HB2544

SECTION 1. The legislature finds that between 2020 and 2021, Molokai and Lanai lost access to two air carriers, leaving both islands with a single air carrier available to the public for departures from each island. Since then, residents have been plagued with inconsistent and undependable air transportation services, including frequent and last-minute flight changes, cancellations, and lengthy delays. As rural communities, residents of Molokai and Lanai are medically underserved, which means that residents are routinely referred to providers on Maui or Oahu for medical care. Delays, cancellations, and flight changes may cause residents traveling for medical treatment to miss important and potentially life‑saving treatments, including surgeries and chemotherapy treatments that were scheduled months earlier and may take weeks to months to reschedule.

The purpose of this Act is to establish a pilot project to make chartered plane seats available to patients, medical insurers, and medical service providers to consistently and dependably transport residents of certain medically underserved rural communities.

SECTION 2. (a) There is established within the department of health the essential rural medical air transport pilot project.

(b) The purpose of the pilot project shall be to provide residents in rural islands with increased access to medical care.

(1) Allow insurance companies to reserve and pay for seats on those flights for:

(A) Insured individuals residing on a rural island to be transported to and from an urban island for medical and healthcare services, including appointments with medical providers; and

(B) The companions of insured individuals to accompany the insured individuals;

(2) Allow companions of insured individuals to reserve and pay for seats on those flights to accompany the insured individuals; and

(3) Allow medical providers to reserve and pay for seats on those flights for transportation to and from an urban island to a rural island for the purpose of providing medical services for residents of the rural island.

(d) The pilot project shall seek reimbursement or payment from insurers and medical providers to the maximum extent possible.

(e) Subject to available funds and demand, the pilot project shall attempt to offer at least twelve roundtrip flights per week.

(f) The department of health shall consult with appointment schedulers, patient navigators, provider staff, and insurers to coordinate patient appointment times with flight times.

(g) The department of health may contract with a private entity to administer the pilot project.

(h) There is established the essential rural medical air transport revolving fund into which shall be deposited:

(1) Appropriations by the legislature;

(2) Payments received from insurers, medical providers, and individuals; and

(3) Any other moneys received by the pilot project.

(i) The department of health shall submit a report to the legislature no later than twenty days prior to the convening of the regular session of 2026. The report shall contain:

(1) The expenses and revenues of the pilot project;

(2) The number of seats sold to:

(A) Insured individuals seeking transportation to obtain medical services;

(B) Companions of insured persons;

(D) Other residents of a rural island,

who used the pilot project;

(3) Any other relevant findings; and

(4) Recommendations about whether the pilot project should be extended, amended, made permanent, or terminated, and any proposed legislation.

(j) For the purpose of this Act:

"Rural island" means an island within the State that has a population of more than one thousand, but less than ten thousand.

"Urban island" means an island within the State that:

(1) Has a population of more than nine hundred thousand; or

(2) Has a population of more than one hundred thousand but less than one hundred eighty thousand.

SECTION 3. This Act shall not be construed to limit or prevent any individual from obtaining transportation to another location for medical treatment or to reduce or limit any insurance reimbursement or coverage for those transportation costs.

SECTION 4. In accordance with section 9 of article VII, of the Constitution of the State of Hawaii and sections 37-91 and 37-93, Hawaii Revised Statutes, the legislature has determined that the appropriation contained in this Act will cause the state general fund expenditure ceiling for fiscal year 2024-2025 to be exceeded by $ , or per cent. The reasons for exceeding the general fund expenditure ceiling are that the appropriation made in this Act is necessary to serve the public interest and to meet the needs provided for by this Act.

SECTION 5. There is appropriated out of the general revenues of the State of Hawaii the sum of $2,000,000 or so much thereof as may be necessary for fiscal year 2024-2025 to be deposited into the essential rural medical air transport revolving fund.

SECTION 6. There is appropriated out of the essential rural medical air transport revolving fund the sum of $2,000,000 or so much thereof as may be necessary for fiscal year 2024-2025 for necessary positions and the other expenses of the essential rural medical air transport pilot project.

The sum appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 7. This Act shall take effect on July 1, 2024; provided that this Act shall be repealed on June 30, 2026, and any unencumbered balance in the essential rural medical air transport revolving fund on that date shall lapse to the credit of the general fund.

INTRODUCED BY:	_____________________________

HOUSE OF REPRESENTATIVES	H.B. NO.	2544
THIRTY-SECOND LEGISLATURE, 2024
STATE OF HAWAII