STAND. COM. REP. NO. 2071

                                   Honolulu, Hawaii
                                                     , 2000

                                   RE:  S.B. No. 2488
                                        




Honorable Norman Mizuguchi
President of the Senate
Twentieth State Legislature
Regular Session of 2000
State of Hawaii

Sir:

     Your Committee on Health and Human Services, to which was
referred S.B. No. 2488 entitled: 

     "A BILL FOR AN ACT MAKING AN APPROPRIATION FOR THE HANA
     COMMUNITY HEALTH CENTER,"

begs leave to report as follows:

     The purpose of this measure is to make an appropriation for
the Hana Community Health Center.

     Your Committee received testimony in support of this measure
from the Department of Health, Office of Hawaiian Affairs, three
council members of the Maui County Council, Hana Community Health
Center, and a private individual.  Testimony in opposition was
received from the United Public Workers.

     The State transferred the Hana Medical Center to the Hana
Community Health Center in July, 1997, with a guarantee to
continue providing needed financial support for the Center's
essential medical programs.  Hana is one of the most isolated
areas in the State.  During the rainy season from October to
March, the frequent storms often wash out the roadways and
disrupt electricity and telephone service.  Hana town is fifty-
seven miles from Wailuku and the trip takes two hours along a
single lane road with six hundred seventeen turns and fifty-six
one-lane bridges.  The district is made up of small, isolated
settlements scattered over more than two hundred square miles.
Many of the villages are located a minimum of forty-five minutes
from the main town of Hana.

 
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     The Hana Community Health Center provides a hybrid of
medical services, including emergency services.  The Center is
the only health care provider in the district.  The coordination
of emergency services and provision of life support care is
absolutely essential to the three thousand residents of Hana and
the 500,000 tourists who visit annually.

     Hana also has the dubious distinction of consistently having
some of the worst health and socio-economic indicators in the
State.  Native Hawaiians account for sixty-five per cent of all
the Center's patients.  Hana is federally designated both as a
medically underserved population and as a health professional
shortage area.

     When the Hana Community Health Center was operating as the
Hana Medical Center as part of the State's community hospitals
system, it required a subsidy of approximately $1,500,000
annually.  Since the Center's transfer to the Hawaii Health
Systems Corporation in 1996, the Legislature has reduced
appropriations each year to the Center.  The appropriation for
fiscal year 1999-2000 of $750,000, was at least fifty per cent
less than the cost of operations before the transfer to the Hana
Community Health Center, or $617,300 less than what it cost the
State to operate.

     Your Committee finds that the Hana Community Health Center
requires a minimum of $952,000 in fiscal year 2000-2001 to
maintain its current level of operations.

     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 S.B. No. 2488 and recommends that it pass Second Reading 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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