Bill Text: HI HB1446 | 2017 | Regular Session | Amended
Bill Title: Relating To Health.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2017-02-17 - Passed Second Reading as amended in HD 1 and referred to the committee(s) on FIN with none voting aye with reservations; none voting no (0) and Representative(s) DeCoite, Tokioka excused (2). [HB1446 Detail]
Download: Hawaii-2017-HB1446-Amended.html
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HOUSE OF REPRESENTATIVES |
H.B. NO. |
1446 |
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TWENTY-NINTH LEGISLATURE, 2017 |
H.D. 1 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
RELATING TO HEALTH.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that over the past ten years, Wahiawa general hospital has experienced severe financial difficulties due to circumstances beyond its control including the reopening of The Queen's Medical Center West Oahu, reductions in public and private insurance reimbursement rates, the statewide physician shortage and its particular severity in central Oahu, new requirements under the federal Affordable Care Act, and an increased indigent care caseload.
Wahiawa general hospital has now weathered difficulties over several years. When Hawaii Medical Center—West closed in 2012, Wahiawa general hospital's acute inpatient caseload nearly doubled since it was required to absorb the closed facility's caseload. Wahiawa general hospital's emergency room, which was designed for a capacity of ten thousand cases per year, treated over twenty thousand cases that year. At the same time, ambulance visits increased by twenty per cent.
To meet the increase in demand, Wahiawa general hospital hired more staff and made improvements to its emergency room. However, when the former Hawaii Medical Center—West was purchased by The Queen's Medical Center West Oahu, and once again began accepting patients, the number of emergency room cases sent to Wahiawa general hospital decreased by approximately twenty per cent per month, despite its recent significant capital and workforce expansion. By the end of the 2015 fiscal year, Wahiawa general hospital had lost more than $7,500,000 in revenue.
Both the medicare and medicaid health coverage programs are subject to statutory limitations on rates of reimbursement to health care providers for services rendered. Because of these limits, services to individuals who are covered by medicare or medicaid often represent a net financial loss to the practitioners and facilities that provide health care to them. Over eighty-five per cent of the patients at Wahiawa general hospital are covered under medicare or medicaid. Reimbursements and payments from the remaining private-pay patients are insufficient to offset the cost of care to those who depend on public health coverage. Wahiawa general hospital has been forced to absorb these net losses.
Wahiawa general hospital's finances have been further stressed by rising costs of providing health insurance to its own workforce and by reduced reimbursements rates and increased denials of reimbursements by private, as well as public, insurers.
The legislature further finds that Wahiawa general hospital serves a community that is more severely affected by the statewide physician shortage than most other areas of the State, including rural communities on the neighbor islands. The shortage of private care physicians in central and west Oahu has forced Wahiawa general hospital to spend an additional $1,700,000 per year to acquire specialized inpatient hospitalists and on-call surgeons to treat patients. The presence of these physicians on-site is critical because ninety-five per cent of Wahiawa general hospital's inpatient admissions are through emergency services.
By law, Wahiawa general hospital is required to treat patients for emergency care regardless of the patient's ability to pay. As the homeless population surrounding Wahiawa general hospital has grown, so has the hospital's share of non- or under-reimbursed indigent care cases.
To address these circumstances, Wahiawa general hospital has drastically cut its programs, services, and personnel and has been forced to allow basic facility repair and maintenance to go unaddressed. Among other things, Wahiawa general hospital has cut approximately seventy-five full-time equivalent positions, eliminated its long-running family practice residency teaching program, and cut more than $9,000,000 from its annual budget.
The legislature finds that Wahiawa general hospital is the only facility that provides emergency medical services to the area that encompasses nearly one-third of the island of Oahu. If Wahiawa general hospital were to close, the nearest emergency room for a person living in Wahiawa would be approximately fourteen miles away. For a person living in Mokuleia, Sunset Beach, or Kahuku, the distance to the nearest emergency room would be forty miles.
Wahiawa general hospital is not only a critical health care provider, it is also the largest private employer in central Oahu, providing more than six hundred well-paying, mostly union jobs. More than ninety per cent of Wahiawa general hospital's employees live in nearby communities. The closure of Wahiawa general hospital would be devastating to entire families who depend on it for employment. Secondary effects of massive job loss in the community would also be catastrophic to the community's small business owners and service providers who serve the local customer base and, in turn, their employees.
Accordingly, the legislature finds that it is critical to the public health and welfare to provide assistance to Wahiawa general hospital to help it adjust to the requirements of the Affordable Care Act, integrate with the centralized services of a larger health care system, and restructure its clinical services as necessary. Temporary financial assistance from the State will provide Wahiawa general hospital with positive cash flows and financial stability while it transitions to a new business model. Without such assistance, Wahiawa general hospital will run out of cash and will not be able to meet its payroll demands. Workforce reductions would necessitate reductions in services and would inevitably lead to corresponding reductions in reimbursements and revenue. State assistance is the only available option; because of its current financial position, Wahiawa general cannot access private financing to meet its needs.
The purpose of this Act is to provide desperately needed financial assistance to Wahiawa general hospital to ensure the health, welfare, and safety of the people of the State of Hawaii.
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 2017-2018 as a grant pursuant to chapter 42F, Hawaii Revised Statutes, to Wahiawa general hospital, for support of basic operations, staff salaries and benefits, and continued hospitalist physician services.
SECTION 3. This Act shall take effect on July 1, 2090.
Report Title:
Wahiawa General Hospital; Appropriation; Grant
Description:
Appropriates funds as a grant pursuant to chapter 42F, HRS, to support basic operations, staff salaries and benefits, and continued hospitalist physician services at Wahiawa General Hospital. (HB1446 HD1)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
