State funding for an ongoing study of Maui wildfire survivors evaporated after a Hawaii legislative bill failed to make it through conference committee this month.
That leaves the Maui Wildfire Exposure Study facing a deficit of $1.5 million. Without that amount, the study will not be able to continue, according to project lead Ruben Juarez.
The study, which researchers from the University of Hawaii at Manoa launched after the deadly Aug. 8, 2023, Maui wildfires, follows a cohort of survivors over five years or more, documenting their chronic health impacts and social conditions. It also maintains a Maui Health Registry, which was set up to track the long-term effects of the wildfires on their health over time.
“I am extremely
disappointed,” said Juarez, who is with the UH Economic Research Organization. “And frankly, for me, it’s hard to understand, given the level of community need and the amount of support that the bill received.”
The study — referred to as MauiWES for short —
involved questionnaires, health screenings and bio-metric measures, including lung capacity, and toxic exposure testing.
Juarez, along with John A. Burns School of Medicine professor Alika Maunakea, put in the groundwork over the years, establishing trust and a rapport with the cohort of survivors from
Native Hawaiian, Pacific
Islander, Filipino and immigrant communities.
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Juarez said MauiWES is more than just an academic study. It has evolved into a “comprehensive social and health bio-monitoring effort” among a network of a
survivors, and has been a bridge between about 2,000 participants and the resources and health care services they need, he said.
“It is one of the only systems currently in place to understand and respond to the long-term health impacts of the Maui wildfires,” Juarez said. “We are providing people with their results and connecting them to services and building a registry so we can follow them over time.”
Maunakea said that if there was a lesson to be learned following the Sept. 11, 2001, terrorist attacks in New York City, it is that health issues are still prevalent 20 years or more later.
“We started the study hoping we could identify early signs of these conditions to reduce further mortalities from happening,” Maunakea said. “It requires maintaining this vigilance, especially since it’s a complex problem.”
Juarez and Maunakea planned to expand the cohort to 3,000 survivors, including children. They had a waiting list of families willing to participate.
Senate Bill 2969 made it all the way to conference committee, with plenty of testimony in support of the measure, but failed at the last minute.
The bill, introduced by state Sen. Angus McKelvey (D, West Maui-Maalaea-South Maui), initially sought an appropriation of $3 million to UH to fund the study for fiscal year 2026-2027.
In the session’s final weeks, the Ways and Means Committee whittled the amount in the bill down to $500,000 after a separate tax bill had been approved. Then May 1, in a last-minute flurry, the bill was delayed indefinitely before adjournment.
“I do support the study and appreciate the good they have been doing for my community,” McKelvey said in an email.
“As many who are familiar with the legislative process can tell you, difficult decisions had to be made this year, considering the deep federal cuts to programs that support many in the State. In the end, unfortunately, this study was not funded.”
McKelvey added that he is committed to working with the administration and would support the researchers’ pursuit of other funding sources, including possible grants, to continue the study.
The bill, which called the 2023 Maui wildfires the deadliest natural disaster
in state history, noted that beyond the immediate
destruction, survivors continue to face toxic exposures, respiratory illnesses and mental health trauma.
There was overwhelming testimony in support of the bill, including from Maui Mayor Richard Bissen, the Office of Hawaiian Affairs, the Hawaii Medical Association, American Lung Association, American Cancer Society and community nonprofits such as Roots Reborn.
Dr. Jack Lewin, administrator of the State Health Planning and Development Agency, also testified in support of the bill, noting that after 9/11, the World Trade Center Health Registry found 67% of adult enrollees had reported new or worsened respiratory symptoms, and 16% screened positive for probable post-traumatic stress disorder.
“The impacts of the
wildfires did not end in
August 2023,” wrote Lewin, along with many others,
in his testimony. “Many
residents continue to
experience ongoing health concerns, including respiratory problems, mental health challenges, and uncertainty about long-term effects, especially for children and other medically vulnerable individuals.”
When asked whether $500,000 was sufficient to meet the study’s goals, Juarez said no, particularly if the goal is to expand it. He previously said that with $1.5 million, they could maintain the study. He added that both he and Maunakea were at the conference committee May 1 to answer questions but were not asked any.
Juarez said the team
has since reached out to Gov. Josh Green’s office and is speaking with partners to see if they can bridge the funding gap. If not, then MauiWES will not continue past June 30, he said.
Christopher Knightsbridge, MauiWES’s head of mental health research, said he was advocating for more funding for children and
kupuna.
“Children have been hugely neglected,” said Knightsbridge, a mental health therapist who flies to Lahaina weekly to see
patients, “and they always
minimize their mental health symptoms.”
In the latest study, he said, results showed 45% of children had symptoms related to PTSD, and he believes the rates are likely higher. He had hoped to hire two more mental health workers to reach out to
kupuna as well.
“The people of Lahaina and Maui are not doing well,” Knightsbridge said. “They are not in a recovery stage. They’re still in a crisis stage. Their basic needs are not met, and because of stigma, it’s hard for them to come out and ask for support.”
The Maui WES team says they have become the point of contact for many survivors in rural areas, including those who need to connect to mental and physical health services. Juarez said the team has referred dozens of individuals to the Maui Memorial Medical
Center emergency room based on screening results, sometimes for life-saving
interventions.
The team also has been screening children for signs of poor lung function, according to Maunakea, which is important because it can predict long-term cardiovascular conditions and lead to earlier intervention.
Maunakea sees the health needs growing even more
urgent among Hawaii’s rural population, compounded by the recent Kona-low storms that caused intense flooding.
Maui WES, which launched in January 2024, had received at least $2.3 million in prior state funding. It also received a $1.4 million grant from the National Institutes for Health, and funding from the Hawaii Community Foundation and Kaiser Permanente.
Juarez said the team is grateful for this support but that the work cannot depend only on philanthropy in the long term.
He and Maunakea also are sharing their findings nationally, mostly recently at a symposium on wildfires at Rutgers University.
“Without this expansion, the state loses one of its best opportunities to understand the long-term health impacts of the fires,” he said, “and to respond with data-driven interventions.”
