REPORT TITLE:
Rural Health


DESCRIPTION:
Establishes a statewide rural health plan; creates rural health
special fund; requests counties to create a position of rural
transportation coordinator.  (SD1)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        102
THE SENATE                              S.B. NO.           S.D. 1
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
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                   A  BILL  FOR  AN  ACT

RELATING TO HEALTH. 


BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 1      SECTION 1.  The legislature finds that adequate health care
 
 2 for the rural districts of the Big Island are sorely lacking.  In
 
 3 response to this urgent need, senate concurrent resolution no.
 
 4 31, 1998, requested the state department of health (DOH) to
 
 5 develop a rural health plan for the island of Hawaii, including
 
 6 the districts of Puna and Ka`u, to ensure the improvement of
 
 7 health facilities and to make available sufficient medical
 
 8 services.
 
 9      In its report to the legislature pursuant to the resolution,
 
10 the DOH found that the rural community perceptions are that
 
11 comprehensive medical care must come first before the economic
 
12 situation in Ka`u will improve, that elderly retirees have
 
13 limited access to specialists and may suffer long waits for
 
14 transportation to larger or specialized facilities, and that
 
15 there are too few medical facilities in places with inadequate
 
16 transportation and a dispersed population over a large geographic
 
17 area.
 
18      The legislature further finds that compared to the state
 
19 population, Puna has the worst overall socio-economic status in
 

 
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 1 the State, including the second worst per capita income ($9,450),
 
 2 second highest percentage of population below two hundred per
 
 3 cent of the federal poverty level, second highest percentage of
 
 4 households receiving public financial aid, third highest
 
 5 percentage of households receiving food stamps, and fourth
 
 6 highest unemployment rate.  The legislature further finds that
 
 7 Puna has the fourth highest level of overall health risk in the
 
 8 State, including the second highest rate of births to mothers
 
 9 with pre-existing medical conditions, fourth highest percentage
 
10 of low birth weights, fifth highest rate of infant mortality, and
 
11 sixth highest percentage of teen births.
 
12      The legislature further finds that compared to the state
 
13 population, Ka`u has the third worst rate for socio-economic
 
14 status, including the fourth highest percentage of population
 
15 below two hundred per cent of the federal poverty level, forth
 
16 highest percentage of households receiving public financial aid,
 
17 fourth highest percentage of households receiving food stamps,
 
18 fifth worst per capita income, fifth highest unemployment rate,
 
19 and fifth highest percentage of adults without a high school
 
20 diploma.  The legislature further finds that Ka`u has the second
 
21 highest level of overall health risk in the State, including the
 
22 highest percentage of teen births, highest percentage of births
 
23 with low birth weight, third highest percentage of births with
 

 
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                                     S.B. NO.           S.D. 1
                                                        
                                                        

 
 1 inadequate prenatal care, and seventh highest infant mortality
 
 2 rate.
 
 3      The legislature further finds that the health profiles of
 
 4 Ka`u and Puna could be immensely improved with adequate funding
 
 5 for health care needs and with decent public transportation.
 
 6      The purpose of this Act is to implement the recommendations
 
 7 of the DOH to improve the provision of adequate health care
 
 8 services and public transportation for rural communities.
 
 9      SECTION 2.  Chapter 321, Hawaii Revised Statutes, is amended
 
10 by adding a new section to part I to be appropriately designated
 
11 and to read as follows:
 
12      "§321-    Statewide rural health plan; rural health special
 
13 fund.  (a)  The department of health shall develop a statewide
 
14 rural health plan in order to:
 
15      (1)  Obtain federal funds under the Medicare rural hospital
 
16           flexibility program to maintain access to hospitals in
 
17           rural communities by creating a network of shared
 
18           hospital services and resources within the State; and
 
19      (2)  Improve the efficiency and minimize the financial costs
 
20           of rural care by allowing flexibility in staffing and
 
21           in the number and type of beds maintained as a
 
22           requirement of federal funding subsidies.
 
23      (b)  The statewide rural health plan shall be developed and
 

 
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                                     S.B. NO.           S.D. 1
                                                        
                                                        

 
 1 administered by the department of health in conformity with
 
 2 federal requirements for receiving grants pertaining to rural
 
 3 health.
 
 4      (c)  There is established the rural health special fund to
 
 5 be administered by the department of health, into which shall be
 
 6 deposited, if required by federal law or regulation, funds
 
 7 relating to rural health.  Moneys in the fund shall be expended
 
 8 exclusively for improvement of rural health needs and in
 
 9 accordance with federal requirements."
 
10      SECTION 3.  In recognition of article VIII, section 2 of the
 
11 state constitution, each county is requested to establish a
 
12 position for a rural transportation coordinator, to assist in the
 
13 identification, establishment, funding, and coordination of
 
14 affordable and convenient public rural transportation services,
 
15 particularly for the county of Hawaii to allow residents to
 
16 access health care in the Ka`u district, island of Hawaii.  The
 
17 coordinator would develop a plan, with the assistance of the
 
18 state department of health, county public transportation
 
19 agencies, and private nonprofit agencies providing transportation
 
20 services to the elderly and disabled, to establish a public rural
 
21 transportation system for the Ka`u district, particularly to
 
22 provide affordable and convenient access to health care services,
 
23 including primary providers, emergency facilities, and hospitals.
 

 
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                                     S.B. NO.           S.D. 1
                                                        
                                                        

 
 1 The legislature finds this request is not a mandated program
 
 2 under Article VIII, section 4, of the state constitution.  
 
 3      SECTION 4.  New statutory material is underscored.
 
 4      SECTION 5.  This Act shall take effect upon its approval.