Rep. Abercrombie missed a key point in his Sept. 13 letter about services Hawai'i provides to people who migrate here from Micronesia, the Marshall Islands and Palau under the Compact of Free Association.

The fact is, Congress and the federal administration, not the state, are responsible for achieving long-term solutions that meet the needs of COFA migrants.

I understand the frustration Abercrombie must feel at failing to garner support in Congress to compensate Hawai'i for our COFA expenses, which now exceed $101 million per year. In return, we receive about $11 million in federal reimbursement.

This injustice occurs despite language in the compact stating that "it is not the intent of Congress to cause any adverse consequences for an affected jurisdiction," and that for COFA migrants to live here, they must have "sufficient means of support."

Abercrombie added an amendment to a health care bill that would make COFA migrants eligible for Medicaid. Even if that passes, it would only be a half measure. Hawai'i would still have to pay matching state dollars.

Hawai'i should receive full federal reimbursement for all our COFA expenses. Anything less would not be pono.

Henry Oliva | Human Services deputy director

OUR REPRESENTATIVES DIDN'T VOTE TO DEFUND

Recently, the community organizer group ACORN was caught on video offering advice to someone posing as a pimp, telling the alleged pimp how to evade taxes while setting up a child prostitution ring. Currently, ACORN is receiving funding from our tax dollars. When this tape came to light (plus tapes from three other ACORN offices doing similarly sleazy things), the U.S. House swiftly voted to defund ACORN.

You might think this would have been a unanimous vote — you might think no politician in their right mind would continue to support such a corrupt organization. If so, you would be wrong. Both of our U.S. House delegates failed to vote for this defunding. Neil Abercrombie ducked the vote, and Mazie Hirono actually voted against defunding ACORN.

It's time to take these two political "leaders" out. I'm a libertarian, but I'm willing to make an exception and pull a Democratic primary ballot to vote for any Democratic challenger to the person who allegedly represents me in Congress (Hirono). Can someone please step up to the plate?

Jim Henshaw | Kailua

MAYBE BOARD IS THE LEADERSHIP PROBLEM

Let me get this straight: the Hawai'i Public Housing Authority has experienced seven executive directors in 10 years, and only one of them has stayed more than two years? ("Housing agency may hire new chief," Sept. 11)

With so many executive directors going through the turnstile that seems to represent HPHA, I have to wonder when someone will recognize that the problem is not with those in the ED role but actually with the HPHA board and those who provide oversight to the executive director.

Chad Taniguchi has "balanced the agency's budget — bouncing back from a projected $4 million deficit last fiscal year — increasing rent collection to 95 percent, cutting the number of vacant units and addressing tenants' concerns" — all in two years? Dubious accomplishments indeed.

The decision to search for a new ED is another example of public sector inefficiency in the state of Hawai'i and why too many qualified, competent, individuals capable of implementing change become frustrated with the bureaucracy, passiveness and frequent incompetence of those in decision-making positions.

Perhaps the HPHA should slow down and take a good, hard look at their management style, which seems to repel the many EDs who have filed in and out of the organization.

Kristi Schulenberg | Honolulu

EACH CHILD DESERVES A MEDICAL HOME

Thank you for your editorial of Sept. 11, "Time to try more holistic health care." The concept of a patient and his or her family linked to a personal primary care physician who assists in coordinating treatment and emphasizing prevention has indeed been under way in the Islands.

Under the leadership of Dr. Calvin Sia, Hawai'i pediatricians have been involved with the medical home since 1979. The American Academy of Pediatrics has embraced Dr. Sia's idea and believes that "Every child deserves a medical home."

The medical home is a model of delivering primary care that acknowledges the unique needs of children and families. We who strive to create medical homes are charged with providing care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate and culturally effective.

To enable pediatricians to implement quality medical homes, the health care system must finance and support this "quiet revolution." Health care reform should include universal accessibility, appropriate payments and a systems approach to child health care. We encourage employers and health plans to embrace the medical home, and invest resources to help improve health care for our families in Hawai'i.

Every child deserves a medical home.

Galen YK Chock, M.D. | President, American Academy of Pediatrics, Hawai'i Chapter

A FEW WAYS TO HELP MAKE UP SHORTFALL

Our libraries all had inadequate hours, meager collections and many were too small and/or were in disrepair prior to the current financial crisis. Now they report having a $3 million shortfall. They began a campaign asking users to donate $3 each. I am sure that they appreciate the $10,000 or so collected to date. However, they are unlikely to raise enough in this way. I have a few ideas about how they could make up more of this shortfall.

1) When customers request books via the Internet, alert them via e-mail, not through the postal service. This will save money, be better for the planet, and get the information to the patron more quickly.

2) Add a small fee of 50¢ or $1 for each item requested this way.

3) Allow and charge coffee vendors to sell coffee and related items in or near each library.

4) Sell the naming rights and/or recruit corporate sponsors for each branch.

5) Make a list of books that each branch would like to have, and allow patrons to buy them for the branch. Patrons could then donate a book in commemoration of a loved one's special occasion, and receive a card to give to the honoree as well as see the book with an inscription inside noting the donation.

Wayne David Levy, M.D. | Honolulu