Honorable Robert Bunda

President of the Senate

Twenty-First State Legislature

Regular Session of 2001

State of Hawaii

Sir:

Your Committee on Health and Human Services, to which was referred H.B. No. 1234, H.D. 1, entitled:

begs leave to report as follows:

The purpose of this measure is to appropriate funds to provide enabling services under QUEST.

Your Committee heard testimony in support of the measure from the Hawaii Primary Care Association, Aloha Care, and the Waianae Comprehensive Health Center. Your Committee heard testimony in opposition to the measure from the Department of Human Services and Hawaii Medical Service Association.

Your Committee finds that one of the unfortunate realities of managed care is that patients with the greatest health care needs may be an anathema to plans and providers. This is because, in the managed care model, plans and providers are paid a set amount regardless of whether an assigned patient needs frequent and expensive care or never uses his or her benefits at all. Community health centers, by mission, location, and history tend to serve people with the greatest health problems, complicated by socio-economic issues.

Your Committee further finds that health centers reach out to find patients who need help, unlike other private practitioners. The centers have designed their programs to meet the special needs of the Native Hawaiians, immigrants, homeless, and other special populations in their communities. Naturally health centers and the health care plans with which they contract, are financially disadvantaged by the health center model. This measure will help overcome much of the inequity inherent in the unadjusted managed care system.

Your Committee has amended the measure by making technical, nonsubstantive amendments to comport with preferred drafting style and by changing the effective date to July 1, 2003.

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. 1234, H.D. 1, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 1234, H.D. 1, S.D. 1, and be referred to the Committee on Ways and Means.