HOUSE OF REPRESENTATIVES                H.R. NO.74         
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
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                     HOUSE  RESOLUTION

URGING THE DEPARTMENT OF HEALTH TO IMPLEMENT A PROGRAM FOR THE
   PREVENTION AND TREATMENT OF OSTEOPOROSIS.



 1        WHEREAS, osteoporosis, a bone-thinning disease, is a major
 2   public health problem that poses a threat to the health and
 3   quality of life to as many as 28,000,000 Americans; and
 4   
 5        WHEREAS, the 1,500,000 fractures each year that result
 6   from osteoporosis cause pain, disability, immobility, and
 7   social isolation, affecting quality of life and threatening
 8   people's ability to live independently; and
 9   
10        WHEREAS, because osteoporosis progresses silently and
11   without sensation over many years, and many cases remain
12   undiagnosed, its first symptom is often a fracture, typically
13   of the hip, spine, or wrist; and
14   
15        WHEREAS, one of two women and one of eight men will suffer
16   an osteoporotic fracture in their lifetime; and
17   
18        WHEREAS, a woman's risk of hip fracture is equal to her
19   combined risk of breast, uterine, and ovarian cancer; and
20   
21        WHEREAS, the annual medical costs of osteoporosis to the
22   health care system are estimated to be nearly $13,800,000,000,
23   and are expected to rise to $60,000,000,000 to $80,000,000,000
24   by the year 2020; and
25   
26        WHEREAS, since osteoporosis progresses silently and
27   currently has no cure, prevention, early diagnosis, and
28   treatment are key to reducing the prevalence of and devastation
29   from this disease; and
30   
31        WHEREAS, although there exists a large quantity of public
32   information about osteoporosis, it remains inadequately
33   disseminated and not tailored to meet the needs of specific
34   population groups; and
35   
36        WHEREAS, most people, including physicians, health care
37   providers, and government agencies continue to lack knowledge
38   in the prevention, detection, and treatment of this disease;
39   and

 
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                                  H.R. NO.74            
                                                        
                                                        

 
 1        WHEREAS, experts in the field of osteoporosis believe that
 2   with greater awareness among medical experts, service
 3   providers, and the public, osteoporosis can be prevented in the
 4   future, thereby reducing the costs of long-term care; and
 5   
 6        WHEREAS, osteoporosis is a multi-generational issue
 7   because building strong bones during youth and preserving them
 8   during adulthood may prevent fractures in later life; and
 9   
10        WHEREAS, educating the public and health care community
11   throughout the State about this potentially devastating disease
12   is of paramount importance and is in every respect in the
13   public interest and to the benefit of all residents of the
14   State of Hawaii; now, therefore,
15   
16        BE IT RESOLVED by the House of Representatives of the
17   Twentieth Legislature of the State of Hawaii, Regular Session
18   of 1999, that the Department of Health, (DOH) in cooperation
19   with the Department of Education, and the Executive Office on
20   Aging, is urged to establish, promote, and maintain an
21   osteoporosis prevention and treatment education program to
22   raise public awareness, educate consumers, and educate and
23   train health professionals, teachers, and human service
24   providers; and
25   
26        BE IT FURTHER RESOLVED that DOH is urged to use the
27   following strategies for raising public awareness on the causes
28   and nature of osteoporosis, personal risk factors, value of
29   prevention and early detection, and options for diagnosing and
30   treating the disease:
31   
32        (1)  Sponsor an outreach campaign using print, radio, and
33             television public service announcements,
34             advertisements, posters, and other materials;
35   
36        (2)  Sponsor community forums;
37   
38        (3)  Provide health information and risk factor assessment
39             at public events;
40   
41        (4)  Sponsor information dissemination programs targeting
42             at-risk populations;
43   
44        (5)  Provide reliable information to policy makers; and
45   

 
 
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                                  H.R. NO.74            
                                                        
                                                        

 
 1        (6)  Distribute information through county health
 2             departments, schools, the Executive Office on Aging,
 3             area agencies on aging, employer wellness programs,
 4             physicians, hospitals, health maintenance
 5             organizations, women's groups, nonprofit
 6             organizations, community-based organizations, and
 7             departmental regional offices;
 8   
 9   and
10   
11        BE IT FURTHER RESOLVED that DOH is urged to use the
12   following strategies for educating consumers about risk
13   factors, diet and exercise, diagnostic procedures and their
14   indications for use, risks and benefits of drug therapies
15   currently approved by the United States Food and Drug
16   Administration, environmental safety and injury prevention, and
17   the availability of diagnostic, treatment, and rehabilitation
18   services:
19   
20        (1)  Identify and obtain educational materials, including
21             brochures and videotapes, which translate accurately
22             the latest scientific information on osteoporosis in
23             easy-to-understand terms;
24   
25        (2)  Build a statewide capacity to provide information and
26             referral on all aspects of osteoporosis, including
27             educational materials and counseling;
28   
29        (3)  Establish state linkage with an existing toll-free
30             hotline for consumers;
31   
32        (4)  Facilitate the development and maintenance of
33             osteoporosis support groups; and
34   
35        (5)  Conduct workshops and seminars for lay audiences;
36   
37   and
38   
39        BE IT FURTHER RESOLVED that DOH is urged to use the
40   following strategies for educating physicians and health
41   professionals and training community service providers on the
42   most up-to-date, accurate scientific and medical information on
43   osteoporosis prevention, diagnosis, and treatment, therapeutic
44   decision-making, including guidelines for detecting and
45   treating the disease in special populations, risks and benefits
46   of medications, and research advances:

 
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                                  H.R. NO.74            
                                                        
                                                        

 
 1        (1)  Identify and obtain educational materials for the
 2             professional which translates the latest scientific
 3             and medical information into clinical applications;
 4   
 5        (2)  Raise awareness among physicians and health and human
 6             services professionals as to the importance of
 7             osteoporosis prevention, early detection, treatment,
 8             and rehabilitation;
 9   
10        (3)  Identify and use available curricula for training
11             health and human service providers and community
12             leaders on osteoporosis prevention, detection, and
13             treatment;
14   
15        (4)  Provide workshops and seminars for in-depth
16             professional development in the field of the care and
17             management of the patient with osteoporosis; and
18   
19        (5)  Conduct a statewide conference on osteoporosis at
20             appropriate intervals;
21   
22   and
23   
24        BE IT FURTHER RESOLVED that DOH is requested to conduct a
25   needs assessment to identify:
26   
27        (1)  Research being conducted within the State concerning
28             osteoporosis;
29   
30        (2)  Available technical assistance and educational
31             materials and programs nationwide concerning
32             osteoporosis;
33   
34        (3)  The level of public and professional awareness about
35             osteoporosis;
36   
37        (4)  The needs of osteoporosis patients, their families,
38             and caregivers;
39   
40        (5)  Needs of health care providers, including physicians,
41             nurses, managed care organizations, and other health
42             care providers;
43   
44        (6)  The services available to the osteoporosis patient;

 
 
 
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                                  H.R. NO.74            
                                                        
                                                        

 
 1        (7)  Existence of osteoporosis treatment programs;
 2   
 3        (8)  Existence of osteoporosis support groups;
 4   
 5        (9)  Existence of rehabilitation services; and
 6   
 7         (10)  Number and location of bone density testing
 8               equipment;
 9   
10   and
11   
12          BE IT FURTHER RESOLVED that based on the needs
13   assessment, DOH is requested to develop and maintain a list of
14   osteoporosis-related services and osteoporosis health care
15   providers with specialization in services to prevent, diagnose,
16   and treat osteoporosis.  This list should be made available to
17   interested parties and disseminated with a description of
18   diagnostic testing procedures, appropriate indications for
19   their use, drug therapies currently approved by the United
20   States Food and Drug Administration, and a cautionary statement
21   about the current status of osteoporosis research, prevention,
22   and treatment.  The statement should also indicate that the
23   department does not license, certify, or in any way approve
24   osteoporosis programs or centers in the State; and
25   
26          BE IT FURTHER RESOLVED that DOH is urged to establish an
27   interagency council on osteoporosis.  The Director of Health is
28   requested to chair the council.  The council should be composed
29   of representatives from the Department of education, the
30   Executive Office on Aging, and other appropriate public and
31   private entities with expertise in such areas as aging, health
32   care reform implementation, education, public welfare, and
33   women's programs.  The council is requested to:
34   
35          (1)  Coordinate osteoporosis programs conducted by or
36               through DOH;
37   
38          (2)  Establish a mechanism for sharing information on
39               osteoporosis among all officials and employees
40               involved in carrying out osteoporosis-related
41               programs;
42   
43          (3)  Review and coordinate the most promising areas of
44               education, prevention, and treatment concerning
45               osteoporosis;

 
 
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                                  H.R. NO.74            
                                                        
                                                        

 
 1          (4)  Assist the department and other offices in
 2               developing and coordinating plans for education and
 3               health promotion on osteoporosis;
 4   
 5          (5)  Establish mechanisms to use the results of research
 6               concerning osteoporosis in the development of
 7               relevant policies and programs; and
 8   
 9          (6)  Prepare a report that describes educational
10               initiatives on osteoporosis sponsored by the State;
11   
12          (7)  Make recommendations for new educational
13               initiatives on osteoporosis;
14   
15          (8)  Transmit the report to the Legislature; and
16   
17          (9)  Make the report available to the public;
18   
19   and
20   
21          BE IT FURTHER RESOLVED that the interagency council on
22   osteoporosis is urged to establish and coordinate an advisory
23   panel on osteoporosis, which would provide nongovernmental
24   input regarding the osteoporosis prevention and treatment
25   education program.  Membership should include but not be
26   limited to persons with osteoporosis, women's health
27   organizations, public health educators, osteoporosis experts,
28   providers of osteoporosis health care, persons knowledgeable in
29   health promotion and education, and representatives of national
30   osteoporosis organizations or their state or regional
31   affiliates; and
32   
33          BE IT FURTHER RESOLVED that DOH is urged to accept
34   grants, services, and property from the federal government,
35   foundations, organizations, medical schools, and other entities
36   as may be available for the purposes of fulfilling the
37   obligations of this program and seek any federal waiver or
38   waivers that may be necessary to maximize funds from the
39   federal government to implement this program; and
40   
41          BE IT FURTHER RESOLVED that a certified copy of this
42   Resolution be transmitted to the Director of Health.
43   
44   
45                         OFFERED BY:  ____________________________