SB2624

SECTION 1. The legislature finds that many Hawaii residents are unable to obtain timely and appropriate healthcare and behavioral healthcare due to shortages of primary, specialty, and behavioral care providers. Vulnerable residents, including the elderly, and rural residents experience even greater barriers to provider access. These barriers include issues relating to fixed or limited financial resources, lack of physical mobility or other disabilities, cognitive impairment, transportation, and a lack of readily accessible physicians and other healthcare providers.

Telehealth is a viable solution to maximize existing local resources and increase patient convenience and compliance. However, the best available data indicates that the use of telehealth is limited in the State. No more than fifteen per cent of practicing providers in the State report a telehealth experience, even though the State has among the most progressive telehealth laws in the nation.

Preliminary findings from the 2017 State Telehealth Summit confirm that provider comfort and patient expectations are the most significant barriers to greater telehealth adoption. Department of health research, including direct observation of strong telehealth programs in other jurisdictions, reveals that staff support is needed to ensure that both the patient and technology are situated correctly for a telehealth encounter. Ideally, staff support should be situated at both the provider's and the patient's location. Support staff for the patient, however, is critical when the patient is in a non-traditional healthcare setting, including a home, community center, or school.

The legislature believes that establishing a telehealth pilot project will expose the State's healthcare providers and patients to the benefits of telehealth, increase provider adoption of telehealth, support healthcare workforce development related to telehealth, and evaluate the clinical and administrative efficacy of various telehealth delivery models. The legislature also believes that establishing a rural healthcare pilot project to pay an availability fee to eligible providers servicing rural areas will help to encourage providers to prioritize these rural areas. In turn, an increase in provider prioritization of these rural areas will increase rural residents' access to previously less than accessible medical specialties.

Accordingly, the purpose of this Act is to establish and fund telehealth and rural healthcare pilot projects.

SECTION 2. (a) The department of health shall implement a telehealth pilot project.

(b) The telehealth pilot project shall:

(1) Assist residents at two distinct project sites, both of which shall have a medically underserved area designation by the United States Department of Health and Human Services; provided that one site shall be located in a rural county and the other site shall be located in an urban county;

(2) Utilize telehealth as the primary means to deliver healthcare; and

(3) Include at least one federally qualified health center or rural health clinic in each project site.

(c) Within six months of the exhaustion of all telehealth pilot project funds, the department of health shall make available to the public an evaluation report on telehealth pilot project outcomes, including the quality of care, patient satisfaction, training and workforce development issues, and financial sustainability of telehealth activities.

(d) Chapters 103D and 103F, Hawaii Revised Statutes, shall not apply to procurements made pursuant to this Act for a period of twelve months following the effective date of this Act; provided that the department of health shall only obtain goods and services for the telehealth pilot project:

(1) In a manner that is cost-effective and provides the most benefit to the telehealth pilot program on contractual terms that are most advantageous to the State; and

(2) If the execution period of all procurements does not exceed the term of the telehealth pilot project.

SECTION 3. (a) The department of health shall implement and administer a rural healthcare pilot project.

(b) The rural healthcare pilot project shall:

(1) Assist residents in three distinct rural areas, one each on the islands of Maui, Molokai, and Lanai; provided that the area selected on the island of Maui shall be in the Hana district;

(2) Pay a $250 availability fee to each licensed physician providing healthcare services in one or more of the areas selected pursuant to subsection (1); provided that each physician shall practice in a medical specialty that is difficult for rural residents to access, including but not limited to cardiology, gastroenterology, endocrinology, dermatology, and nephrology; provided further that the availability fee shall be separate from, and in addition to, any charges billed by the physician; and

(3) Reimburse each eligible physician for any costs that the physician deems necessary to provide in-person healthcare services to patients in the areas selected pursuant to subsection (1), including airfare and lodging costs and a per diem.

(c) The department of health may contract with eligible physicians and hospitals, including but not limited to those within the Hawaii Pacific Health, Queen's Health Systems, and Kaiser Permanente networks, to carry out the rural healthcare pilot project.

SECTION 4. 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 2022-2023 for the telehealth and rural healthcare pilot projects established pursuant to this Act.

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

SECTION 5. This Act shall take effect on July 1, 2022.

INTRODUCED BY:	_____________________________

THE SENATE	S.B. NO.	2624
THIRTY-FIRST LEGISLATURE, 2022
STATE OF HAWAII