HB3413 HD1

SECTION 1. The legislature finds that Act 263, Session Laws of Hawaii 1996, authorized the transfer of the Hana Medical Center to Hana Health (formerly known as Hana Community Health Center) in 1997, with a guarantee to continue providing needed financial support for its essential medical programs. The Hana community would not have accepted this transfer without the commitment to ensure the center's continued viability.

The legislature further finds that Hana, Maui 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 services. Hana town is fifty-seven miles from Wailuku. The trip takes approximately 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 two hundred thirty-three square miles. Many of the villages are located a minimum of forty-five minutes from the main town of Hana. A number of homes in the district do not have basic infrastructure such as electricity, telephones, or running water.

Hana Health provides a hybrid of services due to Hana's relative isolation. Unlike most primary care clinics, Hana Health must also coordinate activities with the ambulance service and provide assistance in stabilizing patients with life threatening illness or traumatic injury. These services are required twenty-four hours a day because the center is the only full service health care provider in the district. The coordination of emergency services and provision of life support care is absolutely essential to the residents of Hana and the six hundred thousand tourists who visit annually.

Built in 1965, the current medical center is more than forty years old and its programs have outgrown the four thousand square foot facility. Six trailers have been leased and located on the grounds to house behavioral/mental health and wellness programs, acupuncture, lomilomi services, administrative offices, and farm support. Programs are often conducted in tents outside the trailers and toilet facilities are inadequate. Board and staff meetings are held in a tent because there are no conference rooms. A rapidly deteriorating seventy-five-year-old house is being used to house the nutrition center, administrative office, and staff residence. A second house is occupied by paramedics who provide urgent care and transportation in partnership with Hana Health. Plumbing requires constant repair, existing cesspools need to be replaced with septic tanks, electricity is inadequate, and there is no staff lunch room or space for storage. Currently, there is no senior housing in the Hana district although many of Hana's seniors live in geographic and social isolation.

When Hana Health operated as the Hana Medical Center as part of the State's community hospitals system, it required a subsidy of approximately $1,500,000 annually, not including the administrative functions provided by the Maui Memorial Hospital. Immediately upon transfer to the private, not-for-profit Hana Health in 1997-1998, the legislature reduced its appropriation for the center's operation to $1,064,000. This was a thirty per cent reduction in funding in Hana Health's first year of operation. In fiscal year 1998-1999, the legislature appropriated $800,000 for the operation of the center. This was $264,000 less than the amount appropriated the year before, or a second reduction of twenty-five per cent in the center's second year of operation. In the following two years, the legislature appropriated $750,000 for operations, a further reduction of six per cent during the center's third year of operation. In fiscal year 2003-2004, the legislature reduced the appropriation to $700,000, but increased it back to $750,000 for fiscal year 2004-2005. Finally, in fiscal years 2005-2006 and 2006-2007, the legislature increased the appropriation to $1,000,000. This is still thirty per cent less than the $1,500,000 provided to the original Hana Medical Center, and does not account for cost-of-living increases that have taken place over the past nine years.

Hana Health has demonstrated its commitment to the people of the Hana district and its ability to generate funds from a variety of funding sources to start up new and innovative programs. Despite this, Hana Health will always need state support to fund core medical services. This is a fact that has been recognized by the administration and the legislature prior to privatization.

The purpose of this Act is to appropriate funds to Hana Health to allow it to continue its current level of operations and to further develop its capacity to meet the ongoing needs of this isolated community.

SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2008-2009 for the following at Hana Health:

(1) Commercial kitchen construction/ equipment installation $

(2) Independent senior housing design and construction, including home-based dialysis, adult day care, and respite services $

(3) Medical facility upgrade/expansion design documents $

The sum appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 3. This Act shall take effect on July 1, 2008.

HOUSE OF REPRESENTATIVES	H.B. NO.	3413
TWENTY-FOURTH LEGISLATURE, 2008		H.D. 1
STATE OF HAWAII