SB2657

THE SENATE	S.B. NO.	2657
THIRTY-FIRST LEGISLATURE, 2022
STATE OF HAWAII

A BILL FOR AN ACT

relating to medical education and training.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that many Hawaii residents are unable to obtain timely and appropriate health care due to a shortage of health care providers in the State. The ongoing shortage threatens individual health and may pose adverse effects to the State's health care costs. The neighbor islands, which have been designated by the federal government as medically underserved areas, have been disproportionately adversely affected by shortages of physicians in all areas of practice. The John A. Burns school of medicine has engaged in strategies to increase the numbers of physicians in Hawaii, including, among other endeavors:

(1) Enrolling more students each year;

(2) Rotating medical students to the neighbor islands for preclinical rotations for up to twelve weeks;

(3) Developing longitudinal third-year rotation sites where a small number of students are in the same location for five months;

(4) Developing a small number of sites for four-week fourth-year clinical rotations;

(5) Developing residency or fellowship rotations on neighbor islands; and

(6) Administering the state's loan repayment program that places recipients in underserved communities, especially the neighbor islands.

Current physician workforce data indicate that Hawaii has a shortage of about seven hundred fifty doctors when compared to the general United States physician-patient ratios of a similar demographic population. Primary care, internal medicine, and some specialty physician shortages represent Hawaii's greatest area of need. Without these physicians, the people of Hawaii do not have access to the health care they need.

At the John A. Burns school of medicine, research suggests that if graduates complete their medical school and residency training in Hawaii, about eighty per cent of those physicians remain in Hawaii to practice. Medical residents who train on the neighbor islands are more likely to subsequently practice on the neighbor islands. Expanding capacity for year-round neighbor island medical education training will create a pipeline of new physicians positioned to initiate a neighbor island practice. With a fully developed neighbor islands program, it will be possible to expand the State's neighbor island primary care family medicine, internal medicine, and some specialty residencies.

In Hawaii, graduate medical costs are largely borne by the University of Hawaii and its affiliated health systems. Although some federal funding has been used by the health systems to cover a portion of the costs, there are areas where the State can invest and expand medical education training using the newly available American Rescue Plan Act funding.

Current primary care residencies hosted in Hawaii's health systems on the neighbor islands would be leveraged for expansion of medical education training. The logistics of expanding residency training to the neighbor islands require that dedicated teaching faculty be hired to deliver and lead medical education and training. Funding is also required for student and resident support, including travel, housing, and other coordinated activities across all sites.

The legislature further finds that considerable public outcomes achieved by expanding capacity for training medical students on the neighbor island with the goal of having these students ultimately remain in Hawaii to practice. Continuation of funding for medical education is vital in addressing the physician shortage in Hawaii.

Therefore, the purpose of this Act is to appropriate funds to the John A. Burns school of medicine to expand medical education and training to the neighbor islands.

SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $6,700,000 or so much thereof as may be necessary for fiscal year 2022-2023 for the creation of additional medical residencies and training opportunities for medical students on the neighbor islands.

The sum appropriated shall be expended by the University of Hawaii at Manoa John A. Burns school of medicine for the purposes of this Act.

SECTION 3. This Act shall take effect on July 1, 2022.

INTRODUCED BY:	_____________________________