STAND. COM. REP. NO. 1162

                                   Honolulu, Hawaii
                                                     , 1999

                                   RE:  H.B. No. 1641
                                        H.D. 1
                                        S.D. 1



Honorable Norman Mizuguchi
President of the Senate
Twentieth State Legislature
Regular Session of 1999
State of Hawaii

Sir:

     Your Committee on Health and Human Services, to which was
referred H.B. No. 1641, H.D. 1, entitled: 

     "A BILL FOR AN ACT RELATING TO THE MEDICALLY UNDERSERVED,"

begs leave to report as follows:

     The purpose of this measure is to maximize the availability
of combined state and federal resources to ensure the viability
and sustainability of the nonprofit community-based system of
care for the uninsured and persons covered by QUEST.

     This measure provides that:

     (1)  Whenever the Department of Human Services (DHS)
          contracts with a federally qualified health center or
          rural health center for the provision of QUEST services
          to enrollees, payment by the DHS to the health center
          shall be comparable to and no less than the amount paid
          by the DHS to its other providers in the same
          geographic area for comparable services;

     (2)  At least quarterly, the DHS shall pay health centers
          under contract the difference between the payment
          received by the health center and the reasonable cost
          of the health center in providing services to QUEST
          enrollees; 

     (3)  The DHS be required to provide financial resources to
          nonprofit, community-based providers to care for the

 
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                                   STAND. COM. REP. NO. 1162
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          uninsured, including community health centers, school-
          based clinics, and Care-A-Van for the homeless; and

     (4)  $1 be appropriated to support health care for medically
          underserved populations.

     Your Committee received testimony in support of this bill
from the Department of Health, Office of Hawaiian Affairs, Papa
Ola Lokahi, Waianae Coast Comprehensive Health Center, and Health
Care for the Homeless Project.  The DHS provided informational
testimony.

     Your Committee finds that this bill would alleviate the
shortage of medical services to certain gap group populations in
the areas of primary and preventive health care, thereby reducing
publicly supported costs for hospital and emergency room use for
preventable conditions.  The gap group is the medically
uninsured, which is estimated to be 105,600 individuals.  The gap
group is served by community-based providers such as health care
centers whose financial viability in these hard economic times is
of major concern to the State.

     Upon further consideration, your Committee has amended this
measure by deleting its contents and inserting S.B. No. 395,
S.D. 1, to make an unspecified appropriation to support primary
health care for medically underserved and uninsured populations.
Your Committee believes that the priority at the present is for
an appropriation.

     As affirmed by the record of votes of the members of your
Committee on Health and Human Services that is attached to this
report, your Committee is in accord with the intent and purpose
of H.B. No. 1641, H.D. 1, as amended herein, and recommends that
it pass Second Reading in the form attached hereto as H.B.
No. 1641, H.D. 1, S.D. 1, and be referred to the Committee on
Ways and Means.

     
                                   Respectfully submitted on
                                   behalf of the members of the
                                   Committee on Health and Human
                                   Services,



                                   ______________________________
                                   SUZANNE CHUN OAKLAND, Chair


 
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