WHEREAS, wait listed patients in Hawaii needing long term care will stay and receive treatment at hospitals until a bed is available for them at a skilled nursing facility; and

WHEREAS, according to Hawaii Pacific Health, approximately one fourth of their wait listed long term care patients are from Oahu, another fourth are from the Pacific Islands, and up to one half are neighbor island patients who are transferred to one of Hawaii Pacific Health's hospitals on Oahu or Kauai for care; and

WHEREAS, long term care patients can spend several months occupying an acute care bed at a hospital while waiting for an available bed at a skilled nursing facility; and

WHEREAS, in the meantime, these hospitals bear the additional costs for caring for them, and hospitals are forced to offer their already scarce acute care beds while patients wait for an available space at a skilled nursing facility; and

WHEREAS, most skilled nursing facilities are unable to accommodate patients who are on dialysis, have a tracheotomy, or have mental health issues; thus, these patients are unable to be discharged from the hospital and must stay for an extended period of time; and

WHEREAS, skilled nursing facilities on the neighbor islands are frequently at maximum capacity, which makes it difficult for patients receiving care on Oahu to transfer back to their home island for long term care; and

WHEREAS, the lack of beds available at skilled nursing facilities in Hawaii has caused patients, particularly those with mental health issues, to transfer to mainland facilities, which takes these patients away from their families and a familiar environment; and

WHEREAS, moreover, hospitals are forced to incur the expenses for transferring a long term care patient to the mainland, including travel expenses, nurse care costs, and any additional fees to assist a patient's family member with making the necessary guardianship arrangements for the transfer; and

WHEREAS, skilled nursing facilities will not accept patients until they have a source of payment; thus, hospitals must also bear their patients' health care costs while their applications for Medicaid or QUEST is being considered; and

WHEREAS, hospitals do not receive a full or sometimes any reimbursement from commercial payers for the patient's wait listed days that are spent in the hospital, which creates a growing unsustainable financial burden on acute care hospitals throughout the State; now, therefore,

BE IT RESOLVED by the Senate of the Twenty-third Legislature of the State of Hawaii, Regular Session of 2006, that the Legislative Reference Bureau conduct a study investigating the issues hospitals face with regard to wait listed patients using acute care beds who are there solely because they are in need of long term medical care; and

BE IT FURTHER RESOLVED that the Legislative Reference Bureau is requested to report findings and recommendations to the Legislature at least twenty days before the convening of the Regular Session of 2007; and

BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Acting Director of the Legislative Research Bureau, the Director of Health, the Chief Executive Officer of Hawaii Pacific Health, the Chief Executive Officer of the Queen's Medical Center, the Chief Executive Officer of Kaiser Permanente Hawaii, the Chief Executive Officer of Healthcare Association of Hawaii, the Chief Executive Officer of Hawaii Health Systems Corporation, and the Director of the Hawaii Long Term Care Association.

Report Title:

Wait Listed Long Term Care Patients