RESOLUTION

WHEREAS, the State is committed to ensuring that all residents have access to affordable, quality health care; and

WHEREAS, nationally, there is a shortage of physicians who are willing to practice in specialty fields such as orthopedics, neurosurgery, and child psychiatry, to name a few; and

WHEREAS, Hawaii residents seeking access to specialty care often include our most vulnerable populations, such as our kupuna, persons with disabilities, and children with special health care needs; and

WHEREAS, in this State, thousands of people experience restricted access to specialists because of the limited number of practitioners who are willing to participate in Medicaid or QUEST or to serve the uninsured population; and

WHEREAS, access is further limited by the fact that specialists tend to practice in urban or suburban areas, primarily on Oahu, thereby creating a barrier to care for residents living in rural Oahu and on the neighbor islands; and

WHEREAS, neighbor island residents who need specialty care must often travel to Oahu for services thereby creating a financial burden as many health insurance plans exclude airfare, ground transportation, lodging, and meals from covered benefits; and

WHEREAS, neighbor island residents may also incur lost wages due to the time it takes to travel inter-island, as well as the unreimbursed travel cost for a caregiver, companion, or parent to accompany the patient; and

WHEREAS, Hawaii's designation as a federal health professionals shortage area does not address access to specialty care; and

WHEREAS, previous attempts at physician recruitment and retention have proven to be inadequate and at times unsuccessful; and

WHEREAS, on-call coverage requirements for specialty care physicians are often excessive in frequency, and largely uncompensated; and

WHEREAS, geographic remoteness hinders opportunities for appropriate continuing education, inter-disciplinary collaboration, and disciplinary professional interaction for some specialty providers; and

WHEREAS, the patient volume in these areas may not be enough to sustain a specialty care practice, or the activity at an inadequate level for providers to be able to maintain professional competency requirements or retain professional privileges; and

WHEREAS, there is a perception that cultural, economic, social, educational, recreational and financial opportunities on the neighbor islands differ from Oahu; and

WHEREAS, Hawaii residents, especially those living on neighbor islands, would benefit by having their complex medical needs, including access to specialty care, met in a community-based setting; now, therefore,

BE IT RESOLVED by the Senate of the Twenty-third Legislature of the State of Hawaii, Regular Session of 2005, the House of Representatives concurring, that the Department of Health, State Health Planning and Development Agency (SHPDA) is requested to identify and evaluate the barriers to community-based access to specialty care and make recommendations to improve access to specialty care on the neighbor islands and in rural Oahu; and

BE IT FURTHER RESOLVED that SHPDA is requested to consult with:

BE IT FURTHER RESOLVED that SHPDA is requested to solicit input from rural and neighbor island communities and health care providers; and

BE IT FURTHER RESOLVED that SHPDA is requested to submit an interim report of its findings and recommendations to the Legislature no later than twenty days prior to the convening of the Regular Session of 2006 and a final report no later than twenty days prior to the convening of the Regular Session of 2007; and

BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Director of Health, the Director of Human Services, the Insurance Commissioner, the Chair of the State Council on Developmental Disabilities, the President and Chief Executive Officer of Hawaii Health Systems Corporation, the Dean of the John A. Burns School of Medicine, Office of Rural Health, Aloha Care, Hawaii Medical Service Association, Kaiser Permanente, Hawaii Primary Care Association, Healthcare Association of Hawaii, Hawaii Psychological Association, Hawaii Psychiatric Medical Association, and Hawaii Disability Rights Center.

Report Title:

Health; Access to affordable, quality health care.