hawaii, the sons and daughters of Micronesia who are U.S. citizens have to rise up and follow in their footsteps.

“This is our new home. I would like everyone to work together. Together we make the Hawaii community, and that’s why everyone needs to be included.”

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Part 6: Employee Wellness

Promoting employee wellness is now company policy at many local businesses

Tuesday Pires-Piimauna remembers her dread as she faced the stairs to her first NuFitness class. “They did me in. … I could barely walk up the steps,” she says.

But she persisted, signed in at the registration desk and took the first step to a healthier life – thanks to support from her employer, Bowers + Kubota Consulting, where she’s a project manager and associate.

Pires-Piimauna suffers from lupus, a disease that once controlled her life. “I was taking 26 different medications. Medications told me when to get up, when to sleep, when to feel good, when I needed more.”

That was before she participated in her employer’s Whip It (Wellness and Health for the Individual Program) that reimburses up to $300 annually for the cost of exercise classes or equipment. The company says it has spent more than $100,000 on employee reimbursements since the program began and more than 70 percent of its 200 workers participate.

“B+K challenges us to be fit and healthy, and also rewards effort,” says Pires-Piimauna who has turned her health around and come off all of her medications. “Half the battle is showing up. This year I also won a cash prize for my  Whip It points.”

Bowers + Kubota Consulting is one of hundreds of Hawaii companies that actively support employee health with wellness programs.

“We offer our wellness programs because we recognize that fostering healthy individuals translates to an improved quality of life, high job satisfaction and healthy work environment,” says Dexter Kubota, the firm’s co-founder and president.

“The program is a multifaceted approach to wellness by offering support in fitness, nutrition, emotional counseling, community outreach and financial guidance, among other things. Wellness has become intrinsic to our company culture. The intent is for this wellness culture to also permeate to the homes of employees, benefiting their families as well.”

Tuesday Pires-Piimauna | Photo: Brandon Smith

All of that leads to stronger communities and potentially a reduction in health care costs that could theoretically reduce health care costs statewide.

Robert Harrison, chairman and CEO of First Hawaiian Bank and chair of the health and wellness committee for the Hawaii Change Project, has high regard for local wellness programs.

“Employees are the most important asset any organization has, and improving their wellness helps all of us. The better our employees feel, the more they are able to enjoy life and contribute to both their family and the community. It helps the community be more positive and productive,” Harrison says.

Dr. Virginia Pressler, former director of the state Department of Health and former executive VP and chief strategic officer with Hawaii Pacific Health, agrees with that evaluation, and sees a definite community benefit from companies committed to their employees’ overall well-being.

“Work site wellness is important as a way to increase awareness among employees on how to care for themselves and their families,” says Pressler. “That also means work site health policies that foster healthy living such as removing doughnuts and sugary drinks from work site meetings, encouraging walking, biking and mass transit to get to work, and encouraging policies like flex time to allow for enough sleep, family time and physical activity.”

Mark Fukunaga, Chairman and CEO of Servco Pacific Inc. and the 2018 Hawaii Business Magazine CEO of the Year, has long championed a wellness strategy for his employees. As part of a wide array of wellness programs and activities, 10 years ago Fukunaga oversaw construction of a gym for his team at the company’s Mapunapuna headquarters.  Hundreds of Servco employees have benefited from the classes and sports it offers.

“From a business perspective, the rising cost of health care is a concern that touches our entire economy,” says Fukunaga. “Employers benefit by taking proactive measures to enable employees to be more accountable for their own physical, mental, social and financial wellness. If every employer in some way positively influences the health of that part of the community that works for them, the entire community benefits.

“The effect is a chain reaction. If we can impact our team members, those that participate will impact other team members. It helps create healthier habits, which they then take home and into the communities where they live and play. I think more companies are becoming aware of the value this kind of program can bring, and are implementing solutions in varying degrees.”

Daphne Mendiola, a senior payroll specialist at Servco, joins in exercise classes at the company gym four days a week. Her fellow employees are now also exercise buddies.

The attractive, spacious Servco gym opens at 5 a.m. and accommodates many classes as well as sports like pickup basketball games.

“We work hard but we also have fun,” Mendiola says. “I have a desk job and sit all day, so after attending the exercise classes I feel more energized. I did lose weight and my clothes fit better.”

Each year, as part of the Best Places to Work survey sponsored by Hawaii Business Magazine, leading local companies are honored for supporting healthy workplaces and healthy workers.

Companies’ health and wellness offerings run the gamut. Howard Hughes Corp.’s Hawaii employees are offered surfboards, bicycles and Fitbits. Swinerton Builders offers discounted rates to 24 Hour Fitness and free registration for the Great Aloha Run. Island Insurance brings Weight Watchers programs right into the office. American Savings Bank promotes a wide range of challenges for employees to get healthier.

Even smaller companies, with fewer resources, are finding ways to support the health of their workers. Hawaii Diagnostic Radiology Services employees receive annual reimbursements for the wellness program of their choice. Skyline Eco-Adventures on Maui provides reimbursements for gym memberships. Atlas Insurance Agency features a monthly on-site farmers market that brings fresh items to the office.

Peter Burke, the co-founder and president of the Best Companies Group based in Harrisburg, Pennsylvania, which administers the Best Places to Work surveys for Hawaii Business Magazine, says wellness programs help to engage employees. And that, says Burke, whose organization runs similar surveys in 23 other states and four countries, leads to better employee performance and ultimately better bottom lines.

Five years ago, Linda Kalahiki, senior VP and chief marketing officer of UHA Health Insurance, helped launch the Hawaii Health at Work Alliance, which advocates for wellness programs statewide. HHWA now includes more than 200 companies. The alliance shares best practices  regarding workplace wellness, and has created a support network for Hawaii companies.

For her part, Pressler welcomes company wellness programs, but says they should only be part of the picture. She’d like to see greater focus on “serious policy changes to allow employees and their families to eat better, stay physically active, avoid tobacco and vaping, and take care of their mental health.

“We need to change the entire culture in the U.S. to focus on health, much as Japan has done as a nation,” says Pressler. “And we need to create a culture of health throughout our state. That means livable, walkable, bikeable communities, and more personal understanding of how to be healthy.”

Learn More

Many efforts are underway to improve health in Hawaii; the Hawaii Community Foundation lists these sources:

• Hawaii Healthy People 2020
• Hawaii Public Health Institute
• Healthy Hawaii Initiative
• Office of Hawaiian Affairs, Mauli Ola and the Determinants of Health
• Hawaii Health Matters Healthy People 2020
• Hawaii Health Disparities Dashboard and Socioneeds Dashboard
• Kids Count Data Center for Hawaii

This report on our public schools offers many reasons for optimism and just as many causes for concern about difficulties that have lingered for too long.

Table of Contents

Part 1:
Real-World Learning

Part 2:
Student Success

Part 3a:
Trying to Solve the Teacher Shortage

Part 3b:
New Way to Home Grow Teachers

Part 4:
Designing Schools of the Future

Part 5:
Different Approach

Part 6:
How You Can Help

This report on education does not try to be comprehensive. Staff Writer Noelle Fujii focuses on major issues in public education – the good and the bad – on smart innovations and ways forward, about key challenges and possible solutions. It concludes with a section on how you and your organizations can support our public schools. We welcome your feedback and suggestions on Facebook, Twitter, LinkedIn and Instagram using the tag #hawaiiforchange.

The six CHANGE reports from Hawaii Business Magazine are based on a framework created by the Hawaii Community Foundation and adopted by the Hawaii CHANGE Initiative. “The CHANGE framework acknowledges the interconnected nature of community issues and zeroes in on six essential areas that constitute the overall well-being of these islands and people,” HCF says.

CHANGE stands for:

• Community & Economy
• Health & Wellness
• Arts & Culture
• Natural Environment
• Government & Civic Engagement
• Education

Hawaii Business published the first CHANGE Report in the February issue: It covered Community and Economy by focusing on the ALICE families, the 37 percent of local households that have at least one working adult but are barely getting by. Further reports will appear in April, May, June and July. As HCF says, “By examining critical community indicators by sector, we can identify gaps where help is specifically needed and opportunities where help will do the most good.” Find all the reports at hawaiibusiness.com/changehawaii.

Disclosure: Hawaii Business got support from the aio Foundation, HCF and other organizations, and input from many people, but no one outside the Hawaii Business editorial team had any control over the content of these reports.

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Part 1: Real-World Learning

An exciting transformation is occurring in Hawaii’s public schools and those changes are supported by a broad consensus, including education leaders inside and outside the DOE, nonprofits, foundations and even Mainland experts. Big challenges remain – such as low test scores, chronic absenteeism and poor teacher retention – but hands-on projects that address modern problems better engage all students while preparing them for a world in which traditional careers are dying or being reinvented.

Public education in Hawaii is undergoing a transformation.

No longer is school just about teaching students how to ace standardized tests required by a top-down mandate. Instead, the focus is increasingly on learning that’s hands-on, relevant and driven by students.

The classroom is no longer confined to four walls; it’s common for students to learn math concepts at a loi, polish their writing on a public service announcement and learn about careers in internships. In these settings, teachers are often alongside them serving as resources, rather than as experts lecturing at the front of a room.

Leaders in education inside and outside the DOE and elsewhere in government are encouraging this transformation and the empowerment of schools to be innovative in how they teach. After all, schools have a bigger challenge than ever: to prepare students for a rapidly changing global economy and jobs that either don’t yet exist or will be constantly reinvented.

Click here to find out how you can help.

Catherine Payne, chair of the state Board of Education, says Hawaii has had this conversation for decades but has finally reached a tipping point. “You have to reach that point where people are all ready to do what needs to be done – and I think we’re there,” she says.

Payne formerly worked as a public school teacher, vice principal and principal and was most recently the chair of the State Public Charter School Commission. “I think there’s recognition that we cannot continue to do things in the same way we’ve been doing them. We cannot keep chasing test scores as the primary reason for our existence.”

Many agree that this is an exciting time for public education. Joshua Reppun, a former teacher, says: “Now they’re hearing this message: school empowerment, school design is yours, teacher collaboration, get students involved in their own education, personalized learning. … This thing that has been predisposed for a very long time, to do innovative, imaginative creative things in education for the benefit of student engagement, is now popping up everywhere.” (Disclosure: Reppun is married to Hawaii Business publisher Cheryl Oncea.)

Change Needed

“Today, I think a lot of us would agree that too many students – especially those furthest from opportunity – are unprepared for the challenges of the 21st century,” says Lisa Mireles, a director of district and school leadership at PBLWorks and a former school renewal specialist for the Kauai Complex Area.

Schoolchildren who focused for generations on how to memorize material and replicate low-level tasks have turned into adults who don’t know how to reinvent themselves as the economy changes and careers either change or disappear, says Ted Dintersmith, a former venture capitalist who visited all 50 states to learn about best practices in education. He produced and funded the documentary, “Mostly Likely to Succeed,” which examines the shortcomings of conventional learning and encourages schools to rethink how they should prepare students for the future.

Schools in their current form were created for an industrial society that produced workers who could be cogs in a machine, says Buffy Cushman-Patz, school leader of the School for Examining Essential Questions of Sustainability, SEEQS, a charter school based at Kaimuki High School.

“We’re training kids that (when) a bell rings, to get to class on time, you sit down, you do what someone says, the bell rings and you do some completely other different subject that’s not related – and you repeat that six times a day,” says Rick Paul, who just retired after serving as Hana High and Elementary School’s principal for 14 years.

It hasn’t helped that, in the last couple of decades, life in schools has revolved around standardized reading and math tests thanks to the No Child Left Behind Act of 2001, a federal law that reprimanded schools if they failed to produce higher scores each year, and Race to the Top, a competitive federal grant that Hawaii received to raise test scores, ensure college and career readiness and close achievement gaps. This contributed to a top-down mentality where central administration told schools what do, including what curriculum to use, says Corey Rosenlee, president of the Hawaii State Teachers Association.

These testing mandates forced many schools to focus their teaching on what would be on those tests, he says. And standardized tests don’t teach students much, he adds, except that there’s only one correct answer to a problem – and that’s not what students need to learn today.

Mireles says as Hawaii moves toward a more innovative, knowledge-sharing economy, schools must think of themselves less as dispensers of knowledge and more as facilitators of knowledge creation. They also need to understand that significant learning takes place everywhere – in and out of school.

“Many of the jobs we’re preparing our students for today don’t exist,” says Gov. David Ige. “It’s that whole notion that public schools are being asked to do more, to prepare our children for jobs that don’t exist today.” That means what and how schools teach have to change, he says.

College Graduation – Only 62% of first-time, full-time UH Manoa students will complete a degree or certificate within eight years. The rate for community college students is 26% to 40%, depending on which community college they attend.

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Turning the Tide

Conversations surrounding school empowerment have been going on for decades, Payne says, recalling former Superintendent Charles Toguchi’s calls for decentralization when he led the DOE from 1987 to 1994.

Today, most people see school empowerment as necessary, says Randall Roth, a retired UH law professor and former president of the Education Institute of Hawaii, a think tank made up of current and former educators and administrators who have advocated for schools to have more decision-making power since its establishment in 2014.

Desires for school empowerment and innovative educational methods are echoed and supported in three documents:

• Hawaii’s Blueprint for Public Education, a guiding document that was completed in 2017, outlines the community’s vision for public schools;
• The DOE’s 2017-2020 Strategic Plan;
• The state’s plan for how it will use federal funds authorized under the Every Student Succeeds Act, a 2015 law that replaced No Child Left Behind and grants states more flexibility to design their education systems.

Several sources say they’re encouraged that school empowerment is supported by key decision-makers like the governor, DOE superintendent and Board of Education chair.

“When you have the three people in alignment, then school empowerment really breeds innovation,” says Ray L’Heureux, chairman and president of the Education Institute of Hawaii, which is working on a fiscal transparency tool to see what the DOE’s resources are, where they’re going and who’s making the decisions. 

School empowerment means putting the decisions that affect students as close to them as possible. Those decisions could include things like instruction, curriculum, support services and facilities, though Ige adds that there are still statewide standards that schools must adhere to.

Christina Kishimoto, who has been superintendent of the DOE since August 2017, says this means celebrating each school’s uniqueness. The department’s main strategies to pursue this approach focus on incorporating student voice, encouraging teacher collaboration and purposefully designing schools in ways so every student is engaged in rigorous and innovative learning environments.

Kishimoto previously worked as the superintendent and CEO of Gilbert Public Schools in Arizona and says Hawaii’s interest in school empowerment was what drew her to the Islands. Around the nation, communities generally aren’t ready to engage in a distributed leadership model, she says, because empowering school principals and their teams means other people have to give up some decision-making power – and that includes the superintendent. Kishimoto emphasizes that she too must do her job differently.

She’s already started those changes. For instance, in the past year, she’s moved $13 million of the DOE’s professional development funds to the complex area level. Complex areas are clusters of adjacent high schools and their feeder elementary and middle schools. Schools and their complex area superintendents – instead of the state office – now decide how they want to use more of the department’s professional development funds. And last school year, the department created $1 million worth of innovation grants that traditional and charter schools could apply for to implement creative practices.

Ige says changes like the DOE’s innovation grants have encouraged a culture within the department that values innovation and school level ownership of curriculum and programs. Schools are already innovating their learning practices and teaching approaches. Much of that takes the shape of learning that is student-centered and relevant to the real world, and emphasizes skill building.

“What we’ve learned, and we’ve seen when we listen to student voice and we challenge students, is that they often exceed our expectations of what they can do,” Ige says. “I think that it’s really creating a system that can support the students and let them achieve to their level because they are so committed to taking on the challenges that many of us would think they are not capable of, but they have demonstrated over and over and over again that they can.”

Such student-centered learning often presents itself in project-based and work-based learning – examples of which can be seen across the state. Terrence George, president and CEO of the Harold K.L. Castle Foundation, which invests in education initiatives, describes what he sees as the best approach: “I think that the work related to project-based learning, school redesign, empowerment and innovation that is student-centered, rigorous, connected to (the) real world that the kids will inhabit when they graduate is our recipe for success.”

Relevant Experiences

On a breezy Monday afternoon, a group of students at SEEQS, the charter school focused on sustainability, are tending to cilantro and lettuce plants growing in their aquaponics and hydroponics systems. A few feet away, another group uses power tools to build a farm stand. These students are preparing for public exhibitions later in the week. Their job will be to present projects exploring the relationship between food and community to their families and the public. 

Cushman-Patz founded the school in 2013 and centered its instruction on community-focused, project-based, interdisciplinary learning experiences with a focus on sustainability. The hands-on aspect of the school resulted from her own schooling, which she says did not prepare her for life.

Four days a week, students at SEEQS dedicate 115 minutes – a little more than a quarter of the entire school day – to work on projects related to their Essential Question of Sustainability, or EQS. Depending on the quarter, students might be working on teacher-led or individual or group projects relating to their question. SEEQS serves about 180 students in grades six through eight, so the school’s job, Cushman-Patz says, is to teach students about the project process of proposing an idea, receiving feedback, making iterations, presenting their work and making further improvements. Each EQS course is composed of 60 students and is co-taught by English, science, history, math and art teachers, so students can incorporate skills and tools from each discipline into their projects.

These students are engaged in project-based learning. The definition of project-based learning varies, but Mireles, of PBLWorks, defines it as a teaching method in which students gain knowledge and skills by investigating and responding to authentic, engaging and complex questions, problems or challenges. Students work on these projects for an extended time and have opportunities to continually reflect and improve their work, and they produce a public product. The organization provides training in project-based learning for schools and teachers. In 2018, PBLWorks reached more than 30,000 teachers and provided workshops and services across all 50 states.

Project-based learning is often lauded as an effective way to engage students in hands-on learning that’s relevant to their interests or experiences in the real world. By completing projects like designing a logo for a local business or creating a video public service announcement, students build knowledge in subject areas as well as skills in communication, collaboration and critical thinking – skills that employers want, says Candy Suiso, program director of Searider Productions, Waianae High School’s multimedia program.

In August, Hana High and Elementary School launched a nontraditional campus at Hana Bay for 16 high schoolers who were interested in interdisciplinary and hands-on learning. Their first project was to build the structures for their campus, including an open-air pavilion and computer lab. The purpose of this nontraditional school, says former principal Rick Paul, is to better integrate the real world with the classroom. The hands-on activities come first, says Rick Rutiz, executive director of Ma Ka Hana Ka Ike, the nonprofit vocational training program that the school teamed up with to launch the project. For example, math can be taught using canoe paddling or by going to a loi to figure out how much water runs through it in a certain time.

Students from Ma Ka Hana Ka Ike calculate water flow in an East Maui loi kalo  |  Photo: Courtesy of Kirsten Whatley, Ma Ka Hana Ka Ike

Paul says one challenge of project-based learning is giving grades based on DOE requirements, which segment graduation credits and standards by subject, like English, science and math. “What’s difficult is to build a pretty fancy building or structure and then say, ‘I can give you a grade in Algebra 1.’ Because all those Algebra 1 standards aren’t (met in that project). But there is some Algebra 1, some Algebra 2, there’s some of everything,” he says.

Rutiz says another challenge is motivating the 16 students to engage with their learning and step up in an environment where they’re not given worksheets and not told what to do all the time. This nontraditional school, however, is an experiment and elements of it will likely be incorporated into the whole school later.

“The renegade thing was to try to demonstrate to others in Hawaii education that you take these kids who don’t do well in a four-walled classroom and you put them in a different situation, and they will excel and do great things,” he says. “They won’t be absent 25 percent of the time. They won’t have 40 referrals in a year. They won’t be in the same situation they were the year before.”

He adds that he’s not saying Hawaii needs to throw out its education system, but it is the responsibility of educators to do better and try new things.

“We’re making the kids spend all the years – (when they are) 15, 16, 17, 18 – when kids should be on fire, just ‘Whoa, how do you do this?’ ‘Show me how to do this.’ ‘How can I turn this upside down?’ ‘There’s got to be a better way to do that.’ That’s how they should be spending these years. And they’re not; they’re alienated,” he says. “They’re saying – excuse my language – but ‘What the f— am I doing here?’ We’ve got to find a way to … inspire and to motivate.”

Mireles says she’s seen project-based learning grow in the 15 years she’s been in the Islands. Project-based learning is the foundation of several charter schools – such as those that focus on Hawaiian culture-based education. Several years ago, PBLWorks (formerly the Buck Institute for Education) and the Harold K.L. Castle Foundation teamed up to launch the Hawaii Innovative Leaders Network, a project that trained and supported two cohorts of public and charter school principals to create school cultures in which project-based learning was encouraged. Another two HILN cohorts are expected to begin this year, according to Alex Harris, the Castle Foundation’s senior education advisor.

A lot of the project-based learning happening at schools on Kauai’s west side resulted from this network, says Melissa Speetjens, principal of Waimea Canyon Middle School. This year, her school is implementing a new bell schedule that dedicates 20 percent of the school day for project-based learning – fueled by a DOE innovation grant.

PBLWorks and Castle Foundation are also working on another, larger, multiyear project to train educators in the Pearl City-Waipahu high schools complex area. (The project also targets the Manchester School District in New Hampshire.) The goal is to scale high quality project-based learning in the complex area so all classrooms conduct at least two projects a year. So far, 315 Pearl City-Waipahu teachers and school leaders from 10 schools have been trained, says complex area superintendent Keith Hui. Outside of this project, about 1,120 Hawaii teachers have participated in PBLWorks’ Project-Based Learning 101 training since 2012.

Real-World Learning

Scroll through Searider Productions’ Vimeo page and you’ll find about 800 skillfully crafted videos ranging from news stories about the Waianae community to advertisements for nearby organizations to public service announcements – and they’re all produced by students.

Waianae High’s multimedia program was established in 1993 as a way to keep students in school and make learning fun and relevant, says Suiso, who co-founded the program. Today, students can pursue pathways in photography, video production, graphic arts or journalism, and they’re employable by the time they graduate because they’ve already developed many of the skills needed for these fields, she says.

Nicholas Smith was in Searider Productions for four years and graduated from the high school in 2004. He now works at the Institute for Native Pacific Education and Culture (InPeace) as director of communications and says he wouldn’t be doing what he does today if not for the program, which offers skills that Waianae students would otherwise have to travel to learn.

“To allow students to find their purpose and passion, we need to give them room to explore different careers, to do learning in teams on issues that are relevant to them, to make the learning of basic content, like writing a persuasive essay or doing algebra, to apply that to things that matter to kids,” says George of the Castle Foundation.

This work is often seen in Career and Technical Education programs that allow public high school students to explore careers. There are six CTE pathways, each with more specific programs of study; for example, the Arts and Communication pathway features a program focusing on animation. Each pathway is made up of a sequence of courses and spans at least two years of high school and into postsecondary education. The number of students completing a CTE sequence of courses has grown over the last four years. Almost a third of the class of 2014 statewide completed a CTE program; for the class of 2017, that number was 42 percent, according to data from Hawaii P-20 Partnerships for Education, a statewide effort led by the DOE, UH and the Executive Office on Early Learning.

“When students are in high school and they see high school as something they have to do before they get to college and then they see college as something they have to do before they get a job, then it’s a real slog along the way. Whereas if they can see ‘Hey I want to be an auto mechanic, here’s my path to get there,’ that can be inspiring,” says Stephen Schatz, executive director of Hawaii P-20.

At Waipahu High School, the CTE programs are housed in five career academies, where coursework is grouped and sequenced into programs of study that prepare students for particular career fields while also bringing in real-life experiences. Fifteen DOE high schools have career academies. Waipahu High’s principal, Keith Hayashi, says some of Waipahu’s academies have been around for 25 years, giving students voice and ownership over their learning as they figure out what their passions are. The school’s motto, after all, is “My Voice, My Choice, My Future.”

Waipahu High School Senior Christine Alonzo

The school’s Academy of Professional and Public Services helped senior Christine Alonzo decide to pursue a career in accounting and has provided her with valuable real-world experience in the field. Through the academy, she’s volunteered for Leeward Community College’s Volunteer Income Tax Assistance Program, which helps low-income people prepare taxes, and she’s interned with HawaiiUSA Federal Credit Union.

Daniel Hamada, who just retired after eight years as principal of Kapaa High School, says the purpose of school is to provide education that’s relevant, rigorous and built on relationships with teachers. During his first year he saw that school was not that relevant for the students: 12 percent of the freshman class was chronically absent, a third were getting D’s and F’s, and about 20 percent weren’t progressing into 10th grade. Since then, career academies have been created to better connect students to support and make their learning relevant. Freshmen are grouped into one of two hui where a team of teachers builds relationships with them and helps them transition into high school. And in their sophomore year, they enter one of two career academies – one focused on service careers, like health service and culinary, and the other on design-related careers, like building, business and digital media.

The school’s transformation has meant fewer ninth-graders are held back from 10th grade and a lower chronic absenteeism rate, Hamada says. Students in the class of 2018, for example, maintained attendance rates ranging from 89 to 93 percent throughout their four years at the school, and each year most students passed core academic classes such as math, English and science.

“Today’s generation, they know what’s out there, they know about what they’re interested in; now we just have to provide an environment for them to help find their way,” Hamada says, adding that building partnerships with the community and businesses is important too. For example, students interested in teaching can tutor at a nearby elementary school, and students interested in health care can shadow workers at a nearby hospital. And the high school is looking at providing access to industry certifications.

Waipahu High School already does this for some of its pathways. Students can be certified as food handlers, pharmacy technicians and medical assistants, and for software like SolidWorks and Revit, which are used by engineers, architects, contractors and designers – and the school is looking to expand its certifications as it continues to partner with industry, Hayashi says. This year, the school principal estimates about 158 certifications will be earned by students across the different academies.

Kishimoto says the involvement of industry in career academies is pushing the design of instruction and learning in a different direction, where learning spaces include the community and teachers work alongside industry experts. Business leaders are excited about helping schools shift from a content-focus to a skills-focus, says the Castle Foundation’s George, who is also co-chair of the Hawaii Executive Conference’s education committee, which provides industry perspective and support to education. He adds there’s alignment between employers, students and educators that he hasn’t seen in a while.

On Kauai, the Keiki to Career initiative is helping to bridge the gap between public schools and industry by creating academy coordinator positions at each of the three high schools to coordinate work-based learning experiences, like bringing in guest speakers and creating teacher “externships” so educators can learn about current trends in industry. The initiative is also creating islandwide advisory boards composed of leaders from businesses, the DOE and Kauai Community College, says Dana Hazelton, director of Keiki to Career’s Career Connections.

It Takes a Village

“Never in my whole life have I been more excited about public education anywhere than now – and it’s in Hawaii,” says Reppun, a former teacher who is now a specialist at Apple and organizes discussions centered on screenings of the 2015 education-reform documentary, “Most Likely to Succeed.”

Several sources interviewed for this story agree with him. There’s a lot of collaboration occurring among public, private and charter schools – all trying to figure out how to move education forward in the 21st century. Dintersmith, the education change agent and executive producer of “Most Likely to Succeed,” says Hawaii’s level of collaboration exceeds that in any other state.

It’s been a long journey to get to where education is today, says Hamada, the retired Kapaa High principal. “We have to take this upon ourselves to now innovate and partner, to make this happen. So in the most positive ways, it’s our kuleana, our responsibility, to really make it happen.”

Superintendent Kishimoto says she’s excited to see so much energy behind this movement. She’ll often receive emails from teachers telling her about the innovative things they’ve recently done in their classrooms. “It’s not going to be led by the state. I can set vision. I can set direction. And I can provide resources and advocate at the Legislature for the resources we need,” she says. “But the rest of the work happens at the school level. The exciting work happens there.”

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Part 2: Student Success

As Schools Change, So Do Measures of Student Success

Standardized tests. Those words invoke memories of students sitting in rows of desks, heads down, filling in bubbles on a multiple-choice test.

For a long time, those tests largely determined whether schools and students were considered successful. They’re still important for measuring student performance, but there’s recognition today that these tests do not reveal all of what students know.

Schools and the state Department of Education are rethinking what student success should look like and how it should be measured. That rethinking is taking place at the same time that more power, money and decisions are being shifted from DOE headquarters to the schools, as educators are encouraged to innovate and as students learn more and more with hands-on projects.

“We also have to start looking at what are some other ways to measure student growth and gains in terms of achievement because a standardized exam is not going to measure hands-on learning opportunities and it’s not going to necessarily measure the students’ ability to gain knowledge on their own and think differently unless it is directly aligned to particular items on an exam,” says Christina Kishimoto, superintendent of the DOE.

Tests Are Not Everything

Cynthia Tong, an 8th grade social studies teacher at Ewa Makai Middle School, has been teaching for 23 years. One year at Waipahu Intermediate, she estimates, students spent 13 whole school days taking standardized tests.

Students are under a lot of pressure to do well on these tests, she says. “I see more kids sick, crying, a sense of helplessness, hopelessness, when we have testing, no matter how much we try to buff them up and tell them that they’re good and we practice for the test,” she says.

Standardized tests were the primary focuses of many public schools for years. Federal mandates under the No Child Left Behind Act of 2001 pushed schools to improve their test scores each year or be labeled as failing. 2010’s Race to the Top further encouraged the testing culture.

“It’s very hard for teachers and for principals, too, I think, when you’re being judged on these scores to not push your kids to be good test takers, which is not the best way to educate children,” says Catherine Payne, chair of the Board of Education.   

Ewa Makai Middle School Teacher Cynthia Tong | Photo: Elyse Butler

Today, federal law requires students to be tested in certain grades in English, math and science. Hawaii also requires 11th graders to take the ACT, and every other year a sample of 4th and 8th graders take the National Assessment of Educational Progress for Reading and Math. The state DOE also administers statewide tests for English language proficiency and for students in its Hawaiian immersion program.

Students’ scores on the statewide assessments for math and science have remained relatively consistent for the last three years. In 2017-18, 42 percent of students were proficient in math, and 46 percent were proficient in science. And language arts scores grew by 4 percentage points, from 50 percent of students proficient in 2016-17 to 54 percent in 2017-18. 

Under No Child Left Behind, school performance was measured mostly by test scores. Today, the Strive HI school accountability system measures school performance using multiple indicators such as student achievement, chronic absenteeism, high school graduation rates, college enrollment and the achievement gap between special needs students and other students.   

Educators agree that standardized tests are an important measure of whether students are learning – but they’re not the only indicator.

Buffy Cushman-Patz is the school leader of the School for Examining Essential Questions of Sustainability. The Honolulu-based charter school focuses on interdisciplinary, real world, project-based learning that’s rooted in sustainability. Her students have outperformed the state test score averages in every subject and grade for several years, but what matters more, she says, are the quality of their projects, exhibitions and portfolio defenses and whether students are able to reflect on their learning.

“What I want is to walk through campus and see happy kids, I want to see smiles on their faces, I want to see them engaged with me, I want to see them engaged with you, I want to see them be able to talk about what they’re learning and why,” she says. “That’s how I measure the success of our school, but those are not easily quantifiable.”

Pursuing Innovation

To flourish in the modern world, students need to graduate with skills in critical thinking, problem solving, communication, creativity and collaboration. Those are difficult skills to measure.

Hawaii will be applying for the “innovative assessments” pilot program under 2015’s Every Student Succeeds Act – which replaced No Child Left Behind and provides states with more flexibility to design their education systems. Under the program, Hawaii will be able to develop, pilot and scale innovative assessments instead of the current standardized tests.

Innovative assessments should provide a richer story about what students can do and how they’re growing. Rodney Luke, assistant superintendent for the DOE’s Office of Strategy, Innovation and Performance, says the state is still working on its plan for what its innovative assessment system might look like and how it will be implemented, but innovative assessments could be authentic, problem-based, project-based or performance-based. Here are some examples of how innovative assessments are already being used in Hawaii’s public schools.

Authentic assessments are assessments in which students demonstrate and apply skills and knowledge by performing real world tasks. Tong does authentic assessments in her 8th grade social studies classes at Ewa Makai Middle School and says she sees students engage more with their learning because they see the connection to the real world. For History Day, students’ projects might involve making documentaries, doing live action performances and creating websites – things that students could get a job doing in the real world, she says.

“Anytime you do an authentic assessment, you have leaps and bounds in learning of skill because it’s bundled together and they’re real, they make sense, they go together. When they’re separated out too far – they’re not within an authentic assessment – kids don’t learn it that fast, they don’t learn it very well, and they don’t commit it to memory,” she says. “But if they’re forced to read a story to a two-year-old and explain every word, that’s an authentic assessment.”

Innovative assessments are typically seen in pockets in Hawaii’s public schools. Some schools require senior projects where students pick a topic, do research, work with a mentor and present their learning experiences in front of community members. Or some teachers, like Tong, do them just in their classes.

Payne, who used to serve as the chair of the State Public Charter School Commission, says local charter schools are leading the way in developing innovative assessments.

Students from Malama Honua Charter School Fall Hoike Hula at Waimanalo Hawaiian Homes Halau 2014 | Photo: Courtesy of Malama Honua

At Hawaiian-focused charter schools like Malama Honua Charter School in Waimanalo, performance assessments are often used to gauge student learning, says Denise Espania, the school’s director. The school and 16 other Hawaiian-focused charters are working on culturally relevant assessments. Over the last several years, the group has developed a framework and toolkit for schools to use to assess student growth.

One example of performance assessments at Malama Honua are hoike, or public presentations of learning, which students do each trimester. During the first trimester’s hoike, students share with families a story they wrote or an image they drew that represents who they are and where they came from. In addition, students also give defenses of their learning, sharing with community members and experts what they’ve learned and what they think is important. Espania says these types of assessments are far more powerful than taking a fill-in-the-blank test.

“I’m hoping Hawaii can be part of this movement that believes in our students, that believes in our children, that they can and they do these amazingly rich rigorous assessments and that we’re, as a community, as a state, we are recognizing those as valuable forms of assessment,” she says.

(View Hawaii Business’ past coverage of authentic assessments.)

Reaching Different Learners

As schools and the system talk about redefining how students are measured, sources agree there’s still a need to make sure that all types of learners are engaged in their learning.

Hawaii’s achievement gaps between high needs and non-high needs students have remained consistent over the last three years. High needs students include students who receive special education services, who are economically disadvantaged or who are English language learners. In school year 2017-18, the gap between high needs and non-high needs students was 28 points in math and 32 points in language arts. The DOE’s goal is to reduce the math gap by six points and the language arts gap by seven points by 2020.

Tong of Ewa Makai Middle School thinks the achievement gap exists because of standardized tests. Not every learner is best fitted for taking multiple choice tests or learning in the same way. In addition, standardized tests tell students that only reading and math are important – and if they don’t do well in those areas, they won’t do well in others. That ignores the fact that students are great at other subjects, like science, physical education and music, she says.

In her class, she tries to close the achievement gap and engage all learners by teaching and assessing in different ways. For example, instead of always having multiple choice tests, essays or worksheets, she might ask her students to do a vertical learning discussion, create a thinking map or draw a cartoon.

“There’s lots of different ways to get at judging how kids learn, but the fallback has always been writing and reading, and that’s not fair to the kids,” she says. “A lot of our kids are strongly visual learners or strongly musical learners, so they might write a rap song or decide to do a skit, they might do a performance. I’ve even had kids who have created a video game or they created a board game to demonstrate what they knew about the Civil War.”

Getting creative in assessing and teaching can also help students who are struggling in a subject like math. A smaller percentage of Native Hawaiian students are proficient in statewide math tests than most other ethnic groups. Maya Chong, a K-5 curriculum coach at Kanu o Ka Aina, a Hawaiian-focused charter school in Waimea, says these test scores show Native Hawaiian students lack confidence in math. She says at her school in particular, students have trouble seeing why algebra or trigonometry are relevant.

“I think they see math as much more western than it is cultural. So bringing those two worlds together and also having practical application and showing them this math problem that is so black and white on paper or on a computer screen when they’re taking a test, just means this, like remember when we went out and we did this outside with our hands,” she says.

This past summer, she and two other teachers at Hawaiian-focused charter schools on Kauai and in Hilo each developed 30 Hawaiian culture-based math lessons. They’re operating as part of the Kanaeokana network made up of Hawaiian immersion schools, culture-based charter schools, the UH community, DOE programs and community-based nonprofits, with support from Kamehameha Schools. 

This year she’s helping to implement the lessons she created for kindergarten students. One unit focused on measurements, so students measured objects in the school’s garden. Another unit focused on geometry, so students identified shapes on kapa. Once students have a firm understanding of the different shapes, another lesson will involve them creating their own kapa.

Chong says students are better retaining the math concepts that are being taught. The next step, she adds, is to get more teachers involved. Eventually, the goal is to have teachers across all grade levels developing culturally relevant math lessons.

Providing support to students is another way to help them succeed in school. Kapolei High School opened its Hoola Leadership Academy in Fall 2008 as an alternative learning program to help struggling students. The name means “to heal,” and the program was meant to offer prevention and intervention so students could successfully progress through high school in a family style environment, says Joan Lewis, who was one of the founders and is now an instructional coach at the school.

Today, the program has about 200 students in 9th through 12th grade. It’s one of the school’s academies and provides curriculum centered on Hawaiian culture and natural resources. Students often work on hands-on projects, like developing climate-appropriate landscaping and produce, and offering solutions for consideration to issues like homelessness, waste management and bullying.

The key, Lewis says, is providing students with support as well as opportunities for them to apply their learning and helping them to identify their personal strengths. “… What it comes down to is giving them the time, the space, the direction, the redirection to find who they really are and what their gifts are for themselves and for us as a program and a school but for their community,” she says.

She adds that the students that are in Hoola and other similar learning programs are typically the ones who have historically asked teachers over and over why they need to know what they’re teaching. “Our students push us to make sure we stay relevant and we can explain thoroughly the purpose of it, how they’re going to use it, why it matters, whatever you want to think, and then once our kids get into it and see what comes of their work, they’re hungry for what comes next.”

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Part 3a: Trying to Solve the Teacher Shortage

Students in schools with high turnover ask if their teachers are going to finish the school year so often that there’s a term for it: “Gone by December.”

“That was a story that I have heard from students who didn’t believe the teachers would be staying for very long in these areas,” says Corey Rosenlee, president of the Hawaii State Teachers Association. “But we do know that there are teachers who leave during the year. … I’ve seen teachers at Campbell High School who just stayed a couple of months.”

The challenges of finding and retaining teachers have long been exacerbated by the Islands’ isolation and high cost of living. Every year, the state Department of Education hires an average of 1,200 new teachers – about 9 percent of the department’s 13,000 teaching positions – to replace those who have retired or resigned.

Many of these positions are filled by residents, but local teacher preparation programs aren’t graduating enough teacher candidates to keep up with demand. The solution, then, has typically been to recruit teachers from the Mainland, but because they’re often placed in the most remote areas – where they find it hard to put down roots – they tend to only fill the gaps temporarily, says Catherine Payne, chair of the state Board of Education.

According to the DOE’s 2017-18 Employment Report, the number of public school teachers leaving the Islands has increased 71 percent, compared to 2012-13. More teachers are leaving Hawaii than retiring. As the state’s teacher shortage drags on, the number of teacher positions filled by uncertified teachers continues to climb. And more than 500 teaching positions continue to be unfilled at the beginning of the school year each August.

“What we’re experiencing is that we have a lot of schools that do not have qualified teachers in the classroom. We have long-term subs, and some are very good – some of them are retired teachers who are coming back – but you cannot fill the system around an unstable teaching force,” Payne says.

“This is where equity comes in, because even though Honolulu has some problems, the most serious problems are in the areas where you have the most struggling students. And to say we’re going to be OK with giving them the lower qualified teachers is not an acceptable response.”

Solving Hawaii’s teacher shortage will take a multifaceted approach, several sources agree. That includes things like increasing teacher pay, improving the public’s perception of the teaching profession and thinking outside of the box. Here’s a look at some potential solutions.

Locally Grown

“We’ve got to do our best to making teaching cool again,” says Stephen Schatz, executive director of Hawaii P-20 Partnerships for Education. “We really want our kids to grow up and realize what a great profession it is.”

In November, Hawaii P-20 convened a meeting with representatives of the Chamber of Commerce Hawaii, local teacher preparation programs, and public, private and charter schools to talk about ways to address the teacher shortage. Schatz says there’s a lot of energy around getting students interested in teaching when they’re in high school or younger.

“At the end of the day we’re recruiting about a thousand teachers here (a year), and locally we’re not producing a thousand teachers, so there’s just a simple supply and demand mismatch,” he says.

Over the years, UH Manoa’s College of Education has seen a decline in both the number of students pursuing teacher licensure and the number of eligible teachers it produces. In 2012, the COE produced 296 eligible teachers; in 2017, 193. Nathan Murata, dean of UH Manoa’s COE, says that’s a trend seen at other education colleges around the country.

Various programs exist to encourage keiki to become teachers. Several high schools have teacher academies or programs of study that give students exposure to the profession. COE partners with academies at Waipahu, Farrington, Waianae and Campbell high schools to bring them to the UH Manoa campus, so high schoolers can observe COE classrooms and ask faculty questions, says Denise Nakaoka, director of student academic services for the COE, adding that the college wants to expand its outreach to more high schools. In addition, COE is starting to recruit in middle schools. 

In 2017, UH launched its Be a Hero, Be a Teacher multimedia campaign to encourage working professionals and high school and college students to consider becoming teachers. Murata says that campaign resulted from conversations among UH administrators about the need to reimagine the teaching profession and improve the perception of what it means to be a teacher. Many people are deterred by the low pay, he says.

UH and the DOE are also looking at ways to help working professionals become teachers. Several years ago, state Sen. Michelle Kidani, who chairs the Senate Committee on Education, learned that a majority of Hawaii’s substitute teachers already had bachelor’s degrees, but not teaching degrees.

“I think at the time they figured out that we probably had 5,000, 6,000 substitute teachers. So you’re looking at a pool of probably about 2,800 teachers in the classroom who are substitutes and do not have teaching certificates,” she says. “So why not recruit from there?”

Today, Grow Our Own is a partnership between the state Department of Education and UH Manoa’s COE. The program targets educational assistants, emergency hires and substitute teachers who are already working in public secondary school classrooms. They work toward post-baccalaureate certificates in secondary education, which leads to teacher licensure, and their tuition is covered by funding from the state Legislature and the DOE.

Classes are delivered in an online/hybrid format, Nakaoka says, so participants can continue to work full time. Neighbor Island candidates can also receive stipends to attend required face-to-face meetings, she adds. Once they complete the program, participants must commit to three years of full-time teaching in grades 6-12 in charter or traditional public schools.

The first cohort of 30 participants began taking courses in spring 2018. A second cohort of 17 participants began this January.

There are additional efforts underway to help increase Hawaii’s supply of teachers. Leeward Community College and the Institute for Native Pacific Education and Culture launched a pilot program in Nanakuli in fall 2018 to help educational assistants become special education teachers. Accelerated hybrid classes are held in Nanakuli and participants work towards a bachelor’s of science in special education. And in 2018, Kamehameha Schools launched its Hookawowo Scholarship for Native Hawaiian students pursuing education degrees. Eighty-three students received scholarships for this school year. Kanakolu Noa, manager of strategy development in Kamehameha’s Community Engagement and Resources Group, says the scholarship was created to help address the teacher shortage.

Addressing Teacher Pay

The teachers union has long argued that Hawaii’s low teacher salaries are the cause of its poor retention. HSTA’s Rosenlee says those salaries are the lowest in the nation when adjusted for cost of living. Currently, a starting teacher who’s certified and has a bachelor’s degree makes $49,100.

According to an analysis by HSTA, which looked at 10 Mainland districts with similar costs of living and population sizes, Hawaii’s starting teachers make about $5,400 less than their counterparts in comparable districts. The gap for midcareer teachers – those with 10 to 20 years of experience – is between $18,000 and $30,000, and the gap for the most experienced teachers is between $12,000 and $18,000. Those districts, Rosenlee says, compensate teachers based on years of experience, a practice not followed in Hawaii.

Currently, Hawaii’s teachers receive pay increases by accumulating DOE-approved professional development or academic credits, or through salary step increases, which have to be negotiated. Joan Lewis, an instructional coach at Kapolei High School and a former HSTA VP, says that means local teachers who have 10 years of experience could be making the same amount – or more, depending on the number of credits a teacher accumulates – as a teacher with 20 years of experience. That’s demoralizing to a veteran teacher, she adds.

HSTA’s suggestion is to pay teachers based on years of service, which would allow teachers to better plan their futures, like when they’ll be able to afford to buy a house, Rosenlee says. Lewis adds that annual step movements would also give teachers more confidence that their salaries will keep up with cost of living increases.

The DOE and Board of Education agree that teacher compensation needs to be addressed. Cynthia Covell of the DOE’s Office of Talent Management says the department is preparing to launch a study that will look at pay, incentives, bonuses and other benefits to give the department a better idea of what it needs to do to be competitive. Teacher and student voices will be included.

“As a state we need to make a decision about what competitive level we want to maintain in terms of teachers’ salaries with where salaries are nationally as adjusted for cost of living in Hawaii,” says Superintendent Christina Kishimoto. “And so you know, depending on what values are put into that, that can be we’re $30 million short all the way up to several hundred million dollars short, depending on the competitive level.”

She adds that the DOE isn’t just competing against other school districts for teachers. It’s also competing against other careers, such as those in math and STEM, that pay higher salaries. But the department currently doesn’t have enough funds to make teacher pay competitive. In 2018, HSTA advocated for a proposed constitutional amendment that, if approved by voters, would have allowed the state Legislature to use property taxes to help fund public education. The state Supreme Court invalidated the proposed amendment in October.

Several sources agree that increasing teachers’ pay is only part of the solution. Covell says of 822 exit survey responses for the 2017-18 school year, 13 people indicated they were dissatisfied with salary. She adds there are also discussions about teacher housing – the department currently only has 59 units in various states of repair – and housing stipends.

Rural Areas Get Creative

Many of the 1,200 new teachers each year end up in rural areas, such as in Leeward and Central Oahu and on Hawaii Island.

The problem is that it’s hard for teachers who are new to Hawaii to build a life there, Payne says: “If you don’t have family and you’re in a very transient group of people who don’t have roots either – like Lanai has a hard time hanging on to their teachers – it’s just very, very hard.”

Rick Paul, who just retired after serving as Hana High and Elementary School’s principal for 14 years, says his school has always struggled to retain and recruit teachers. The town of Hana is nestled on the east side of Maui and a two- to three- hour drive from the main city of Kahului. When the DOE recruits, he says, it goes to big cities like Portland and Los Angeles – and those aren’t places where suitable teachers for rural schools are found.

That means schools in rural areas have to be creative in how they recruit and retain teachers.

At one point, that meant taking a trip to South Dakota. Paul says he and a team from the “Canoe Complex” – made up of the Hana, Lahainaluna, Lanai and Molokai areas – did this for two years and targeted the state because it had high test scores, low teacher salaries and bad weather in the winter. The idea was that those teachers would be used to living in rural areas, they’d get a pay raise and they’d get to work in a warmer climate, he says.

In the years leading up to his retirement, however, most of his new teachers were starting out as substitutes or instructors at the school and enrolling in teacher preparation programs to become certified. Paul says that right before he retired, six or seven teachers were enrolled in such programs: “It’s kind of like on-the-job training, so we call it growing our own. And then that’s how I get my teachers.” Part of the problem with finding teachers for Hana, he says, is the lack of affordable long-term housing, so the school has been hiring more and more people from the community to be teachers.

For Naalehu Elementary, the challenge of retaining teachers also stems from the school’s remoteness. Naalehu Elementary is about 60 miles from both Kona and Hilo, and teachers commute from each side of the island, says Darlene Javar, who has been the school’s principal for eight years. Some of these commuters leave after three years – when their probationary periods are up – for jobs closer to home. Of her 30 teachers, anywhere from two to 11 are new each year, with larger numbers seen every third year. This trend has caused her to shift her focus from retention to training.

“My philosophy has been if you’re going to stay with me for three years, they have to be three good years, and so it’s how to train them fast and hard,” she says. “I stopped looking for retention at the school and I thought, ‘OK, if I’m going to train teachers, we’ll train them well and they will be good for the state of Hawaii.’ ”

Training begins before the school year with a 10-day new teacher academy. New teachers include those who are in their first or second year at the school and teachers who are switching grades. They learn about the DOE, the school’s academic plans and goals, and systems and curriculum used on campus. Follow-up training and mentoring are done throughout the year.

Javar says she’s not just trying to fill a space when hiring teachers. She needs the best for her students, who she describes as struggling learners. The school is located in a remote, high poverty area, where students have limited resources and transportation and often start school without the advantages conferred by preschool and kindergarten. In the 2017-18 school year, 28 percent of her students were English-language learners and 40 percent were chronically absent.

The DOE also provides a Beginning Teacher Summer Academy in 14 complex areas, and has a mentoring program. This year, about 650 mentors are advising 1,400 new teachers, according to the department.

Big Picture

Hawaii hasn’t always had a teacher shortage. When Payne and Joan Husted, a board member at the Education Institute of Hawaii and former HSTA executive director, began teaching in the 1960s and ’70s, it was hard to get a teaching job because it was a popular profession and for many people, a long-term career.

Then in the ’90s, a wave of teacher retirements and new career possibilities, especially for women, led to pockets of teacher shortages, such as in math and science. Today, the shortages have accelerated to the point where public schools are turning over 50 percent of their teachers in five years. The DOE’s goal is to retain 60 percent of its teachers for five years by 2020.

Husted says Hawaii won’t be able to progress in areas like student achievement, or move toward a school empowerment model, until it stabilizes its workforce.

“One of my frustrations is I don’t think enough people are talking about ending the teacher shortage,” she says. “They get so hung up with reforming the department and they don’t recognize if you don’t stabilize the people, you’re not going to reform the department.”

Lewis, who has been an educator since 1989, says the teacher shortage is a multifaceted and nuanced issue, so there needs to be a larger discussion about what Hawaii’s goals are for the teaching profession and public education and what it’s willing to do to improve them.

She says that involves everything from talking about teacher housing, how educator preparation programs need to prepare teachers for the 21st century, whether the state would be willing to pay more money to increase teacher pay and, with the growing number of Millennials in the workforce, whether Hawaii has to shift its mindset to thinking about teaching as a five-year career instead of a 30-year career.   

“Until we’re going to sit down and have the real wraparound discussion – what do we expect, what do we want and what are we willing to commit to – everything we do is going to be a Band-Aid,” she says. “And then we’re going to wonder why we didn’t solve the problem.”

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Part 3b: New Way to Home Grow Teachers

For decades, the Waianae Coast has imported teachers who often ended up leaving after only a few years. Now, a pilot education program is turning motivated area residents into qualified teachers.

Hawaii’s teacher shortage requires thinking outside the box, especially when it comes to growing teachers on the Waianae Coast. 

Leeward Community College and the Institute for Native Pacific Education and Culture are running a new pilot program that brings a teacher preparation program to Nanakuli. The pilot program targets educational assistants and paraprofessionals who live in the 96792 ZIP code – Nanakuli to Makaha – and want to become special education teachers, says Christina Keaulana, special education coordinator and instructor in LCC’s Teacher Education Program.

The Nanakuli pilot program is part of LCC’s 3+1 Bachelor’s of Science in Special Education program, which leads to licensure as a special education teacher. Classes are offered through LCC for the first three years, and the final year will be done online through Chaminade University, which will grant students their degrees. The pilot program began in fall 2018, and LCC anticipates that a cohort of about 16 candidates will complete their degrees, Keaulana says.

Christina Keaulana | Photo: Elyse Butler

“Securing a nontransient, rooted teacher workforce is imperative to delivering quality educational services for a population who has consistently received the highest percentage of nonqualified educators in the state over the last several decades,” she says.

The Nanakuli-Waianae complex area is well-known for its high teacher turnover. Only 43 percent of teachers hired in the 2014-15 school year are still teaching in the complex area this school year, according to the state Department of Education’s Strategic Plan Dynamic Report. And teachers in this area are more likely to be unlicensed than in other complex areas. This school year, 16 percent of teacher positions in the Nanakuli-Waianae complex area are filled by teachers who are unlicensed and have not completed a state approved teacher preparation program. For special education teacher positions, that number is 29 percent. Both figures are far above the statewide average.

Untraditional Program

Bringing the program to participants on the coast removes many barriers that would typically prevent them from pursuing a teaching degree, like accessing classes they’d have to take in person and the rigid nature of traditional teacher preparation programs that require students to commit to taking a certain number of courses each semester, Keaulana says. The program’s hybrid classes are held during evenings, which allows most participants to continue working in their current jobs. Participants meet at Nanakuli Elementary School and at the Waianae Moku LCC campus, and classes are accelerated – it takes eight weeks to complete a course instead of the traditional 16 weeks during the fall and spring semesters.

Participants also attend a weekly study session facilitated by InPeace’s Kulia and Ka Lama Education Academy, which aims to help Native Hawaiians become teachers. The education academy provides wraparound services to help teacher candidates and current teachers succeed, including financial aid, textbook reimbursements, academic and career coaching, and connecting participants to support like housing and food.

Christina Keaulana with students from LCC’s Teacher Education Program | Photo: Elyse Butler

Participants in the pilot program who work as educational assistants in the DOE can move up two pay steps as they complete parts of the program, says Cynthia Covell, assistant superintendent for the DOE’s Office of Talent Management. The progression through the two pay steps, which would classify them as teaching assistants, and associated pay increases reflect the additional responsibilities the participants undertake as they develop their teaching skills. She adds that if participants do not become certified teachers, they return to their educational assistant class of work and pay.

“They’re able to stay in their classrooms and work and continue to have health benefits, continue to support their families, and continue to serve the community they love,” Keaulana says. “They really like working with this population. Why should they have to resign from the position just to become teachers?”

Another benefit of the pilot program, she says, is that both class instructors and participants are familiar with the culture of Nanakuli’s students. Teacher preparation programs, she says, typically lack cultural training.

Teachers Needed

Special education teachers are needed across Hawaii but the greatest need tends to be in Leeward Oahu. The Leeward district – home to the Nanakuli-Waianae, Campbell-Kapolei and Pearl City-Waipahu complex areas – often has the most new teachers, many of whom are for special education. The DOE’s Employment Report for the 2017-18 school year says 327 newly hired teachers were placed in the Leeward district, and almost 35 percent were for special education.

Keaulana thinks the state has a shortage of special education teachers because of a misconception about special education students. She says people imagine either a medically fragile classroom with children who are nonverbal or have severe disabilities, or students who have behavioral issues and might bite or scream. “They don’t understand that there’s just this population of students who learn differently,” she says.

“We always call it like differently abled, not disabled,” she adds. “You find these amazing students who are just so unique that I think as a teacher you get to really showcase some of your best teaching … because it requires you to think, ‘How do I serve a student who has these, you know, sensory issues? How do I serve a student who sees words differently on a page?’ ”

She adds that special education has a reputation of being challenging and overwhelming for teachers. People tend to get nervous about the amount and importance of paperwork associated with the job, like individualized education programs, progress reports and data collection.

Sanoe Marfil, program director of InPeace’s education academy and Kupu Ola, the nonprofit’s culture-based education program, says children on the Waianae Coast aren’t encouraged to pursue a teaching career: “Our kids aren’t seeing folks who are super excited ‘Let’s be a teacher.’ ” 

The DOE pays a $3,000 yearly differential to licensed teachers employed in hard-to-staff areas such as Nanakuli, Waianae, Kau, Molokai and Lanai, Covell says. But she’s heard that’s not enough to persuade teachers to stay in some areas where they must commute long distances.

Game-Changer

Diana Espanto, an educational assistant at Nanaikapono Elementary School, says the pilot program is a win-win for participating schools and educational assistants. She didn’t go to college and says she wouldn’t have pursued a teaching degree if it weren’t for the program.

“This is the best investment they can ever do because you’re helping people who are already in the school system, and they have on-the-job training. They live and work it. They know what to expect. But it’s just that piece of paper that’s holding them back,” she says.

Click here to learn more. | Source: Annie E. Casey Foundation Kids Count Data Center

Educational assistants at her school, she says, would make great teachers because they’ve worked there for years and understand what students’ needs are. She’s worked at the school in various positions since the 2004-05 school year and says she’s seen teachers – especially those who are fresh out of college or from the Mainland – quickly leave because they’re not ready to teach students like those in Nanakuli, who might come from broken families or be homeless.

Keaulana says other complex areas have expressed interest in replicating the Nanakuli pilot program. It’s a game-changer, says Darren Kamalu, assistant program director of InPeace’s education academy, because it opens the door to community members who wouldn’t normally be able to pursue teaching if they had to go through a standard teacher preparation program where lessons are held face-to-face on a university campus.

“This program provides the opportunity to think outside of the box and be very innovative when we’re trying to grow our teachers,” Marfil says. “And so more opportunities like this, more programs like this, would benefit.”

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Part 4: Designing Schools of the Future

Students in Mid-Pacific Institute’s eXploratory Program are learning about ancient civilizations, levers, arms and machines.

Over four weeks, their task is to combine the knowledge and skills they’ve learned from their humanities and STEM classes to create physical structures that depict the rise and fall of different ancient civilizations.

The idea is that elements of the structures will move when a crank is turned, says Mark Hines, director of the Mid-Pacific eXploratory Program, also known as MPX. The inspiration for the assignment came from the opening credits of “Game of Thrones,” he adds.

Students from Mid-Pacific’s eXploratory Program Share their Automatons | Photo: Aaron Yoshino

MPX is an interdisciplinary program for 9th- and 10th-graders that teaches literature, history, science, technology and math curriculum through projects. The program launched in 2010 as Mid-Pacific and 17 other private schools were transforming their learning environments to better prepare students for the 21st century under Schools of the Future, a five-year initiative funded by a $5 million grant from Hawaii Community Foundation. The participating schools were encouraged to pursue education in which teachers became facilitators of knowledge – instead of lecturers – and students became active learners.

Today, many of the participating schools are role models for transforming learning and teaching, while 21st century learning is being discussed across Hawaii and the nation. Hines says Schools of the Future, which is also the name of the annual conference that resulted from the initiative, has helped to bring together the public, private and charter school community to address the role education must play in preparing keiki for the future.

By Design

Before the Schools of the Future initiative began, most of Hawaii’s private schools were stuck in the industrial-age model of being teacher- and content-focused, says Philip Bossert, executive director of the Hawaii Association of Independent Schools, adding that the exceptions were the Montessori and Waldorf schools, which focus on student-led, experiential learning. The independent school association ran the initiative with the Hawaii Community Foundation.

Conversations about 21st century learning were happening in pockets, says Piikea Miller, program director of strategies, initiatives and networks at the Hawaii Community Foundation; Schools of the Future made it a larger conversation.

From 2009 to 2014, Schools of the Future helped a cohort of private schools innovate their learning environments so that instruction would be student-centered and would help keiki develop skills in communication, collaboration, critical thinking and problem-solving. Each school set its own goals for how it wanted to accomplish this, and the initiative helped by funding professional development and technology integration, organizing a group tour to Mainland schools already using these learning environments, and hosting quarterly meetings where educators could share lessons learned.

Students construct their Egyptian civilization automaton. | Photo: Aaron Yoshino

Bossert adds that the initiative aimed to break down barriers that otherwise would have prevented the schools from changing their teaching practices. Most teachers, he says, were educated through the traditional teacher-focused, lecture-and-test model, so if they didn’t have time to invest in learning new strategies or couldn’t imagine how this new learning environment worked, they would continue teaching as they always had.

“The wonderful thing about Schools of the Future is it didn’t tell schools ‘Here is how you become a school of the future,’ ”
says Hines, who was part of the grant committee. “It was … a school identifying these are the things we know we need to work on, and then we were aggressive as a grant, as an initiative, to hold them accountable for those but also give them the opportunities to shape and adjust what that looked like so that it was right for them, their students, for where they were as a school and what their resources provided.”

Rethinking School

Fifteen years ago, teachers at Mid-Pacific primarily taught from textbooks, to a test and in isolation, says Hines, who has been with the school in various positions since 1985.

The MPX program came about, Hines says, after finding no examples of schools that were fully doing project-based learning. Mid-Pacific wanted to create a pilot program so the school could explore and understand the principles of project-based learning and deeper learning.

Today, some of these principles are part of the broader preschool to 12th grade campus. Teachers work collaboratively across disciplines, and instruction is rooted in projects and student-driven inquiry.

At Hongwanji Mission School in Nuuanu, David Randall, head of the school, says the initiative helped the campus, which serves about 350 students from preschool through eighth grade, create an environment where teachers feel safer trying new learning activities and teaching styles. Like at Mid-Pacific, much of the learning had been teacher-driven and occurred in silos before Schools of the Future.

Ninth graders from Mid-Pacific’s eXploratory Program learn about food sustainability and resource management. | Photo: Aaron Yoshino

“From the time I got here, I said, ‘We want you to lead by example. We’re lifelong learners, we’re going to be trying new things throughout our lives and not everything is going to work,’ ” he says, adding that much of the culture change resulted from providing teachers with the time to collaborate and communicate about student expectations.

Yearly grants from Schools of the Future allowed the campus to restructure its daily schedule to include weekly meetings for teachers to meet with their grade clusters – such as preschool, K-2, 3-5, middle school – during the school day. Funds were also used for self-directed professional development activities and to upgrade the school’s IT network, which now supports 300 to 500 devices at a time. 

It’s common for students to do hands-on activities like creating their own kapa using materials they grew on campus, building computers from scratch and learning about their family histories, Randall says, adding that he thinks Hongwanji Mission School maintains a good balance between student-centered and traditional teaching practices. While there are some hands-on activities, much of the preschool and elementary school curriculum still involves repetition, practice and support from teachers to set a foundation for students to jump into collaborative and project-based activities in the upper elementary and middle school levels.

Supportive Environment

The Schools of the Future initiative ended in 2014. An independent evaluation of the program by the American Institutes for Research found that the initiative helped teachers understand the importance of learning skills as an instructional goal, opened their eyes to more diverse teaching methods and changed their interactions with students. As a result, teachers saw higher student engagement. 

One of the challenges, Bossert says, was that some teachers were against changes they saw as “destroying” K-12 education – such as replacing knowledge acquisition and standardized testing with “chaotic” student-led classrooms focused on developing skills and individualized learning. In addition, participating schools often accomplished pockets of change, but not widespread change.

The most important outcome, however, was the creation of a local community of educators focused on student-centered learning practices and technology integration that will support schools and teachers that want to change their learning environments, Bossert says.

Another outcome was the annual Schools of the Future conference, which launched in 2008 and is now co-sponsored by the Hawaii Association for Independent Schools, the Hawaii Community Foundation and the state Department of Education. 

Miller of the Hawaii Community Foundation says the initiative did a good job launching the conversation about 21st century learning and then sustaining that conversation through the conference. Today, leading educators from public, charter and private schools agree they have to focus on designing learning experiences that allow students to accumulate knowledge and skills by doing relevant, authentic work, Hines adds.

One outcome at Mid-Pacific, he says, was the establishment of Kupu Hou Academy, which has provided summer workshops for teachers in project-based learning and other deeper learning practices. Since its establishment in 2010, he estimates, the academy has worked with 350 to 400 public, private and charter school teachers. 

“I think most people have recognized this is not one of those moments of, ‘If I wait long enough, education will go back to the way it was,’ ”
Hines says, dismissing any notion that the push for 21st century learning is a short-term thing that will eventually fade away.

“It’s not a thing,” he says, “it’s the thing.”

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Part 5: Different Approach

In a learning style called p4c, children lead their own thoughtful discussions in the classroom

A fifth-grade class at Kaelepulu Elementary School begins its discussion about the French and Indian War as one might expect for a class of 10-year-olds – with predictions about what the war was about.

But over the course of an hour, the conversation evolves into more complex topics, driven largely by what the students are thinking, with some guidance from their teacher. They wonder about the ways in which a conflict over land might be settled, whether it matters who was first to find it and how a country acquires authority to take another’s land. In the process, students make connections to the overthrow of the Hawaiian kingdom and the limitations of authority figures in their own lives.

Almost all 26 students participate in the discussion. They readily agree and disagree with one another, and after each student speaks, several hands are raised – students are eager to share their thoughts.

Illustration: Chris Danger

This class was engaged in philosophy for children, also known as “p4c,” a teaching approach that centers on transforming a traditional, teacher-led classroom into one where students and teachers explore and discuss ideas together.

This approach builds upon students’ sense of wonder, says Thomas Jackson, director of the UH Manoa Uehiro Academy for Philosophy and Ethics in Education, which supports p4c research and education. That sense of wonder typically diminishes as students progress through school, where they’re taught the teacher holds the single correct answer. Doing p4c, Jackson says, brings that sense of wonder back into the schooling process. Students learn to think for themselves, build greater self-confidence and develop reasoning, listening and communication skills.

P4c has been in Hawaii for several decades, and interest in it continues to grow as the state Department of Education encourages schools to design learning that’s rigorous, creative and centered on students’ interests and aspirations. Many educators value its student-centered approach and the way it engages youngsters in their learning.

“I feel like – and teachers see this – the children let us into their world,” Jackson says. “They’re not worried anymore about what’s the correct answer, where’s this lesson going. No, it’s ‘What do we think?’ and ‘We’re going to hear what other thoughts in the circle are.’ ”

Philosophical Thinkers

P4c was developed in the 1960s by philosophy professor Matthew Lipman, who taught at Columbia University and then Montclair State University in New Jersey. Jackson, who is also a specialist in UH Manoa’s philosophy department, introduced p4c in Hawaii in 1984 and has since adapted it to the needs of local schools through, among other things, the creation of philosophers-in-residence – people who provide in-classroom support to teachers. The academy funds five of these positions.

When doing p4c in a classroom, students and their teacher sit in a circle. The development and maintenance of an emotionally and intellectually safe community is the basis of p4c, Jackson says, adding that if a student makes a harsh remark toward another, that student will be able to see the impact her words have. A “community ball” made of yarn authorizes the holder to speak, and that person chooses the next speaker, not the teacher. Students largely drive the discussion, though their teacher might ask questions to help the group think about a certain topic.

There’s no pressure to find definitive answers to any of the questions, problems or inquiries posed during this process, he adds. In fact, students – and even teachers – might have more to think about or they might walk away confused, which is something to celebrate because it encourages deeper thinking, says Chad Miller, director of teacher development at the Uehiro Academy and an associate specialist in UH Manoa’s Institute for Teacher Education. He also serves as a philosopher-in-residence at Kailua High, Kaelepulu Elementary and Sunset Beach Elementary.

P4c allows teachers to create an environment where learning is something students are actively doing, rather than something that’s done to them, he says. One challenge for teachers, however, is to move away from the idea that they always have to be at the front of the room leading the discussion. Another challenge, Jackson adds, is that sometimes students’ thinking can outpace the teacher’s.

“The delivery is so totally student-centered and different,” says Catherine Caine, a second-grade teacher at Waikiki Elementary School who adopted p4c 18 years ago. As a teacher, her role in p4c is more akin to a participant, rather than the expert or driver of knowledge. “I have to wait for my turn, I have to put my hand up. And they don’t always give me a turn. But then what happened for me as I began to do just such deep listening to them, that that let me in to understanding them so I could help them to learn more.”

Francine Honda, principal of Kailua High School, says p4c was the answer to her search for how to teach students to be inquisitive. True education, she says, is when students are encouraged to be independent, creative thinkers and make rational connections between what someone else says and their own experiences or beliefs: “It’s not just a book that you read, answer questions and maybe take a test.”

Today, philosophical thinking is rooted in Kailua High’s culture. Miller, who used to teach English at the school, says p4c has reshuffled the deck. Students who had gotten A’s learned that the teacher doesn’t have all the answers, and students who hadn’t liked school now see their experiences outside of class as avenues to learning.

In the process of doing p4c, students learn to identify and test their assumptions, make inferences, offer evidence and counterexamples, ask for clarification, and provide reasons for their opinions. Miller hasn’t crunched the numbers on how p4c affects grades, but he says he has seen evidence over time that his students are better able to articulate ideas in a variety of forms and to use diverse evidence to support their ideas.

Safe Community

At Waikiki Elementary School, students learn civil discourse by doing p4c. Caine says her students don’t always agree with each other, but the respectful way they respond to one another is excellent training for getting along with others in a democracy.

“The important part is the process of knowing that your ideas can be shared, that nobody’s going to mock you for sharing your ideas, and that it’s important to have a voice – because then you learn from what other people are thinking as well,” says Bonnie Tabor, Waikiki Elementary’s principal. Her school embraces Habits of Mind – 16 life-related skills that encourage higher thinking – in its instruction and culture, and uses p4c as a vehicle to instill those habits in its students.

Tabor and Caine agree p4c also gives students a forum to share their ideas and discomforts, making for an effective anti-bullying program. “If something’s going wrong, they bring it up to the circle. What can we do about this, what can you do if your best friend is not being kind,” Tabor says. “So there’s a remedy or a discussion that can take place to look at some of these things and figure out ways to move forward.”

At Kailua High School, the intellectually safe communities in the classrooms have spread into the campus culture, says senior Laura Acosta. Honda, the principal, thinks p4c has to some extent helped to reduce the number of discipline referrals at the school because it teaches students to respect others’ ideas and that everyone is valued. She believes, however, that p4c is not the only program that’s impacted the school’s culture.

Miller, of the Uehiro Academy, says he and other colleagues are working on a research project to dive deeper into the effects p4c has had at Kailua High School. The Uehiro Academy has a lot of testimony from educators, principals, parents and students about the impacts the intellectually safe classrooms have had and continue to have on their lives, Jackson, the academy’s executive director, says, and some of these effects are documented in dissertations and master’s theses at UH’s College of Education and with his colleagues in Japan, China, Taiwan and Austria.

Growing Movement

It’s hard to say how widespread p4c is in Hawaii, Miller says, but his guess is that thousands of local teachers have been trained.

He’s personally taught hundreds of college students in teacher education programs at UH Manoa and thousands of teachers in a variety of workshops in the last five years – but these numbers do not account for the work of his colleagues at the Uehiro Academy, which was established in 2012, or Jackson, who has been doing local p4c workshops since the 1980s.

Several sources agree that the growth of p4c in Hawaii has played a role in the wide scale push to transform learning environments to be student-centered, hands-on and relevant to the real world. For Caine, the second-grade teacher at Waikiki Elementary, p4c has been a vehicle for her to put students at the center. Students will remember more, she says, when they’re encouraged to think deeply about what they need to know, instead of her telling them what the answer is or how something works.

“The interest in p4c is definitely growing,” says Tabor, Waikiki Elementary’s principal.

So much interest has grown in the Kailua High School complex in the last several years that the high school launched a project in the 2015-16 school year to send high schoolers into K-9 classrooms to help teachers with p4c. These students are called “philosurfers,” and from fall 2016 to spring 2018, an average of 13 or 14 students per semester worked alongside 43 teachers and 1,000 students, Miller says. The project continues today, though philosurfers now work with fewer teachers, which allows them to be in each classroom weekly.

Photo: Aaron Yoshino

Kailua High senior Laura Acosta became a philosurfer when she was a sophomore. She goes into Waimanalo Elementary and Intermediate classrooms twice a week to facilitate discussions and help with activities that build community. She says she’s seen a lot of growth in the students she works with, especially regarding the intellectually safe community that’s fostered.

“They’ll share a personal experience that has to do with our discussion, and I think that’s where you think, ‘Oh they feel comfortable in this community, in this classroom,’ ”she says, adding that her senior project is to bring back Waimanalo Elementary and Intermediate School’s “We is Greater Than I” day, a community event in which high schoolers come to the campus to facilitate p4c discussions. Acosta, a former student at the Waimanalo school, says her time there led her to become a philosurfer. 

Thanks to the project and teachers’ desire to have p4c in Kailua complex classrooms, there are now some fourth- and fifth-graders whose school experiences have always included p4c, Miller says. The goal is to have p4c be part of students’ schooling experiences from kindergarten through 12th grade.

In the years he’s been supporting this vision, Miller says, he’s been constantly surprised by the sophistication students have when they tackle tough questions that adults are typically afraid to answer. “I can’t help thinking that if people of all ages, especially those who go to school, had more opportunities to do this, then our world would be a more thoughtful and compassionate place – a place I want to raise my children in.”

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Part 6: How You Can Help

People interviewed for this report and others provided these suggestions for how businesses and individuals can help public education. This is by no means a comprehensive list. We invite you to share suggestions with us on Facebook, Twitter, LinkedIn and Instagram. Use the tag #HawaiiforChange.

Waipahu High School Principal Keith Hayashi | Photo: Aaron Yoshino

Donate supplies:

Commonly needed supplies include paper, pens, pencils, crayons, binders, tape and markers. Some schools have pages on DonorsChoose.org and TeacherLists.com. Darlene Javar, principal of rural Naalehu Elementary on Hawaii Island, says her school also accepts donations of slippers and shoes, including running shoes for students who want to participate in track meets.

Donate money:

The Public Schools of Hawaii Foundation accepts mail-in donations and uses contributions to award Good Idea grants to innovative teachers and schools. Donations can be mailed to the foundation at P.O. Box 4148, Honolulu, HI 96812. Several schools have their own private foundations that accept donations on their behalf. The Hawaii Department of Education lists some of these foundations.

Host student and/or teacher visits:

Terrence George, president and CEO of the Harold K.L. Castle Foundation, says teachers need to understand how workplaces function and what different careers look like to tailor instruction to the real world. Javar of Naalehu Elementary adds that short, hourlong “internships” are beneficial for younger students. Earlier in her career at a different school, she took fifth-graders to visit one of the island’s resorts, where students experienced an atmosphere of professionalism they hadn’t seen before.

Participate in a career day:

Cynthia Tong, an 8th grade social studies teacher at Ewa Makai Middle School, says students love seeing community members demonstrate or explain what they do for a living. She recalls her own daughter’s career day about 25 years ago when she worked as a cake decorator. She calls it a three-hour “whoopee” with the tools of the trade like tubes of frosting. Students helped her decorate a Styrofoam wedding cake. “I made a whole bunch of kids squeeze stuff. But it made a huge impact on her and her friends, and I’m surprised that they still talk about it 25 years later.” 

Get involved in advisory councils:

Some high schools have advisory councils or boards made up of educators, administrators and businesspeople. They help inform schools about what’s happening in industry, says Keith Hayashi, principal at Waipahu High School. That information, he says, helps Waipahu HS, which has an advisory board for each career academy, know what relevant technology and equipment it should use in its classrooms.

The DOE’s Career Readiness Section (305-9705) can assist businesses and individuals interested in joining advisory councils. The state DOE also has advisory councils for each Career and Technical Education pathway; members advise on standards and curriculum. Those interested in joining can contact Troy Sueoka at troy_sueoka@hawaiidoe.org.

Tong says community members who are interested in donating time, money or supplies should contact their school’s main office to be connected to the:

• principal;
• parent teacher student organization;
• school community council, which is part of each school’s leadership structure;
• or parent-community networking center.

These groups can help connect community members to volunteer opportunities and provide information on a school’s needs. A list of DOE schools can be found here. For broader volunteer opportunities that may not be specific to one school, contact the DOE’s Community Engagement Office at 305-0688.

The DOE also has a webpage dedicated to ways people can help the schools.

Be an advisor or mentor:

Community members can help by serving on charter schools’ governing boards. At one charter school, the School for Examining Essential Questions of Sustainability, or SEEQS, where students are often engaged in projects, community members act as resources and mentors, says Buffy Cushman-Patz, the school’s leader. Go to seeqs.org, click on contact and say you want to volunteer or contact SEEQS’ student experiences coordinator at seeqsinfo@seeqs.org.

Another mentoring opportunity:

A local nonprofit called the Center for Tomorrow’s Leaders has launched Unfold, a program that pairs leaders from businesses and nonprofits with diverse high school seniors to help them transition to college.  To learn more about this and other CTL programs, email ctl@ctlhawaii.org or visit www.centerfortomorrowsleaders.org.

Two or three jobs are not enough to provide financial stability for many local families. How can we create CHANGE?

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Table of Contents

Introduction
CHANGE Framework
Part 1: Hard Work is Not Enough
Part 2: Possible Solutions
Part 3: What Can I Do?

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by Steve Petranik

This report is about change – CHANGE in capital letters – because Hawaii cannot continue on its current path. We need to change.

We face many significant problems but the biggest may be that half of Hawaii’s people are struggling financially today despite a booming tourist economy and full employment. Even with frugal spending, they cannot save money for future financial needs regardless of whether they work two or three jobs. That struggle affects every aspect of their lives and their children’s lives.

Those families are the subject of this report: Who they are, how they barely get by and what we can do to help. There is no silver bullet, but there are key areas where changes can have a major effect.

This is the first of six reports from Hawaii Business Magazine based on a framework created by the Hawaii Community Foundation. “The CHANGE framework acknowledges the interconnected nature of community issues and zeroes in on six essential areas that constitute the overall well-being of these islands and people,” HCF says.

CHANGE stands for:

• Community & Economy
• Health & Wellness
• Arts & Culture
• Natural Environment
• Government & Civic Engagement
• Education

Hawaii Business will publish reports for the next six months on each of these topics. As HCF says, “By examining critical community indicators by sector, we can identify gaps where help is specifically needed and opportunities where help will do the most good.”

The six reports will not be comprehensive; that would take an encyclopedia. Instead we will focus on key elements and dive deep into specific subjects, with a focus on good ideas that might drive solutions. This first report focuses on the hundreds of thousands of working families and individuals in Hawaii who are living paycheck to paycheck, unable to thrive, barely able to survive financially.

Why is a business magazine doing these reports and why this business magazine?

A business magazine is doing these reports because businesses and business leaders must be part of the solutions. Government and nonprofits have not been able to solve these problems, so businesses must help.

This particular business magazine is stepping up because the owner and CEO of our parent company, aio, is Duane Kurisu. He is a successful businessman, but his roots are humble – he grew up in the plantation village of Hakalau and went to Hilo High School and UH. He knows what it is like to live like the struggling working families in this report.

He is the catalyst behind Kahauiki Village, the community for homeless families off Nimitz Highway near Keehi Lagoon Park. Homelessness is one of Hawaii’s seemingly impossible problems, but Kahauiki has made a big difference. Kurisu succeeded by bringing together business and nonprofit leaders, government, labor and many hundreds of individual volunteers.

His next step was to revive the annual Hawaii Executive Conference this past October as a way to bring together business leaders, nonprofit executives and senior politicians to focus on the major challenges facing our Islands. In between conferences, six CHANGE committees will focus on finding and implementing solutions to those challenges. This is not a single-year effort but a long-term commitment from many people.

This report and the five that will follow are part of that multifaceted approach. Positive change never happens unless people understand the challenges they face. Our reports intend to provide that intelligence. Full disclosure: We got support and input from Kurisu, the Hawaii Community Foundation and many other organizations and individuals, but no one outside the Hawaii Business editorial team had any control over the content of these reports.

We’d love to learn on social media about programs you recommend that are dealing with these problems. Please use the tag #ChangeHawaii on Facebook, Twitter, LinkedIn and Instagram. Or tell us about issues we missed in our reporting and your overall thoughts on this CHANGE Report.

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Change Framework

Here is what the Hawaii Community Foundation says about the CHANGE framework: “Taking on the most pressing needs of our community relies on deep reserves of knowledge and the ability to bring people and resources together to find high-impact, long-term solutions.

“Leaders who step up to initiate change are well-suited to influence others to follow suit. When change advocates from across sectors choose to move forward collectively and commit to work in a results-focused, networked, and systems-oriented way, measurable progress can occur.

“The process begins with a personal commitment and expands to include allies whose missions align, as well as voices that currently go unheard. It is only by constructing effective coalitions between people and communities that we can create lasting change in and for Hawaii.”

Learn more here.

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Costs for Housing, Child Care, Food and Transportation

HOUSING COSTS

The National Low-Income Housing Coalition reports that Hawaii was the most expensive state for housing in 2015.

Least expensive county: Hawaii County, $1,151 on average per month for a two-bedroom apartment, $749 for a studio (also called an efficiency apartment).

Most expensive: Honolulu County, $1,810 on average per month for a two-bedroom apartment, $1,260 for a studio.

Mortgage foreclosure rate: 2.4 percent in Hawaii in 2015, third-highest in the country and double the national average of 1.2 percent.

CHILD CARE COSTS

Licensed and accredited child care centers, which are regulated by the state Department of Human Services to meet standards of quality care: $870 on average per month for an infant and $658 for a 4-year-old; total on average for children of this age is $1,528. The household survival budget includes the cost of registered home-based child care at an average rate of $1,207 per month ($610 per month for an infant and $597 for a 4-year-old). Sources: Hawaii’s Child Care Resource and Referral Agency, 2017; Hawaii Department of Human Services, 2015; Hawaii Department of Human Services, 2017.

FOOD COSTS

The cost of food increased in Hawaii by 35 percent from 2007 to 2015, more than double the overall rate of inflation.

Within the household survival budget, the cost of food in Hawaii is $1,032 per month for a family of two adults and two young children and $312 per month for a single adult, according to the U.S. Department of Agriculture in 2015.

Food accounts for only 17 percent of the household survival budget for a family and 13 percent for a single adult in Hawaii.

TRANSPORTATION COSTS

A Hawaii family pays an average of $544 per month for gasoline and other vehicle expenses.

Average cost for public transportation is $64 per month, but comprehensive public transportation is available only in Honolulu County. Across all Hawaii counties, fewer than 8 percent of workers use public transportation, so most workers must have a car to get to work.

Transportation costs represent 9 percent of the average household survival budget for a family and 12 percent for a single adult.

From 1999 to 2012, the auto debt per capita in Hawaii increased by 73 percent to $2,510, according to a national report by Stacy Jones at Bankrate.com.

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Part 1: Hard Work is Not Enough

Half of Hawaii’s people are struggling financially
even while many work two and three jobs

by LiAnne Yu

Lanae Anakalea, her husband and their two young daughters are not what most people would envision as a family in economic distress.

Both parents are fully employed. He’s a valet at a major hotel on Kauai, with full health benefits and a 401(k). She works at a foundation promoting Native Hawaiian culture. Their combined yearly take home pay of $60,000 is in line with what the U.S. Census Bureau says is an average U.S. household income, and over twice the federal poverty level.

But look closer and the picture gets complicated. Rent is their biggest cost: Even though their current home is just a “laughable jungle home,” as Anakalea puts it, they cannot find anything cheaper for their family of four. To cover the monthly rent of $2,350 plus $600 for utilities, they sublet one room.

Two full-time jobs are not enough. She waits tables on the weekend and picks up catering gigs whenever she can. Even with the extra income, they can’t afford child care or the $300 a year to put both daughters on the school bus, so they spend hours every week shuttling their kids back and forth to school, and she brings them to work with her after school.

Despite being frugal, they have nothing left at the end of the month. Anything beyond basic survival expenses means a difficult trade-off. “When my kids want something, I say that means we have to be separated more so I can work.”

The Anakalea Family | Photo: Mallory Roe

Anakalea and her family aren’t unique in their community. All of the people around her work multiple jobs and still struggle to get by. “Everyone here is surviving. But we don’t want to just survive, we want to thrive,” she says.

“To thrive is to not have to choose between putting gas in the car or buying groceries for the kids. It’s to be able to say it’s Christmas and I want to buy my kids these toys and not have to stress over that. To thrive is to live and move forward without picking and choosing.

“That’s not to say you can’t be frugal and thrive. But for me, thriving is feeling safe and secure and not having to stress about survival.”

Many numbers suggest that most people in Hawaii should be thriving. Only 11 percent of the population lives in poverty according to federal standards, one of the lowest rates in the nation. The unemployment rate is a historically low 2 percent, the visitor economy keeps growing and Hawai‘i’s median household income is relatively high compared to the rest of the country.

Yet so many of us can name friends, colleagues and relatives who, like Anakalea’s family, are just a paycheck or emergency away from losing their homes.

The Aloha United Way wanted to better understand the challenges of people who are hardworking yet financially vulnerable. So the nonprofit commissioned a report called “ALICE: A study of financial hardship in Hawaii.” The acronym describes working individuals and households living on the financial edge.

• AL for Asset Limited: little or no savings and owned property to fall back on during times of sickness, job loss or other financial crisis.
• IC for Income Constrained: not earning enough money to create a savings cushion to weather those crises.
• E for Employed: working and still not getting ahead even in a strong local economy.

The ALICE report defines a household survival budget specific to Hawaii. This includes the bare minimum amount of after-tax income needed to cover the fundamentals of housing, transportation, child care and food. For a single adult under 65, it’s $28,128, and for a family of four, like Anakalea’s, it’s $72,336. These figures are much higher than the federal poverty level, which accounts for some increases in the cost of living over the years, but is based on a formula that has remained largely unchanged since 1965.

In Hawaii, 11 percent of the population falls below the federal poverty level. An additional 37 percent don’t make enough to meet the basic survival budget, according to the ALICE report. Combined, 48 percent of the state is financially vulnerable – either in deep poverty, or on the precipice of it. People like Anakalea and her family and most of the people she knows. And they are spread across all the islands.

In other words, almost half of Hawaii’s residents are, as Anakalea puts it, focused solely on surviving rather than thriving.

“Those in the social services space and the nonprofit space where we serve and are involved in helping human services, were not surprised by the high number of ALICE households in our state. Nonetheless, it’s good data to have because we now have a reference point, a benchmark to measure against,” says Cindy Adams, president and CEO of Aloha United Way.

For Joyce Lee-Ibarra, who was on the ALICE Research Advisory Committee for Hawaii, recognizing ALICE households as a large segment of the population also helps us come to grips with the reality of financial hardship all around us. “People tend to compartmentalize the homeless – they are seen as ‘the other.’ But in reality, so many of us know so many people who are just a health crisis or major car repair away from catastrophe. This report helps us understand that we in fact sit on a continuum and our experiences are not that far separated,” says Lee-Ibarra, the president and CEO of JLI Consulting.

The ALICE findings have, for many of the state’s business leaders, made it clear that despite how well we compare numerically to the rest of the U.S., our communities are not as healthy as they may appear from just a numbers standpoint.

“It’s important for our business community and policymakers to recognize that if we continue to have this condition, this extreme lack of affordability for such a large portion of us, this will become something of an economic crisis in and of itself,” says Peter Ho, chairman, president and CEO of Bank of Hawaii. “The people who can’t afford to live here will simply leave the Islands. So what we’re on the forefront of is an exodus of an important part of our community, both from a social standpoint and an economic one.

“That potential outcome should alarm everyone. That situation left unchecked for an extended period of time threatens the economic underpinnings of our fragile economy,” Ho adds.

In this next section, we put names, faces and real-life stories on the statistics to understand the personal struggles and aspirations of the local people we call ALICE. Who are they and what shapes their choices?

One Job is Not Enough

Lourdes Maquera’s day begins at 5 a.m., when she starts getting her 13-year-old son ready for school. At 6, the single mother of three is on her way from her Waipahu home to Waikiki for her job as a hotel housekeeper. Just before 2 p.m., she rushes to change and get to her second housekeeping job. Her knees are so worn from the work that she can barely get out of her car when she gets home by 11 p.m. But she still has to do her own housework, prepare meals for the next day and check in on her son’s homework.

Her annual take home pay of about $40,000 is only about half of the household survival budget for a family of four. Despite two jobs, she is barely able to cover everything: rent, utilities, food and car payments, and her two daughters’ college loans. Most months, she has to rack up more credit card debt.

“When we came to America from the Philippines, we knew it would be difficult. But we thought that the promise of life here is that so long as you work hard, you’ll earn enough and not be drained. But it’s not like that at all,” she says.

To save money, she moved her family of four from a three-bedroom place that cost $1,700 a month to a two bedroom for $1,375. Even at this lower price, her rent eats up 40 percent of her take-home pay. According to federal guidelines, families that pay more than 30 percent of their income for housing are considered cost burdened and may have difficulty affording other necessities. Maquera is far from alone: 47 percent of Hawaii’s residents spend more than a third of their monthly income on housing

There is almost nothing she can do to reduce her rent even more. The average rent for a two-bedroom apartment in Hawaii is $1,362 per month, according to the federal Department of Housing and Urban Development. But on Oahu the average rent for a two-bedroom in November 2018 was $1,800, according to Rent Jungle, an online search engine that tracks rental housing in cities nationwide. That makes Maquera’s Waipahu place a relative bargain.

“In 1968, 23 percent of Honolulu renters were paying more than 30 percent of income for rent. By 2005, 46 percent of Honolulu renters. By 2016, 54 percent of Honolulu renters.” – Gavin Thornton, Co-executive director, Hawaii Appleseed Center for Law and Economic Justice

Gavin Thornton, co-executive director of the Hawaii Appleseed Center for Law and Economic Justice, has been looking at housing studies dating back to 1946. He found one from 1970 describing Hawaii’s housing problem. “That study from 48 years ago was already saying we were in a crisis. And what has changed since then? In 1968, 23 percent of Honolulu renters were paying more than 30 percent of income for rent. By 2005, 46 percent of Honolulu renters. By 2016, 54 percent of Honolulu renters.

“So we were calling it a crisis back in 1970. And yet the problem is twice as big now,” adds Thornton, who was on the ALICE committee.

The high cost of living is also driven by the state’s reliance on imported oil for electricity generation and transportation. The average retail price of electricity in Hawaii is 33 percent higher than in the second-most expensive state, Alaska, according to the U.S. Department of Energy.

Workers like Maquera face not only high housing and electricity costs but low wages, relative to cost of living. About 62 percent of the jobs in the state pay less than $20 per hour. Of that portion, two-thirds pay less than $15 per hour. According to the ALICE study, a parent supporting a family of four working 40 hours a week would need to make at least $36 an hour just to reach the threshold of the survival budget, but when I first spoke with Maquera, she was only making $22.14 an hour at her primary job.

The state’s reliance on the general excise tax for its revenue also makes necessities for ordinary people more expensive. That’s because the tax is applied at each step as products make their way to the consumer: from an item coming into the harbors, through the wholesaler and over to the retailer. That raises the price of everything, from toilet paper and diapers to milk and rice.

“The lowest-income folks in Hawaii are paying 11 percent of their income in just GET. That’s a lot of money. Yes, we have to raise wages, and we have to work on affordable housing. But we also need to look at the tax burden,” says Nicole Woo, senior policy analyst at Appleseed.

Maquera says, however, her most challenging burden is the emotional one. “My son is growing up and wants his own room. I keep telling him, just be patient. Just help me save money for now, so one day we can get our own house. I’m so lucky because he is bright, he understands a lot. But I can’t make it to any PTA meetings. I can’t hear the teacher announce how well he’s doing. Then he says, ‘Mom it’s not fair. Why do other moms get to spend time with their kids, and why can’t you?’ This tears my heart apart.”

The High Cost of Being Poor

Nicole Schubert has been making regular payments of $380 a month toward her student loan. The Kalihi public school teacher, who has both an MBA and a master’s degree in teaching, is paying as much as she can toward her debt, but it just hasn’t been enough.

“My total payments since 2013 have been more than $12,000, but the principal balance has only been paid down $12. All of my payments go towards interest, so my student loan balance continues to rise every year and is now over $145,000,” says Schubert.

The recently divorced 39-year-old describes herself as a hustler, supplementing her teacher’s salary with side gigs, including managing an AirBnB, remodeling and painting homes, and selling things on eBay. Among the teachers she knows, she is not unique.

“Everyone I work with does something on the side because everyone here is so vastly underpaid but still has to pay $2,200 for a two-bedroom. I know teachers who are part-time financial planners, Uber drivers and bartenders. The only people I know who don’t have second and third jobs are teachers who have a spouse who makes a lot of money,” she says.

“My friends and I talk about our hustle all the time. It’s just part of our livelihood. I don’t even think about how much I’m doing, I’m just doing it every day. It becomes part of your life. Your free time is working. At the end of the day, you’re exhausted,” Schubert adds.

Nicole Schubert in her classroom | Photo: Elyse Butler

ALICE households typically don’t have anything at the end of the month, so they cannot build savings, accumulate assets or protect themselves from emergencies such as a car repair bill or medical costs.

“They put it on credit cards and it becomes a vicious cycle. The interest continues to grow; it comes back around full circle in that they can’t start saving or putting away for a rainy day,” says Lee-Ibarra of JLI Consulting.

In “The High Cost of Being Poor,” an essay funded by the Annie E. Casey Foundation, the authors describe how the poor end up paying far too much for basic necessities. For example, owning a car is critical for lower-wage workers who work odd hours or live far from public transportation. But if the person has poor credit or no credit history, that can mean incurring excessive fees and interest rates. According to the ALICE report, people with only fair credit may spend six times more to finance a vehicle than those with excellent credit.

Jamie Borromeo Akau, a Hawaii Island schoolteacher who also has nothing left at the end of the month, saw her car payments go up due to some late payments. “I just trusted that my husband was sending in the check or paying it automatically. When we went to trade in the car for a new one, they told us that our credit score was lower because my husband was making the car payments late. I was only paying 2 percent interest. Now it’s like at 6 or 7 percent.”

Low-income consumers often have less access to mainstream banks, and end up turning to subprime or predatory outlets such as check-cashing and payday lending places.

“A lot of families we serve fall into getting scammed,” says Samantha Church, executive director at Family Promise Hawaii, a nonprofit that helps homeless families transition into permanent housing. “They go to payday advance places, or a lot of them get a car with a loan that’s an insanely high rate. It’s their first time learning about credit and interest rates and basic financial literacy. We have families who don’t know what a credit score is. They don’t realize what affects it and impacts it. It’s a life skill that so few people know.”

Among her schoolteacher friends, Schubert says, she’s not the only one mired in debt. “My first year here, I knew a teacher whose student loan payment was so high, he lived in his truck and showered at school. This is the plight of our generation – you have to go college, and now we are all broke.”

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Thriving or Struggling in Hawaii?

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Percentage of each group that is
either in poverty or ALICE:

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Little or no Savings

Hawaii is the state where you’re most likely to live paycheck to paycheck, according to the latest annual survey by gobankingrates.com.

Sources: U.S. Census Bureau’s American Community Survey, 2015, and the ALICE threshold, 2015

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Loved Ones Suffer the Trade-Offs

Akau, the Hawaii Island teacher, and her husband, Charles, have discovered the joy they expected in having a child. But they have also discovered new financial obligations they can barely cover with their combined take home pay of $4,000 a month.

“When Eva came it threw our budget completely out of whack. Diapers. Oh, my God. Her diapers were $45 for a box that lasts us about two weeks, so $90 a month. Baby wipes is probably another $50 a month. Formula’s about $35 a week.

“There’s no savings. There can’t be. My mom’s a big stickler. She’s like, ‘Put 10 percent away.’ I’m like, ‘Mom, you don’t get it. There is no 10 percent,’ ” says Akau.

To make ends meet, they sublet two rooms and AirBnB a third room in the Hawaii Island house that actually belongs to her mother, leaving the young couple and their baby just one room upstairs in a house that feels more like a hotel than a home.

“I can’t even come out in my pajamas downstairs because I’ve got customers there. I literally just stay in my room. I close the door when I come home from work and I don’t open it because this is not my house. This is my place of business. I don’t even sit on the couches. We have no privacy at all,” she says.

The new parents barely see each other. As a schoolteacher, Akau works in the day while her husband works in the evening. They take turns watching their 1-year-old, but there’s an overlap in their work schedules, during which they need help with the baby.

The Akau Borromeo family | Photo: Dino Morrow

“The one expense that we cannot handle is day care. You’re talking 15 to 20 bucks an hour. That’s how much Charles makes. So we use this unlicensed baby sitter. It’s $5 an hour. Her sister’s up the street and baby-sits eight to 10 other kids. It’s just a local network of unlicensed baby sitters,” Akau says.

She emphasizes that the woman running the place is a trustworthy auntie, but at the same time, the conditions aren’t ideal. “It’s small, it’s tiny, there’s one little playpen and all the older kids napping. Just lined up bodies.”

The average cost to put an infant in a licensed and accredited child care center is $870 a month; it’s $658 a month for a 4-year old. Even if they could afford the care, the Akaus have few choices as the Neighbor Islands are considered child care deserts.

“Families are piecemealing things together, relying on friends and neighbors to watch kids, and sadly, we’ve had a lot of children in substandard care that’s not regulated,” says Deborah Zysman, executive director of Hawaii Children’s Action Network.

And standard child care doesn’t accommodate the working hours of most ALICE parents. “Only about 2 percent of our child care seats in the state offer any evening or weekend hours. Those most likely to have those kind of jobs tend to be your low-income workers who are doing fast-food, restaurant and janitorial work,” says Barbara DeBaryshe, interim director at the UH Center on the Family.

Even though Akau loves teaching in her community and wants her daughter to grow up surrounded by her Native Hawaiian heritage, the trade-offs they are forced to make may be too much for her. She and her husband are seriously considering moving to California, where her mother could help with child care. “This is not normal. People in and out of your home is not normal. A husband working six days a week is not normal. Not ever seeing your spouse because you have to flip schedules is not normal. Not being able to afford child care, cost of food, cost of gas, is just not normal.”

Putting My Well-Being Last

Andre Holcom regrets not having enough time for everything that’s important to him. He and his wife work two jobs each to support their three children. On weekdays, he’s a server at a major hotel on Maui. On weekends, he works the lū‘au at another hotel. His wife works as a waitress and then takes the graveyard shift at the supermarket. They barely see each other, and he describes their relationship as “two ships passing each other in the night.”

“We rarely do stuff all together as a family – that’s hard when you juggle a schedule. It’s emotional, and kids start off as little kids and suddenly they are adults and you feel like you’ve missed their childhood because you’ve worked their whole life,” Holcom says.

But he doesn’t see any way out of this. “If one of us couldn’t work, we wouldn’t be able to pay our bills. We would probably have enough for one month. But that’s pushing it,” he says.

His wife and kids aren’t the only ones he’s not seeing enough of. He’s also not visiting a doctor regularly to manage his diabetes, even though he has health care coverage.

“I just don’t have time for the doctor. You have to take time off work to go. I’d only go if I were so sick I couldn’t go to work. And anyway, they’re just going to tell me to take medicine and eat this or not eat that,” he says.

Maquera, the housekeeper who works seven days a week at two different hotels, struggles with pain in her knees and back. Even though she has insurance, she hasn’t seen a doctor because that would mean taking time off work. She fears that any missed days on her record would endanger her job.

“I just don’t have time for the doctor. You have to take time off work to go. I’d only go if I were so sick I couldn’t go to work.” – Andre Holcom, He and his wife both work two jobs on Maui

“You don’t go to the doctor unless you can’t get up from bed. Even though you have pain from last night, just take a pain reliever, or put pain oil on it and get to work. Even if we don’t feel good, we have to go,” Maquera says.

ALICE households often make trade-offs on health care. “A family may have expensive medication as a household cost. But paying for that medication as it’s prescribed might mean they have less money for groceries, or come up short in rent. Maybe they will fill their prescription half as often, or split up medications so they are only taking half of the prescribed dosage. People are trying to figure out how to be creative given the means that they have,” says Lee-Ibarra of JLI Consulting.

Low-wage workers, who frequently deal with physical stress on the job, must also deal with the mental stress from financial hardship. “You have so much on your mind to think about every day. How am I going to get through this, how am I going to survive, are we going to be able to have enough for this month, can I pay the bills? With all this, there’s not a time when your mind is at rest,” says Faye Cholymay, a mother of three who works in catering for a major airline and takes home $1,400 a month.

Lee-Ibarra describes the impact of financial distress on their decision-making. “There are the manifestations of that type of stress in terms of physical and mental health. But I think more deeply than that, it has an impact on the kind of time-horizon people are able to make decisions on. If you are constantly in a situation of worrying what fire you might have to put out or fending off emergencies, then your thinking and decision-making tends to be very present focused. That present bias means personal health may get pushed to the wayside.”

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Can You Survive on This?

Here are two household survival budgets from the Hawaii ALICE report. These budgets include nothing for entertainment, auto repairs, restaurant meals, children’s birthday or Christmas presents, new appliances or emergency costs.

The household stability budget is a measure of how much income is needed to support and sustain an economically viable household. The stability budget represents the basic expenses necessary for a household to participate in the modern economy in a sustainable manner over time. Here are figures for the stability budget for a family of four.

*2 adults, 1 infant, 1 preschooler; ** Miscellaneous includes toiletries, diapers, cleaning supplies, work clothes and smartphone.

ALICE report sources: U.S. Department of Housing and Urban Development, 2015; U.S. Department of Agriculture, 2015; Bureau of Labor Statistics, 2015; Internal Revenue Service, 2015; Tax Foundation of Hawaii, 2015, and Hawaii Department of Taxation, 2015; and Hawaii Department of Human Services, 2015. For full methodology, see methodology overview at unitedwayalice.org/hawaii.

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Getting Worse

More and more Hawaii families have gone from financial stability to instability in the past decade.

Source: ALICE Report; American Community Survey, 2015, and ALICE threshold numbers for 2015

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Navigating a Complex System

Retired Navy veteran Carl Stork, 70, says food stamps have made the difference between making ends meet and going homeless. The bulk of his $1,400 Social Security check goes toward his 200-square-foot Kalihi studio, which is a bargain at $735. But outstanding medical bills for a bad shoulder leave him broke every month, while his credit card bills remain unpaid.

Food stamps (now officially known as SNAP) cover a few trips to Costco every month, where he stocks up on low-cost items like rice and Spam. But getting the food stamps is, he says, just good luck. A random person mentioned that he should find out about qualifying, which had never occurred to him before.

“The biggest challenge for people like me is knowing what you qualify for. The only people who have any counselors are the homeless. But people like me, who are retired, have to poke around. The state doesn’t come out and ask you if Social Security is your only form of income. They don’t care. The places that do offer the benefits, they don’t have any outreach. There was nobody checking in on me, asking, are you making enough?” Stork says.

Even if a person finds out about the benefits, there are other challenges. “Some of these applications are very long and arduous for just a small amount of support,” says Brent Kakesako, executive director of the Hawai‘i Alliance for Community Based Economic Development.

“For example, for SNAP you’re required to do a six-month review, and if you’re houseless, you may not have a permanent address. And it may be hard to get ahold of you by phone. If you don’t respond you automatically lose your benefits. If you try to reapply you have to start from scratch. It’s a disincentive for people to improve their situation.”

Kakesako adds: “Others may argue that we’re just trying to hold people accountable, but statistically, fraud is extremely low. And most people try to use the benefits the way they are supposed to. They aren’t trying to game the system.”

The ALICE report also states that many needy families choose not to apply for help because of all of the costs incurred in the application process. It involves time off work, child care, transportation and potentially lost wages.

“For people who need timely access to critical benefits, interacting with the government can become as time consuming as a part-time job,” write Jess Kahn and Mollie Ruskin in an article for the U.S. Digital Service, a federal agency set up to “deliver better government services to the American people through technology and design.”

There is also a matter of trust, Kakesako says: “Applications ask for lots of sensitive information such as Social Security numbers, birth certificates. An application process also asks a lot of questions, sometimes very personal ones. That creates a hesitancy to engage and a defensiveness. It’s not clearly communicated why an institution needs to know all of this, and unclear what part is federally required, what is state, and what is obsolete.”

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In most cases, the biggest burden for ALICE families is housing.

That’s not surprising: Hawaii has the nation’s costliest housing. There isn’t enough affordable housing, and Hawaii Business has reported repeatedly on the many reasons why: The cost of land and construction is usually high compared to most of the rest of the country; the permitting process can be arduous; building affordable housing often requires free land and other subsidies to pencil out.

According to a report put out by the Department of Business, Economic Development and Tourism, an additional 64,700 to 66,000 housing units will be needed by 2025 in Hawaii to meet demand. But in a similar period of time, 2008 to 2015, available housing in Hawaii, regardless of price level, increased by only 14,448 units, according to federal Census Bureau statistics.

To address the crisis, Gov. David Ige signed a housing measure in June injecting more than $200 million into state funds aimed at increasing the production of affordable rental units across the state. In November 2018, the Honolulu City Council passed a bill requiring building permits for one- and two-family homes to be issued within 60 days after applications were submitted. Honolulu Mayor Kirk Caldwell allowed the bill to become law without his signature.

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A Holistic Way to Understand

The image below shows a few loops from a more detailed systems map of the challenges faced by ALICE households.

A systems map is a visual representation of how cause-and-effect relationships perpetuate or worsen aspects of our society. These cause-and-effect relationships often form “loops” that feed themselves – which can help explain why some social problems get worse despite efforts to reduce them.

The full Hawaii ALICE systems map, with a step-by-step introduction, is at hlf.kumu.io/alice-systems-map. You can go directly to the map at kumu.io/hlf/alice.

The overall ALICE map is one way to help understand the challenges these families face. It is especially valuable because it identifies the negative feedback loops that reinforce a problem and the positive feedback loops that might help solve it. Maybe most important of all, the map can help nonprofits identify key places in the system where social service action and spending might help the most.

The Aloha United Way and other nonprofits use the map to help them focus on prevention and identify high leverage points where spending “a dollar would have maximum impact,” says Cindy Adams, president and CEO of AUW.

The map was created with the help of the Hawaii Leadership Forum and Sam Dorios, the forum’s systems and complexity associate, with input from ALICE households and the agencies that support them, Adams says. She says the map continues to evolve as more is learned.

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Needed: A Comprehensive Solution

Leaders of the Aloha United Way say no single fix will solve the problems of Hawaii’s ALICE families. What’s needed instead is a multifaceted approach.

by Steve Petranik

Aloha United Way coordinated the creation of the Hawaii ALICE report with support from the Bank of Hawaii Foundation, the Hawaii Community Foundation and Kamehameha Schools. Hawaii Business Editor Steve Petranik interviewed three of AUW’s leaders: President and CEO Cindy Adams, COO Norm Baker and VP for Community Impact Elizabeth McFarlane. Here are condensed highlights of that conversation.

Petranik: The Hawaii ALICE Report is part of a national effort.

Cindy Adams

Adams: Eighteen states have published ALICE reports that cover more than 60 percent of the nation’s population. The data starts in 2007 and works forward to track how well households have recovered from the Great Recession.

The systems map (detail is shown on the previous pages) helps to explain Hawaii’s ALICE households’ challenges. The map is informed by community input from a broad cross-section of stakeholders, including ALICE individuals and families. It is a living document that will evolve as we learn from collaborating with nonprofits and work with ALICE households. Some loops have already been revised to reflect learning that has taken place.

Aloha United Way has committed funding for three years toward an ALICE grant whose goal is to support financial stability and upward mobility of ALICE households. During the grant period, we will learn more about where the map’s assumptions were correct or maybe underdeveloped. We will make adjustments to the map and, more importantly, improve upon the work we are funding in the community.

Elizabeth McFarlane

McFarlane: The map shows key areas where change can be leveraged. If we can support the financial well-being of a household, we know that the

ripple effects going forward are substantial: for health, for education, for long-term employment outcomes. There are benefits across the life-course for individuals, and the potential to influence the inter-generational impacts of disadvantage which is a benefit to all of us in Hawaii.

A significant underlying factor is the growing cost of living in Hawaii and the squeeze that it puts on all citizens, but particularly for ALICE families.

A Scarce Treasure is Time

Petranik: Can you give an example of something you reconsidered?

Adams: One assumption was, given the opportunity, that adults in ALICE households would want to go back to school, finish a degree or learn new skills to increase their household income. In fact, we found that the majority were not interested in going back to college or allocating extra time to skill development because it was more important to spend time with their family and children, which was already very limited.

Norm Baker

Baker: The ALICE families understood that a large part of their children’s quality of life and their own quality of life was their time together. And they wanted more of that, the reward of being together. This meant a lot to them.

Adams: Parents work long hours and odd hours, often on weekends. There is some sense of guilt when you don’t have time to be with your children. This is universal, but this was a very basic loss for these parents, like one more thing they couldn’t give their children.

Baker: Another interesting thing came up in interviews with ALICE families. They didn’t say they were happy with where they were at. What they said was, “I’m accepting of where I am at, but I want something better for my kids.” That was almost universal. They had a real, real heavy focus on their children.

Another thing that our mapping of the ALICE families “system” clearly identified for us was places where the system was frozen, where there is very, very little that can be done to it. From our perspective, those were areas where we wouldn’t want to invest dollars because obviously you’re not going to get as much impact.

One of those frozen areas is the whole issue of government support and government benefits and how difficult that is for people to navigate these systems. Government support and assistance is more abundant for poverty-level households than the ALICE population, but even the ALICE population can benefit from many of those government support programs. Once again, it’s a time issue: The time it takes to work their way through that system is overwhelming.

Take-home Pay

Adams: There’s a sensitivity among businesses about raising wages and compensation. This is understandable. The solution to ALICE is not just about compensation. It includes addressing the high cost of living in Hawaii. We cannot pay people enough to get ourselves out of the high cost of living cycle. We must address housing affordabililty. Housing is the single largest household expense. The second is the cost of child care and preschool. If we can address child care, parents will have more flexibility for upward financial mobility and this will help break multi-generational cycles of poverty. The same with access to preschool.

The big challenge is coming together as a community to look at all these issues within the context of a dynamic system instead of as independent problems. We have to figure this out.

Other Solutions

Adams: One thing businesses can do is something we challenged ourselves with at Aloha United Way. What could we do in the way of a benefits package to help address some of our employees’ household needs? We made paid time off flexible, meaning not just for use when the employee gets sick, but allows the employee to take time off if the child is sick, or if they are a primary caregiver for somebody else in their family. Another example was allowing flexible work hours so employees could coordinate their work schedule with lower or no-cost child care.

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Part 2: Possible Solutions

Four strategies that can help ALICE families

by LiAnne Yu

There are many efforts to support ALICE families, but people disagree on some of the proposed solutions.

For example, some people argue that short-term rentals for tourists are a problem, taking homes out of circulation and raising rental prices for locals. Others say Airbnb rentals provide critical extra income for working families.

Some argue we must increase the minimum hourly wage to at least $15. Others say this would make it harder for small businesses – many owned by ALICE households – to compete.

Some argue for raising taxes on investment properties owned by residents of other states and countries to pay for housing and education. Others believe the costs would just be passed down to tenants and local consumers.

Cindy Adams, president and CEO of AUW, emphasizes there simply is no silver bullet. “Helping ALICE and our community and helping our families is a multifaceted issue. It’s compensation. It’s affordable housing. It’s affordable child care. It’s free preschool. It’s better benefits from our employers. It’s all of those things. But what is important to understand is that we can’t fix ALICE on just the back of one piece of that puzzle.”

Gavin Thornton, co-executive director of the Hawaii Appleseed Center for Law and Economic Justice, suggests that instead of focusing on what’s right in front of us, we step back to identify the more fundamental issues. He uses an analogy to illustrate. “You’re standing on a river bank and someone comes down the river and they are drowning. You jump in and save them. Later on, you see someone else going down. You jump in again. And it keeps going on like that: You keep seeing people drowning, you keep jumping in.

“But what if you actually walked upstream to figure out what was causing this to happen? How is it that we’ve gotten to the point that 48 percent of our families are a paycheck away from homelessness?”

In this section, we explore four ways forward that some local leaders have identified.

1. Be willing to disrupt old processes

Last Christmas, Faamamamika Vaesau and his wife were living in a homeless shelter with their three children. Their two jobs were just not enough to cover rent and groceries. This Christmas, things are different. They live in a two-bedroom place with rent he can afford, neighbors who help him watch his kids, and a new job that pays him $5 more an hour than his previous one. He’s even able save a little at the end of the month.

“We couldn’t celebrate Christmas for so long because all the money went toward the bills. This was the first year my kids got to have a tree and presents. To see them so excited, I felt so happy. And, to be honest, I felt so happy I started to cry,” says Vaesau.

What turned things around for him was the chance to live at Kahauiki Village, which provides permanent affordable housing to working families who were once homeless.

Faamamamika Vaesau and his family | Photo: Elyse Butler

The story of Kahauiki Village is, in many ways, the story of how different groups disrupted the typical inertia for the sake of doing something extraordinary together. It starts with catalyst Duane Kurisu, who was deeply moved by the plight of homeless people in Hawaii and wanted to help develop more affordable housing. (Disclosure: Kurisu is the owner of Hawaii Business.)

Instead of slogging through the usual process, Kurisu took advantage of an emergency proclamation allowing government agencies to be fast-tracked through the bureaucratic process. In essence, as he describes it, government provided free land, got approvals completed quickly and provided infrastructure. The private side took on the financial risk and brought agility and creativity to the project.

“I cannot overemphasize the importance of a public-private partnership,” says Kurisu. “Government cannot do this alone and the private industry cannot do it alone. It has to be done together and it needs to start from a standpoint of trust.”

Others volunteered their time, donated resources and provided expertise. Even outsiders were persuaded to provide support. For example, Japanese manufacturer Komatsu donated modular homes and Tesla provided the batteries that allowed the development to function off the grid.

The Vaesaus at their current home in Kahauiki Village  | Photo: Elyse Butler

“The amount of giving that came from people, both in monetary terms, but more importantly from their hearts and from the energy that was given to the project, exceeded all of our expectations. I think what we saw was that people want to help. They just need a way to help,” says Kurisu.

Inspired by memories of the plantation culture he grew up in, Kurisu envisioned an environment where people could live in dignity and in community. To that end, the village includes a day care, preschool, laundry, grocery store and community garden for people to learn how to grow food.

Many hope Kahauiki Village is a model that others can follow. “When people say we can’t build affordable housing in Hawaii, that’s baloney. We can,” says Marc Alexander, executive director of the city and county of Honolulu’s Office of Housing. “Not only that, he (Kurisu) did it. It’s our proof of concept. When people say public-private partnerships can’t work, that’s also baloney. There is the example.”

2. Design solution systems, not just fixes

Lourdes Maquera works 15-hour days at two different housekeeping jobs. Her commute between Waipahu and Waikiki eats up at least an hour each way. Most of the week, she’s away from home from 6 a.m. to 11 p.m. When she’s running late she’ll drive, but parking can cost $20. Such expenses can mean the difference between making ends meet or having to pay groceries on a credit card.

If Harrison Rue’s vision for the future of transportation comes to pass, commuters like Maquera won’t have to spend that kind of money or time getting to and from work. Rue is the administrator of Honolulu community building and transit-oriented development.

At the heart of his vision is rail. As Rue explains, we shouldn’t see rail as an end in itself but as a catalyst. It will spur development in housing, and at least a portion of that will be dedicated to affordable options. It will drive investments in sidewalks, parks and sewer lines. It will bring more bike sharing and ride-hailing services. It will reduce the number of parking garages needed, potentially opening up their use for more housing. It will make apartment buildings more affordable because they will no longer need as much parking.

In this future, Maquera could save as much as $10,000 a year – the average cost Hawaii residents pay for car payments, maintenance and gas.

“When I grew up in suburbia, the car was freedom for me,” says Rue. “But now the car is a ball and chain around the neck of somebody. Especially if it comes down to whether I can afford my own place versus crashing on my uncle’s living room couch.”

Aki Marceau, managing director of the Elemental Excelerator, sees rail as the first of the interconnected services that will make life better for ALICE families and bring Hawaii closer to its goal of using 100 percent renewable energy sources by 2045. She points out the state currently spends $5 billion every year to import crude oil to power our cars and produce electricity. When all of our energy is created entirely within the state, energy bills such as Maquera’s will go down – currently hers is at least 2.5 times more than the average person living on the Mainland.

The clean economy will also create an estimated 3,500 new jobs every year, paying on average $3-$7 more than the median wage today, says Marceau. These will include roles in construction, solar panel installation, wind-farm maintenance, data reading and coding. Most of these, Marceau says, will require training but not necessarily a college education, making them attainable for most people in society.

“I believe we can actually design the future that we want to live in. We shouldn’t let technology just happen to us. We should harness technology and innovation to achieve the type of world and type of communities that we’re trying to achieve,” Marceau says.

“We’re going to be a postcard from the future about how we mitigate and adapt to the impacts of climate change. And with that will come higher paying jobs for so many people.”

3. Support our youth

Every day, Kalihi public school teacher Nicole Schubert sees how financial distress impacts her students’ ability to envision their futures. “We’re pushing college on these kids, but I don’t think they can fathom picking up a student loan or leaving the state to go to school. Those things are hard for them to visualize because their whole family has lived here their whole lives, or maybe their parents are from Micronesia and never went to college. And so it’s hard for many of them to picture anything but going into low-wage jobs like their parents.”

Kamehameha Schools’ VP of strategy and innovation, Lauren Nahme, describes this cycle of poverty: “Having household stresses affects education priorities, and it affects their readiness to learn when they go to school. They are experiencing lack of connection and mentorship at home because parents are stressed out or maybe there is only one parent or no parent. A really big part of financial stability is having asset ownership and health that you can transfer from generation to generation. The less base you have, the less you’ll prioritize higher levels of education, especially if there are costs involved.”

YouthBuild, a program funded by the U.S. Department of Labor, seeks to break that cycle by offering 15-25-year-olds from low-income families the opportunity to complete their GEDs while simultaneously gaining job training by constructing 400-square-foot residential units. What makes this program even more relevant when it comes to solving the ALICE challenge is that the homes these youths build will be reserved for low-income renters.

“It’s hard for many of them (students) to picture anything but going into low-wage jobs like their parents.” 
– Nicole Schubert, Kalihi public school teacher

“The goal is that when the students are done with our eight-month program, they have OSHA, forklift and other certifications under their belt, so they can get jobs in the construction field. But at the same time we’re working with these at-risk youth, we’re also addressing the affordable housing issue,” says interim project manager Mona Bernardino.

Terrence George, president and CEO of the Harold K. L. Castle Foundation, says one way to reduce the number of ALICE families is to show students the connection between education and higher salaries. “There’s national data that shows that if you get a B.A., your lifetime earnings are $1 million more than if you just had a high school degree,” he says.

His foundation supports partnerships between educators and high growth industries, early college work in high school, project-based cultures in schools, field trips to job sites and student apprenticeships.

George’s goal is to empower students with all of the tools and exposure they need to make the best decisions for themselves. “For example, there is plenty of demand for certified nurses in our state. But on those salaries, you may stay ALICE forever. However, if you train to be a nurse for an anesthesiologist, while there may not be as many jobs in the state, you will be able to make a lot more.”

He adds, “If you ensure there’s strong educational opportunities for all, that are reasonably affordable, and lead persons to those life skills they need to lead, we will chisel away at the forces that continue to divide us and make the middle class wither away.”

4. Strengthen workers’ voices and civic engagement

When I first spoke with Rob Valera, the maintenance engineer was 26 days into what would eventually become a 51-day strike at the Sheraton Waikiki. He was also just one payment away from being delinquent on his mortgage. “It’s really scary to know you could receive a letter saying you’re one step closer to foreclosure. I get chicken skin every time I see the mail.”

Despite that fear, he believed it was important to keep up the strike. “I’ve put nearly 20 years of my life into this company. It’s my second home. I spend three hours in traffic every day to get to work and back home. So I’ve got to take care of it, got to take care of the others I work with. And in return, I feel like our employers should take care of us.”

The fundamental problem, Valera and other strikers expressed, is that the biggest companies in Hawaii are increasingly being run by stakeholders who aren’t from Hawaii, may never have lived in the state and thus have little connection to their employees.

For Valera and the others, organizing and speaking with one voice was the best way to be heard. “The benefits and wages we get from employers were never given to us. They were fought for by generations before me. We’re not going to be the generation that gives in,” he says.

After the longest hotel workers strike in Hawaii since 1970, the union negotiated a total increase of $6 across wages and benefits over the next four years. Just as important for the union members were the wins on job security. If the employer wants to introduce new technology that potentially replaces employees, they must notify worker committees, which then have a chance to negotiate retraining for other departments or fair severance packages.

“The word solidarity can seem abstract, but the unity was just something I’d never seen before,” says Paola Rodelas, Unite Here Local 5 communications and community organizer. “We had very few workers actually cross the picket line. It was less than 1 percent of the 2,700 workers. That, to me, was really inspiring.”

Rodelas describes the model of collective action as one everyone should practice, not just union members. She recalls a retiree approaching her in tears because her low income senior housing rent was about to be doubled. The woman wondered if Rodelas could help organize the other residents to come up with a plan of action. Rodelas agreed but didn’t expect much participation. She was shocked to find 60 senior citizen residents gathered and waiting for her.

“They did all of it themselves,” she says. “They organized. They picketed in front of the building to draw attention to the issue. All I did was get the media there. And in a matter of weeks, they got the governor to step in and say, your rent is not going to double.

“For me, that’s a testament to how at the core, we need to get organized. Beyond just wages and benefits, what would our community look like if, say, we as renters organized? The lesson that we can derive is the power of what happens when working people get together and demand things not just for themselves, but for everyone.”

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Some Numbers Can Be Deceptive

Hawaii’s average annual household income of $77,765 was the fourth highest in the nation in 2017.

But Hawaii’s average annual wages per earner were $49,671 – that’s below the national average. How is that possible? Hawaii has the nation’s second-highest average household size; high housing costs often persuade multiple earners to live together in a single household to make ends meet.

Source: DBEDT, federal Bureau of Labor Statistics

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Lower Income Workers Fall Further Behind

About half of Hawaii’s residents have seen their income go down over time. From 1980 to 2015, earners in the 50th percentile of annual income suffered inflation-adjusted income declines of 1.5 percent, while earners in the 20th and 10th percentiles fared worse: income declines of 3.0 percent and 6.1 percent respectively.

In the same period, earners at the 80th and 90th percentiles experienced increases in income of 3.0% and 7.7%.

Source: UHERO, National Equity Atlas, U.S. Bureau of Economic Analysis

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Part 3: What Can I Do?

With so many needy families, businesspeople can feel overwhelmed by the issues that defy easy solutions. But the leaders we interviewed stress that even though the challenges are complex, our individual responses don’t have to be. Here are three principles to follow if you want to help.

by LiAnne Yu

1. Do What You Do Best

Businesspeople may hesitate to weigh in on poverty and social justice issues, believing these are the exclusive domains of nonprofit and community experts.

To the contrary, Hawaii’s leaders urge businesspeople to get involved and bring their entrepreneurial instincts into play. “Businesses can roll up their sleeves and say we’ll bring concepts and solutions to the table for consideration, and strategies for implementing them. After all, that’s what a lot of businesses are good at,” says Colbert Matsumoto, executive chairman of the board at Island Insurance Cos.

Supporting entrepreneurship is one way that businesspeople can help youths from ALICE households potentially break the cycle of poverty. Donavan Kealoha was born and raised in Hawaii. He worked for many years in a Silicon Valley venture capital firm and wondered why there weren’t more people who looked like him in the tech field. To rectify that, he co-founded Purple Maia Foundation, which provides after-school classes in coding and computer science to Native Hawaiian students, low-income youth and others underrepresented in tech fields.

He describes one former student – a shy girl with family challenges who had dropped out of school. She took instantaneously to the coding class and whizzed through the curriculum, got into a more advanced coding boot camp, and ended up helping out on a Microsoft project.

“I see students like that as future CEOs. As for me, I’m just trying to help these kids find their jam,” says Kealoha.

Catherine Ngo, president and CEO of Central Pacific Bank, urges the business community to do what it does best: leverage its connections to create more funding for young entrepreneurs. “I do think that there is the capital out there we can harness – plenty of local capital as well as outside capital from Silicon Valley and Japan, places that have natural ties to Hawaii. We need to make them aware of the number of ideas coming out of Hawaii that they can invest in.”

Another approach businesspeople should support is diversifying and upscaling our visitor economy so that employers can increase service worker wages, says Paul Yonamine, chairman and CEO of Central Pacific Financial Corp. He suggests designing more high-end experiences in wellness, culture, sports and cuisine to attract VIPs. “We do a better job than any other place in the world making people happy. But there’s still lots of work we can do to enhance the quality and value of what we provide in order to generate more money for local workers,” Yonamine says.

Business leaders can also volunteer their expertise. Mona Bernardino, interim project manager at YouthBuild, is looking for architects to help her students build structures that will be rented out to low-income residents. That will save them the $7,000 it takes to hire someone to help them place the structure on-site, connect to utilities and meet permit requirements.

“Businesses should not feel hesitant to be stepping into this space,” says Joyce Lee-Ibarra, president and CEO of JLI Consulting. “They should be asking themselves, how can we harness what we know we’re good at that could be of benefit to ALICE households? How can we be creative in thinking about not just financial costs, but other areas of need for ALICE households? How can we bring in our most experimental, innovative know-how?”

2. Support Your Own ALICE Employees

Give them a raise if you can. But Cindy Adams, president and CEO of Aloha United Way, says businesses shouldn’t think there is nothing they can do for their ALICE employees just because they can’t afford to raise their wages. Instead, she encourages businesses of all sizes to look for creative ways to offer other benefits that help employees become more resilient.

For example, reimbursement for educational enrichment, such as online courses, can help employees gain skills to advance their careers and earn more money. Plus your company could benefit from those advanced skills.

“Take an interest in helping people gain skills in financial management. Provide counselors who can help them understand how to save and how to contribute to a 401(k) – the kind of stuff where they can learn how to put away their money,” suggests Connie Mitchell, executive director of the Institute for Human Services. After all, more financially secure employees can focus less on mere survival and more on their jobs.

Lee-Ibarra describes one business owner who brought in tax assistants to help all employees file for the earned income tax credit. “I loved the creativity – this is really applicable to this target population, and something they wouldn’t take the time or have the mental bandwidth to seek out on their own.”

Offering full on-site child care is a large investment, but Barbara DeBaryshe, interim director at the UH Center on the Family, says there are less costly options: “You could offer space for child care, working with other businesses jointly to rent that space to a child care organization that would come in with their staff, licensing, health and safety, and curriculum. As another option, some companies offer child care vouchers, which is like an employee benefit that employees can apply to a child care of their choice.”

ALICE parents typically can’t afford full-time child care, often juggling work with picking up children and taking them to doctors’ appointments. Providing more flexible work schedules can alleviate the time pressure, as well as encourage families to not skimp on regular medical care. The option to work from home can also make it easier to care for a sick child or elderly relative.

Lee-Ibarra suggests simply asking employees what they need. “There are circumstances where people come up with solutions about a group that they’re not necessarily a part of. But really, the best way to find out is ask the people who are impacted what they need. Ask employees to come to the table for these conversations. They may not be able to generate immediate solutions, but they can speak to the lived experience of the problem that needs to be addressed.”

3. Remember, We’re All Connected

One of the most important things for businesses to do, says Peter Ho, is to realize that the well-being of ALICE community members is, in fact, our own well-being – not something that can be separated out and ignored indefinitely without consequences. “We can think of all sorts of incredibly fantastic, strategic ideas, but fundamentally the most important strategic element of our business has to do with the continued health of the community. Without that, it doesn’t matter what we’ve come up with,” says Ho, chairman, president and CEO of Bank of Hawaii.

“If you think of your own long-term viability as a business, you begin to understand that we have a vested interest in being part of the solution. We can’t just stay observers,” he adds.

Ho’s comment was echoed many times by other leaders. Colbert Matsumoto, executive chairman of the board of Island Insurance Cos., warns that if the situation doesn’t improve, the employees and customers of local businesses will leave the state for better pay and lower costs of living. “I see that as a drain of talent, an exodus of skills. We do a good job of raising our young people. But if ultimately they become one of our exports, we’re not going to be able to get them back.”

Paola Rodelas, communications and community organizer of the union, Unite Here Local 5, says that understanding such interconnectedness makes workers’ struggles and successes ultimately everybody’s. “Hotel companies are billion-dollar industries that aren’t even based in Hawaii anymore. It’s not the Hilton family that owns it anymore, it’s private equity. The only money we as a community get back from them is through our workers. When they are paid well, that’s money they spend back into the local economy and eating at local restaurants. Their tax money pays into our schools and services our state needs. That’s one reason why the business community should care.”

While Hawaii’s leaders want everyone to understand the gravity of the ALICE report’s findings and their impact on all of us, there is also a great deal of hope. That hope is largely based on the fact that so many local leaders understand our interconnectedness.

“We have advantages other places don’t have,” says Gavin Thornton, co-executive director of the Hawaii Appleseed Center for Law and Economic Justice. “We’re a relatively small community and we have the potential to address some of these complex problems just because of that. In a way it makes it easier to have the conversations about change and to effectuate the change so we can all thrive together.

“I do think we’re at a tipping point. I’ve seen a lot of positive changes in just the past couple of years, and the ALICE report has been a big part of that. It has really captured people’s attention. And there are people coming together in ways they haven’t done before.”

Ryan Kusumoto, president and CEO of Parents and Children Together, says the most encouraging thing he has observed is a shift in how the business community talks about the challenge. “We’re starting to see big business and for-profit entities coming in saying, ‘We can be a part of this solution because we get it. These are the people who are working for us, these are the people who are coming to our establishments to shop. And we need to be part of that solution because we’re Hawaii, we care about each other, we need to do that.’ So I think that’s a real bright spot we’re heading toward – a place where we can all be part of that solution because we understand it better,” Kusumoto says.

“And I’ve been starting to hear that shift. There’s less talk of ‘those people’ and more of ‘us.’ More of ‘we.’ More of how can ‘we together’ do this.”