STAND. COM. REP. NO. 475

Honolulu, Hawaii

RE: S.B. No. 1404

S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Thirtieth State Legislature

Regular Session of 2019

State of Hawaii

Sir:

Your Committees on Commerce, Consumer Protection, and Health and Higher Education, to which was referred S.B. No. 1404 entitled:

"A BILL FOR AN ACT RELATING TO LOAN REPAYMENT FOR HEALTH CARE PROFESSIONALS,"

beg leave to report as follows:

The purpose and intent of this measure is to appropriate funds to the Department of Health in coordination with the John A. Burns School of Medicine of the University of Hawaii at Manoa for the health care provider loan repayment program, provided that the funds are matched on a dollar-for-dollar basis by a private or another public source.

Your Committees received testimony in support of this measure from the Department of Health, University of Hawai‘i System, Hawai‘i State Center for Nursing, East Hawaii Region of Hawaii Health Systems Corporation, Hilo Medical Center Foundation, Lanai Community Health Center, Office of the Mayor for the County of Hawai‘i, Hawaii Medical Association, Hawaii Medical Service Association, Healthcare Association of Hawaii, Hawai‘i Pacific Health, The Queen's Health Systems, Hawai‘i Primary Care Association, Hawaii State Rural Health Association, Rural Health Interest Group at the John A. Burns School of Medicine, and twenty-seven individuals.

Your Committees find that Hawaii is experiencing a shortage of approximately eight hundred doctors, and almost all other types of primary care and behavioral health care workers. This shortage is most acute for those on neighbor islands and in rural areas. Your Committees further find that one of the fastest and least expensive methods for recruiting health care providers is through a loan repayment program. The Hawaii state loan repayment program administered through the John A. Burns School of Medicine, has helped forty-three health care providers since its inception in 2012. Of the program graduates, almost two-thirds are still practicing in underserved areas of the State.

Your Committees also find that the average student loan indebtedness for John A. Burns School of Medicine residents and fellows exceeds $235,000. These residents and fellows begin repayment on their loans while in residency training and this, together with the high cost of living and other expenses in the State, results in few physicians choosing primary care specialties or practicing in underserved or rural communities in Hawaii. This measure continues the health care provider loan repayment program benefits in exchange for the commitment to serve in rural, neighbor island populations, which will help reduce the health care provider shortages in those areas.

Your Committees have amended this measure by:

(1) Expanding the eligible health care professionals under the health care provider loan repayment program to include advanced practice registered nurses, registered nurses, and licensed social workers; and

(2) Making technical, nonsubstantive amendments for the purposes of clarity and consistency.

As affirmed by the records of votes of the members of your Committees on Commerce, Consumer Protection, and Health and Higher Education that are attached to this report, your Committees are in accord with the intent and purpose of S.B. No. 1404, as amended herein, and recommend that it pass Second Reading in the form attached hereto as S.B. No. 1404, S.D. 1, and be referred to your Committee on Ways and Means.

Respectfully submitted on behalf of the members of the Committees on Commerce, Consumer Protection, and Health and Higher Education,

________________________________ DONNA MERCADO KIM, Chair

________________________________ ROSALYN H. BAKER, Chair