HB1477 CD1

SECTION 1. The legislature finds that there is a severe shortage of primary care health providers in the state, which threatens the health of our residents and affects health care costs. This shortage has pushed the federal government to designate a number of areas in the State, particularly rural areas, as medically underserved areas, health professional shortage areas, or as having medically underserved populations.

The legislature further finds that family physicians are well‑suited to rural health care due to the broad scope of their practice, which encompasses inpatient, outpatient, and nursing home settings, and addresses acute, chronic, and preventive health across the life cycle. Many family physicians also provide maternity care, family planning, and mental health services through their practices.

The University of Hawaii John A. Burns school of medicine currently offers a three-year residency program in family medicine. The program emphasizes a system-based and interdisciplinary team approach to health care. The mission of the family medicine residency program is to meet the needs of rural and medically underserved areas and populations in Hawaii in a culturally sensitive and medically appropriate manner. Family medicine program residents provide not only health care but also education and outreach at schools and community events. Presently, family medicine program residents spend two months in a federally-funded rural health care training demonstration project, initiated in Hilo in 2006, in which residents learn how to provide health care to medically underserved patients in rural areas as they rotate among private physician offices, emergency departments, and the community, providing outreach and education. It is anticipated that the Hilo rural health training program will be duplicated on Kauai. Additional training sites will be developed in conjunction with the health master planning process underway in Maui and with the hospital and community health center system on Kauai. As these sites are being developed, the curriculum can be structured so that family medicine residents have the opportunity to rotate to neighbor island sites other than Hilo.

The purpose of this Act is to increase access to primary health care services provided by family physicians or residents in the family medicine residency program at the University of Hawaii to medically underserved residents in rural areas of the state by appropriating funds to:

(1) Support and expand the family medicine residency program of the University of Hawaii John A. Burns school of medicine's department of family medicine and community health to provide rural primary health care services; and

(2) Develop a permanent statewide rural primary health care training program in the county of Hawaii to expand the rural health care training available for individuals in the family medicine residency program of the University of Hawaii John A. Burns school of medicine.

SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $1,500,000 or so much thereof as may be necessary for fiscal year 2007-2008 to support and expand the family medicine residency program of the University of Hawaii John A. Burns school of medicine's department of family medicine and community health to provide rural primary health care services.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $2,500,000 or so much thereof as may be necessary for fiscal year 2008-2009 to develop a statewide rural primary health care training program to provide family physicians to rural areas and improve health care access for the people of Hawaii.

SECTION 4. The sums appropriated in sections 2 and 3 of this Act shall be expended by the University of Hawaii John A. Burns school of medicine for the purposes of this Act.

SECTION 5. This Act shall take effect on July 1, 2007.

HOUSE OF REPRESENTATIVES	H.B. NO.	1477
TWENTY-FOURTH LEGISLATURE, 2007		H.D. 2
STATE OF HAWAII		S.D. 2
		C.D. 1