HR49 HD1

WHEREAS, many patients in acute care hospitals whose conditions have improved so that they may be transferred to long-term care will stay and receive treatment at hospitals because beds are not available for them at skilled nursing facilities; and

WHEREAS, according to Hawaii Pacific Health, for example, approximately one fourth of their waitlisted long-term care patients are from Oahu, another one 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, patients who should be receiving long term-care 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 these patients, 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, therefore, 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, 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 and hospitals must also bear their patients’ health-care costs while their applications for Medicaid or QUEST are being considered; and

WHEREAS, hospitals may receive only a partial payment, or sometimes no payment at all, from commercial payers for the patient’s waitlisted days that are spent in the hospital, creating a growing unsustainable financial burden on acute care hospitals throughout the state; now, therefore,

BE IT RESOLVED by the House of Representatives of the Twenty-fourth Legislature of the State of Hawaii, Regular Session of 2007, that the Healthcare Association of Hawaii (HAH) is requested to conduct a study of patients in acute care hospitals who are waitlisted for long-term care, and to propose solutions to the problem; and

BE IT FURTHER RESOLVED that the Department of Human Services and the Department of Health cooperate with HAH in the study; and

BE IT FURTHER RESOLVED that HAH is requested to submit a report of findings and recommendations to the Legislature no later than 20 days prior to the convening of the Regular Session of 2008; and

BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Director of Health, Director of Human Services, Chief Executive Officer of HAH, Chief Executive Officer of Hawaii Health Systems Corporation, Chief Executive Officer of Hawaii Pacific Health, Chief Executive Officer of the Queen’s Medical Center, Chief Executive Officer of Kaiser Permanente Hawaii, Director of the Hawaii Long Term Care Association, and President of the Hawaii Disability Rights Center.

Report Title:

REQUESTING THE HEALTHCARE ASSOCIATION OF HAWAII TO EXAMINE THE PROBLEM OF PATIENTS IN ACUTE CARE HOSPITALS WAITLISTED FOR LONG TERM CARE AND TO PROPOSE SOLUTIONS.

HOUSE OF REPRESENTATIVES	H.R. NO.	49
TWENTY-FOURTH LEGISLATURE, 2007		H.D. 1
STATE OF HAWAII