REPORT TITLE: 
SHPDA repeal
DESCRIPTION:
Repeals the state health planning and development agency.
Transfers the administrator and 1 clerical position to the office
of planning.

 
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HOUSE OF REPRESENTATIVES                H.B. NO.928        
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                     A BILL FOR AN ACT

RELATING TO THE REPEAL OF THE STATE HEALTH PLANNING AND
   DEVELOPMENT AGENCY (SHPDA).



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


 1      SECTION 1.  The legislature finds that services provided by
 
 2 the state health planning and development agency are no longer
 
 3 necessary to the public.  Several reports by the legislative
 
 4 auditor have criticized the agency's performance and questioned
 
 5 its mission.  Furthermore, individuals and organizations in both
 
 6 public and private sectors have demonstrated that current
 
 7 government controls combined with market forces in the health-
 
 8 care industry are adequate to manage or develop health-related
 
 9 services.
 
10      The purpose of this Act is to streamline government
 
11 operations by eliminating the state health planning and
 
12 development agency.  To maintain adequate oversight, two
 
13 positions will be retained from SHPDA and transferred to the
 
14 office of planning.
 
15      SECTION 2.  Chapter 323D, Hawaii Revised Statutes, is
 
16 repealed.
 
17      SECTION 3.  Section 321-225, Hawaii Revised Statutes, is
 
18 amended by amending subsection (b) to read as follows:
 
19      "(b)  The advisory committee shall be composed of [twenty]
 

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 1 nineteen members:  [three]two nonvoting ex-officio members, who
 
 2 shall be the director of transportation, the adjutant general,
 
 3 [and the administrator of the state health planning and
 
 4 development agency, or the designated representatives thereof]
 
 5 and seventeen members representing all counties of the State who
 
 6 shall be appointed by the governor subject to section 26-34 as
 
 7 follows:
 
 8      (1)  Five members who shall be physicians experienced in the
 
 9           conduct and delivery of emergency medical services;
 
10           provided that at least two shall be engaged in the
 
11           practice of emergency medicine and be board-eligible or
 
12           board-certified by the American Board of Emergency
 
13           Medicine[,]; and provided further that at least one
 
14           physician shall be engaged in the practice of
 
15           pediatrics and be board-eligible or board-certified by
 
16           the American Board of Pediatrics;
 
17      (2)  Four members who shall be consumers of health care and
 
18           who shall have no connection with or relationship to
 
19           the health care system of the State and who shall be
 
20           representative of all counties;
 
21      (3)  Four members of allied health professions related to
 
22           emergency medical services; and
 
23      (4)  Four members, one from each county, who shall be mobile
 

 
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 1           intensive care technicians or emergency medical
 
 2           technicians engaged in the practice of pre-hospital
 
 3           emergency medical service.
 
 4 The members of the advisory committee shall serve without
 
 5 compensation, but shall be reimbursed for necessary expenses
 
 6 incurred in the performance of their duties, including travel
 
 7 expenses.  The chairperson of the advisory committee shall be
 
 8 elected by the members from among their numbers.  A majority of
 
 9 the members of the advisory committee shall constitute a quorum
 
10 for the conduct of business of the advisory committee.  A
 
11 majority vote of the members present at a meeting at which a
 
12 quorum is established shall be necessary to validate any action
 
13 of the committee."
 
14      SECTION 3.  Section 325-101, Hawaii Revised Statutes, is
 
15 amended by amending subsection (a) to read as follows:
 
16      "(a)  The records of any person that indicate that a person
 
17 has a human immunodeficiency virus (HIV) infection, AIDS related
 
18 complex (ARC), or acquired immune deficiency syndrome (AIDS),
 
19 which are held or maintained by any state agency, health care
 
20 provider or facility, physician, laboratory, clinic, blood bank,
 
21 third party payor, or any other agency, individual, or
 
22 organization in the State shall be strictly confidential.  For
 
23 the purposes of this part, the term "records" shall be broadly
 

 
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 1 construed to include all communication which identifies any
 
 2 individual who has HIV infection, ARC, or AIDS.  This information
 
 3 shall not be released or made public upon subpoena or any other
 
 4 method of discovery.  Notwithstanding any other provision to the
 
 5 contrary, release of the records protected under this part shall
 
 6 be permitted under the following circumstances:
 
 7      (1)  Release is made to the department of health in order
 
 8           that it may comply with federal reporting requirements
 
 9           imposed on the State.  The department shall ensure that
 
10           personal identifying information from these records are
 
11           protected from public disclosure;
 
12      (2)  Release is made of the records, or of specific medical
 
13           or epidemiological information contained therein, with
 
14           the prior written consent of the person or persons to
 
15           whom the records pertain;
 
16      (3)  Release is made to medical personnel in a medical
 
17           emergency only to the extent necessary to protect the
 
18           health, life, or well-being of the named party;
 
19      (4)  Release is made from a physician licensed pursuant to
 
20           chapter 453 or 460 to the department of health to
 
21           inform the sexual or needle sharing contact of an HIV
 
22           seropositive patient where (A) there is reason for the
 
23           physician to believe that the contact is or has been at
 

 
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 1           risk of HIV transmission as a result of the index
 
 2           patient having engaged in conduct which is likely to
 
 3           transmit HIV, and (B) the index patient has first been
 
 4           counseled by the physician of the need for disclosure
 
 5           and the patient is unwilling to inform the contact
 
 6           directly or is unwilling to consent to the disclosure
 
 7           of the index patient's HIV status by the physician or
 
 8           the department of health; provided that the identity of
 
 9           the index patient is not disclosed; and provided
 
10           further that there is no obligation to identify or
 
11           locate any contact.  Any determination by a physician
 
12           to disclose or withhold disclosure of an index
 
13           patient's sexual contacts to the department of health
 
14           pursuant to this subsection which is made in good faith
 
15           shall not be subject to penalties under this part or
 
16           otherwise subject to civil or criminal liability for
 
17           damages under the laws of the State;
 
18      (5)  Release is made by the department of health of medical
 
19           or epidemiological information from the records to
 
20           medical personnel, appropriate county and state
 
21           agencies, blood banks, plasma centers, organ and tissue
 
22           banks, schools, preschools, day care centers, or county
 
23           or district courts to enforce this part and to enforce
 

 
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 1           rules adopted by the department of health concerning
 
 2           the control and treatment of HIV infection, ARC, and
 
 3           AIDS, or to the sexual or needle sharing contacts of an
 
 4           HIV seropositive index patient for purposes of contact
 
 5           notification as provided in paragraph (4), provided
 
 6           that the identity of the index patient, if known, shall
 
 7           not be disclosed; provided that release of information
 
 8           under this paragraph shall only be made by confidential
 
 9           communication to a designated individual charged with
 
10           compliance with this part;
 
11      (6)  Release of a child's records is made to the department
 
12           of human services for the purpose of enforcing chapters
 
13           350 and 587;
 
14      (7)  Release of a child's records is made within the
 
15           department of human services and to child protective
 
16           services team consultants under contract to the
 
17           department of human services for the purpose of
 
18           enforcing and administering chapters 350 and 587 on a
 
19           need to know basis pursuant to a written protocol to be
 
20           established and implemented, in consultation with the
 
21           director of health, by the director of human services;
 
22      (8)  Release of a child's records is made by employees of
 
23           the department of human services authorized to do so by
 

 
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 1           the protocol established in paragraph (7) in a case
 
 2           arising under chapters 350 and 587 to a natural parent
 
 3           of a child who is the subject of the case when the
 
 4           natural parent is a client in the case, the guardian ad
 
 5           litem of the child, the court, each party to the court
 
 6           proceedings, and also to an adoptive or a prospective
 
 7           adoptive parent, an individual or an agency with whom
 
 8           the child is placed for twenty-four hour residential
 
 9           care, and medical personnel responsible for the care or
 
10           treatment of the child.  When a release is made to a
 
11           natural parent of the child, it shall be with
 
12           appropriate counseling as required by section 325-16.
 
13           In no event shall proceedings be initiated against a
 
14           child's natural parents for claims of child abuse under
 
15           chapter 350 or harm to a child or to affect parental
 
16           rights under chapter 587 solely on the basis of the HIV
 
17           seropositivity of a child or the child's natural
 
18           parents;
 
19      (9)  Release is made to the patient's health care insurer to
 
20           obtain reimbursement for services rendered to the
 
21           patient; provided that release shall not be made if,
 
22           after being informed that a claim will be made to an
 
23           insurer, the patient is afforded the opportunity to
 

 
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 1           make the reimbursement directly and actually makes the
 
 2           reimbursement;
 
 3     (10)  Release is made by the patient's health care provider
 
 4           to another health care provider for the purpose of
 
 5           continued care or treatment of the patient;
 
 6     (11)  Release is made pursuant to a court order, after an in
 
 7           camera review of the records, upon a showing of good
 
 8           cause by the party seeking the release of the records;
 
 9           or
 
10     (12)  Disclosure by a physician, on a confidential basis, of
 
11           the identity of a person who is HIV seropositive and
 
12           who also shows evidence of tuberculosis infection, to a
 
13           person within the department of health as designated by
 
14           the director of health for purposes of evaluating the
 
15           need for or the monitoring of tuberculosis chemotherapy
 
16           for the person and the person's contacts who are at
 
17           risk of developing tuberculosis.
 
18 As used in this part, unless the context requires otherwise:
 
19      "Medical emergency" means any disease-related situation that
 
20 threatens life or limb.
 
21      "Medical personnel" means any health care provider in the
 
22 State[, as provided in section 323D-2,] who deals directly or
 
23 indirectly with the identified patient or the patient's contacts,
 

 
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 1 and includes hospital emergency room personnel, the staff of the
 
 2 communicable disease division of the department of health, and
 
 3 any other department personnel as designated by the director."
 
 4      SECTION 4.  Section 489-2, Hawaii Revised Statutes, is
 
 5 amended by amending the definition of "place of public
 
 6 accommodation" to read as follows:
 
 7      ""Place of public accommodation" means a business,
 
 8 accommodation, refreshment, entertainment, recreation, or
 
 9 transportation facility of any kind whose goods, services,
 
10 facilities, privileges, advantages, or accommodations are
 
11 extended, offered, sold, or otherwise made available to the
 
12 general public as customers, clients, or visitors.  By way of
 
13 example, but not of limitation, place of public accommodation
 
14 includes facilities of the following types:
 
15      (1)  A facility providing services relating to travel or
 
16           transportation;
 
17      (2)  An inn, hotel, motel, or other establishment that
 
18           provides lodging to transient guests;
 
19      (3)  A restaurant, cafeteria, lunchroom, lunch counter, soda
 
20           fountain, or other facility principally engaged in
 
21           selling food for consumption on the premises of a
 
22           retail establishment;
 
23      (4)  A shopping center or any establishment that sells goods
 

 
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 1           or services at retail;
 
 2      (5)  An establishment licensed under chapter 281 doing
 
 3           business under a class 4, 5, 7, 8, 9, 10, 11, or 12
 
 4           license, as defined in section 281-31;
 
 5      (6)  A motion picture theater, other theater, auditorium,
 
 6           convention center, lecture hall, concert hall, sports
 
 7           arena, stadium, or other place of exhibition or
 
 8           entertainment;
 
 9      (7)  A barber shop, beauty shop, bathhouse, swimming pool,
 
10           gymnasium, reducing or massage salon, or other
 
11           establishment conducted to serve the health,
 
12           appearance, or physical condition of persons;
 
13      (8)  A park, a campsite, or trailer facility, or other
 
14           recreation facility;
 
15      (9)  A comfort station; or a dispensary, clinic, hospital,
 
16           convalescent home, or other institution for the infirm;
 
17     (10)  A professional office of a health care provider[, as
 
18           defined in section 323D-2,] or other similar service
 
19           establishment;
 
20     (11)  A mortuary or undertaking establishment; and
 
21     (12)  An establishment that is physically located within the
 
22           premises of an establishment otherwise covered by this
 
23           definition, or within the premises of which is
 

 
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 1           physically located a covered establishment, and which
 
 2           holds itself out as serving patrons of the covered
 
 3           establishment.
 
 4      No place of public accommodation defined in this section
 
 5 shall be requested to reconstruct any facility or part thereof to
 
 6 comply with this chapter."
 
 7      SECTION 5.  Section 622-58, Hawaii Revised Statutes, is
 
 8 amended by amending subsection (d) to read as follows:
 
 9      "(d)  Medical records may be destroyed after the seven-year
 
10 retention period or after minification, in a manner that will
 
11 preserve the confidentiality of the information in the record;
 
12 provided that the health care provider retains basic information
 
13 from each record destroyed.  Basic information from the records
 
14 of a physician or surgeon shall include the patient's name and
 
15 birthdate, a list of dated diagnoses and intrusive treatments,
 
16 and a record of all drugs prescribed or given.  Basic information
 
17 from the records of a health care facility[, as defined in
 
18 section 323D-2,] shall include the patient's name and birthdate,
 
19 dates of admission and discharge, names of attending physicians,
 
20 final diagnosis, major procedures performed, operative reports,
 
21 pathology reports, and discharge summaries."
 
22      SECTION 6.  Section 671-1, Hawaii Revised Statutes, is
 
23 amended to read as follows:
 
24      "§671-1 Definitions.  As used in this chapter:
 

 
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 1      [(1)] "Health care provider" means a physician or surgeon
 
 2 licensed under chapter 453, a physician and surgeon licensed
 
 3 under chapter 460, a podiatrist licensed under chapter 463E, a
 
 4 health care facility [as defined in section 323D-2], and the
 
 5 employees of any of them.  Health care provider shall not mean
 
 6 any nursing institution or nursing service conducted by and for
 
 7 those who rely upon treatment by spiritual means through prayer
 
 8 alone, or employees of [such] the institution or service.
 
 9      [(2)] "Medical tort" means professional negligence, the
 
10 rendering of professional service without informed consent, or an
 
11 error or omission in professional practice, by a health care
 
12 provider, which proximately causes death, injury, or other damage
 
13 to a patient."
 
14      SECTION 7.  Section 671-5, Hawaii Revised Statutes, is
 
15 amended by amending subsection (c) to read as follows:
 
16      "(c)  A failure on the part of any self-insured health care
 
17 provider to report as requested by this section shall be grounds
 
18 for disciplinary action by the board of medical examiners[,] or
 
19 board of osteopathic examiners[, or the state health planning
 
20 agency], as applicable.  A violation by an insurer shall be
 
21 grounds for suspension of its certificate of authority."
 
22      SECTION 8.  Positions that are transferred to the office of
 
23 planning.  (a)  The position of the administrator of the state
 

 
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 1 health planning and development agency and one clerical position
 
 2 in the agency shall be transferred to the office of planning
 
 3 under chapter 225M, Hawaii Revised Statutes.
 
 4      (b)  The one officer and one employee whose functions are
 
 5 transferred by this Act shall be transferred with their functions
 
 6 and shall continue to perform their regular duties upon their
 
 7 transfer, subject to the state personnel laws and this Act.
 
 8      The one officer and one employee of the State who are
 
 9 transferred having tenure shall not suffer any loss of salary,
 
10 seniority, prior service credit, vacation, sick leave, or other
 
11 employee benefit or privilege as a consequence of this Act, and
 
12 the officer or employee may be transferred or appointed to a
 
13 civil service position without the necessity of examination;
 
14 provided that the officer or employee possesses the minimum
 
15 qualifications for the position to which transferred or
 
16 appointed; and provided that subsequent changes in status may be
 
17 made pursuant to applicable civil service and compensation laws.
 
18      The one officer and one employee of the State who are
 
19 transferred who do not have tenure and who may be transferred or
 
20 appointed to a civil service position as a consequence of this
 
21 Act shall become a civil service employee without the loss of
 
22 salary, seniority, prior service credit, vacation, sick leave, or
 
23 other employee benefits or privileges and without the necessity
 

 
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 1 of examination; provided that the officer or employee possesses
 
 2 the minimum qualifications for the position to which transferred
 
 3 or appointed.
 
 4      The one officer and one employee who are transferred to the
 
 5 office of planning shall not be separated from public employment,
 
 6 but shall remain in the employment of the State with the same pay
 
 7 and classification.
 
 8      SECTION 9.  Positions that are not transferred to the office
 
 9 of planning.  (a)  No other officers and employees of the state
 
10 health planning and development agency, except those specified in
 
11 section 8, shall be transferred to the office of planning.
 
12      (b)  All officers and employees who are not transferred and
 
13 having tenure shall not suffer any loss of salary, seniority,
 
14 prior service credit, vacation, sick leave, or other employee
 
15 benefit or privilege as a consequence of this Act.  An officer or
 
16 employee of the State who is not transferred and having tenure,
 
17 at the request of the officer or employee, may be transferred or
 
18 appointed to a different civil service position without the
 
19 necessity of examination; provided that the officer or employee
 
20 possesses the minimum qualifications for the position to which
 
21 the officer or employee requests a transfer or appointment; and
 
22 provided that subsequent changes in status may be made pursuant
 
23 to applicable civil service and compensation laws.
 

 
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 1      An officer or employee of the State who is not transferred
 
 2 who does not have tenure and who, at the request of the officer
 
 3 or employee, may be transferred or appointed to a different civil
 
 4 service position as a consequence of this Act, shall become a
 
 5 civil service employee without the loss of salary, seniority,
 
 6 prior service credit, vacation, sick leave, or other employee
 
 7 benefits or privileges and without the necessity of examination;
 
 8 provided that the officer or employee possesses the minimum
 
 9 qualifications for the position to which the officer or employee
 
10 requests a transfer or appointment.
 
11      SECTION 10.  It is the intent of this Act not to jeopardize
 
12 the receipt of any federal aid nor to impair the obligation of
 
13 the State or any agency thereof to the holders of any bond issued
 
14 by the State or by any such agency, and to the extent, and only
 
15 to the extent, necessary to effectuate this intent, the governor
 
16 may modify the strict provisions of this Act, but shall promptly
 
17 report any such modification with reasons therefor to the
 
18 legislature at its next session thereafter for review by the
 
19 legislature.
 
20      SECTION 11.  This Act shall take effect upon its approval.
 
21 
 
22 
 
23                         INTRODUCED BY:___________________________
 

 
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