HOUSE OF REPRESENTATIVES

H.B. NO.

925

TWENTY-NINTH LEGISLATURE, 2017

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

relating to capital improvement projects for the benefit of the forty-sixth representative district.

 

 

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.  These circumstances have included:

     (1)  The reopening of The Queen's Medical Center West Oahu in Ewa, Oahu;

     (2)  Reductions in medicare/medicaid and private insurance reimbursements;

     (3)  The shortage of physicians in the State and in particular, central Oahu;

     (4)  New requirements under the federal Patient Protection and Affordable Care Act; and

     (5)  Increases in indigent care.

     When Hawaii Medical Center—West closed in 2012, Wahiawa general hospital experienced nearly double the cases for acute inpatient care because patients who would have gone to Hawaii Medical Center—West were diverted to Wahiawa general hospital.  The Wahiawa general hospital emergency room, which was originally designed to handle ten thousand cases per year, treated over twenty thousand cases as patients who would have gone to Hawaii Medical Center—West were transported to Wahiawa general hospital.  Ambulance visits increased by twenty per cent.

     To meet this increase in demand, Wahiawa general hospital hired more staff and made improvements to the emergency room.  However, when Hawaii Medical Center—West was purchased by The Queen's Medical Center West Oahu, the number of emergency room cases sent to Wahiawa general hospital decreased significantly, leading to a drop by approximately twenty per cent per month.  By the end of the 2015 fiscal year, Wahiawa general hospital experienced losses of more than $7,500,000 in revenues.

     The legislature further finds that when a person goes to the hospital their costs are generally paid through medical insurance.  For persons who are seniors, disabled, or poor, their health costs are covered by the federal medicare program, or by the Hawaii state medicaid program.  Both of these programs have limitations on the amounts that may be reimbursed for services rendered, as specified by law.  From a practical standpoint, persons who are covered by medicare or medicaid are served at a loss by the physician and hospitals.

     More than eighty-five per cent of the patients at Wahiawa general hospital are covered under medicare or medicaid.  With only fourteen per cent of admissions being private insurance patients, there are far too few of these patients who are available to offset the losses experienced from the medicare and medicaid patients.  Accordingly, losses from medicare and medicaid have been absorbed by Wahiawa general hospital.

     The legislature further finds that Wahiawa general hospital serves a community with a higher shortage of doctors than Hawaii island, Molokai, and most of Maui.  The shortage of private care physicians on 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.  These physicians are needed at Wahiawa general hospital because ninety-five per cent of inpatient admissions are for emergency services.

     Furthermore, under the federal Patient Protection and Affordable Care Act, the Hawaii Medical Service Association has increased Wahiawa general hospital's employee health insurance costs by over $1,000,000 per year.  In addition, new policies of Hawaii Medical Service Association have increased Wahiawa general hospital costs and cut payments.  Also, Hawaii Medical Service Association, medicare, and medicaid have all recently begun to aggressively deny reimbursement for inpatient and outpatient services.  This, in turn, further reduces patient reimbursements.

     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 grew, the number of indigent care cases have also grown, and the number of homeless individuals in central and north shore Oahu only continues to grow.  Without any reimbursement available for many of these cases, costs of care must be absorbed solely by Wahiawa general hospital.

     To address these circumstances, Wahiawa general hospital has severely cut its programs, services, and personnel, while allowing basic repair and maintenance of the infrastructure to go unmet.  Among other things, Wahiawa general hospital reduced its staff by approximately seventy-five full-time equivalent positions, eliminated the long-running family practice residency teaching program, and cut more than $9,000,000 from the annual budget.

     The legislature acknowledges that Wahiawa general hospital is the only facility that provides emergency medical services in a vast geographical area, extending from Mililani to Wahiawa, Waialua, Sunset and Kahuku, which 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 either Pali Momi near Pearlridge, or The Queen's Medical Center West Oahu, both of which are approximately fourteen miles away.

     For a person living in Mokuleia, Sunset, or Kahuku, the distance would amount to forty miles, or double the distance it currently takes to go to Wahiawa general hospital.

     Furthermore, Wahiawa general hospital is the largest private employer in central Oahu, providing more than six hundred jobs.  More than ninety per cent of the employees of Wahiawa general hospital live in the community, with most of the full-time employees being members of the ILWU, UPD, and HNA unions.

     The closure of Wahiawa general hospital would be devastating to entire families because heads of households would need to seek reemployment while keeping up payments on a mortgage, putting food on the table, and doing their utmost to make life normal for their children and families.

     In addition, as employees and their families lose their sources of revenue, they will not be able to purchase goods and services from within the community.  Thus, shop owners and service providers in the communities where these employees reside will see a decrease in sales, forcing them to possibly reduce hours or staff.  The impact of the possible closure to Wahiawa general hospital would be catastrophic to the region and to the State.  Accordingly, the legislature asserts that the public interest is served by assisting Wahiawa general hospital during its financial crisis. 

     The purpose of this Act is to appropriate funds for desperately needed infrastructure improvements at Wahiawa general hospital to ensure that the hospital continues to operate and to ensure the health, welfare, and safety for the citizens of central Oahu and the people of the State.

     SECTION 2.  The director of finance is authorized to issue general obligations bonds in the sum of $7,935,000 or so much thereof as may be necessary and the same sum or so much thereof as may be necessary is appropriated for fiscal year 2017-2018 for the purpose of financing capital improvement projects for the forty-sixth representative district, as follows:

A.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for elevator upgrades.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     157,000

        Total funding             $160,000

B.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for a new chiller plant.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     597,000

        Total funding             $600,000

C.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for a new generator and transfer switches.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                      87,000

        Total funding              $90,000

D.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for a new fire alarm system.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     187,000

        Total funding             $190,000

E.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for a new nurse call system (WRNC and acute).

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     197,000

        Total funding             $200,000

F.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for replacement hot water tank.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     117,000

        Total funding             $120,000

G.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for new air handling units on roof (L&D, two for WNRC, Old OB, CT).

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

        Equipment                  497,000

        Total funding             $500,000

     H.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for new ceiling air handling unit in medical records.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                      97,000

        Total funding             $100,000

I.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for new ceiling air handling unit in men's restroom across cafe.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                      97,000

        Total funding             $100,000

     J.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for new air handling unit in lab.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                      97,000

        Total funding             $100,000

K.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for replacement roof top chiller for operating room.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     164,000

        Total funding             $167,000

     L.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for replacement of three kitchen exhaust fans.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                      24,000

        Total funding              $27,000

M.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment to renovate admission area for HIPPA compliance.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                      57,000

        Total funding              $60,000

     N.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment to upgrade landscaping.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                       7,000

        Total funding              $10,000

     O.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment to paint facility.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     337,000

        Total funding             $340,000

     P.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment to upgrade public and patient restrooms for ADA compliance.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                   1,197,000

        Total funding           $1,200,000

Q.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for new sprinkler riser and alarm system (Kilani Avenue).

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                      14,000

     Total funding                 $17,000

     R.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for three new roof replacements.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     347,000

        Total funding             $350,000

S.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for arch flash study and full tracing.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     207,000

        Total funding             $210,000

     T.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for parking lot lighting (front).

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                      22,000

        Total funding              $25,000

U.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for hospital bed replacement (forty acute beds).

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     262,000

        Total funding             $265,000

     V.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for hospital bed replacement (Five ICU beds).

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                      97,000

        Total funding             $100,000

W.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for LTC room renovation and upgrade.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     585,000

        Total funding             $588,000

     X.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for patient room renovation and upgrade.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     212,000

        Total funding             $215,000

Y.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for SBH patient room renovation and upgrade.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                      47,000

        Total funding              $50,000

     Z.   Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for storeroom and receiving area renovation and upgrade.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     197,000

        Total funding             $200,000

AA.  Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for cafeteria renovation and upgrade.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                      72,000

        Total funding              $75,000

     BB.  Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for operating room upgrades.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     123,000

        Total funding             $126,000

CC.  Wahiawa general hospital, Oahu

Plans, design, construction, and equipment for technology upgrades.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     477,000

        Total funding             $480,000

DD.  Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for information technology infrastructure and network.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     422,000

        Total funding             $425,000

EE.  Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for lab renovation and upgrade.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

        Equipment                   72,000

        Total funding              $75,000

     FF.  Wahiawa general hospital, Oahu

    Plans, design, construction, and equipment for pharmacy renovations and upgrade.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     157,000

        Total funding             $160,000

GG.  Wahiawa general hospital, Oahu

     Equipment for medical x-ray, lab, and nursing equipment.

        Total funding             $450,000

     HH.  Wahiawa general hospital, Oahu

     Plans, design, construction, and equipment for hospital common area and support area renovation and upgrade.

     Plans                          $1,000

     Design                          1,000

     Construction                    1,000

     Equipment                     157,000

        Total funding             $160,000

     SECTION 3.  The sums appropriated for the respective capital improvement projects set forth in section 2 shall be expended by the department of health for the purposes of this Act.

     SECTION 4.  This Act shall take effect on July 1, 2017.

 

INTRODUCED BY:

_____________________________

 

 


 


 

Report Title:

CIP; 46th Representative District

 

Description:

Authorizes issuance of general obligation bonds and appropriates funds for capital improvement projects in the 46th Representative District.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.