Health Care Community

Authorizes the housing and community development corporation of
Hawaii to work in partnership with private sector entities to
develop health care communities in the State.  Establishes a
health care community revolving fund to make loans to businesses
for the construction of the health care community. (SD1)

HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 1
TWENTIETH LEGISLATURE, 1999                                S.D. 1
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  The legislature finds that in the twenty-first
 2 century, health care providers can no longer focus only on
 3 helping sick and injured people get better.  In Hawaii, there is
 4 a mounting and unanswered problem of providing health care for
 5 seniors.  The emphasis must be on creating health care
 6 communities where wellness and prevention go hand in hand with
 7 diagnosis and treatment.  In health care communities, people will
 8 be empowered to make healthy choices in part by having
 9 information, facilities, and opportunities provided by an
10 integrated state-of-the-art health care network integrated within
11 the community.
12      One example of developing healthy communities is to
13 intentionally place health care providers in a medical mall
14 setting within the community.  A mall would provide sufficient
15 room for flexibility to meet the ever-changing requirements of
16 health care.  Around the mall, residential areas for health care
17 providers could be developed, with inclusion of amenities
18 including jogging trails, bicycle paths, parks, and pools, to
19 promote a healthy lifestyle for residents.

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                                     H.B. NO.           H.D. 1
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 1      The legislature finds that health care communities fit
 2 within state plans to strengthen Hawaii's economy by developing
 3 science and technology industries, and will provide a direct
 4 boost to the health and tourism industries, the two largest
 5 industries in the State.  Because health care is a clean, quiet
 6 industry, the legislature finds that the proposed health care
 7 community will also bring jobs closer to residential areas
 8 without negatively affecting those areas.
 9      The purpose of this Act is to authorize the housing and
10 community development corporation to enter into agreements with
11 private sector entities to develop health care communities in the
12 State, and to create a health care community loan program.
13      SECTION 2.  Chapter 201G, Hawaii Revised Statutes, is
14 amended by adding a new part to be appropriately designated and
15 to read as follows:
16                "PART    . HEALTH CARE COMMUNITIES
17      201G- Definitions.  As used in this part, unless the
18 context clearly requires otherwise:
19      "Health care community" means a master planned health care
20 center and retirement community that generally includes such
21 facilities as a medical mall, a medical technology park,
22 medical-related residential areas, general residential and
23 commercial areas, and appropriate infrastructure.

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                                     H.B. NO.           H.D. 1
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 1      "Medical mall" means a centrally located network of
 2 state-of-the-art health care services and medical research,
 3 training, and technology facilities that promote and support a
 4 health care community's emphasis on wellness, including fitness
 5 and prevention of illness, along with diagnosis, treatment, and
 6 care, and seeks to bring together a wide range of health care
 7 including traditional and nontraditional medicine.
 8      201G-   Health care community.(a)  Private sector
 9 entities may develop appropriate locations, plans, and criteria
10 for the development of health care communities.  The corporation
11 may participate with the private sector entity in the development
12 of a health care community; provided that the corporation:
13      (1)  In consultation with the department of health,
14           determines that it is in the public interest that work
15           on such a project should be instituted to address
16           important health needs; and
17      (2)  Development of such a project cannot occur by the
18           ordinary operations of private enterprise.
19      (b)  Any planned community association that is organized for
20 the purpose of governing all or a portion of the health care
21 community shall comply with chapter 421J.
22      201G-   Master plan.(a)  In developing a health
23 community, the private sector entity shall develop a master plan

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                                     H.B. NO.           H.D. 1
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 1 for the health care community, which may include a medical mall
 2 or similar facility as described in this section.
 3      (b)  The medical mall component of the health care
 4 community, if used, shall consist of a high technology core as
 5 provided in this subsection, other health care services, and
 6 medical-related housing.  The high-technology core may include
 7 one or more of the following facilities:
 8      (1)  A diagnostic-treatment center, or "a hospital without
 9           beds";
10      (2)  Administrative offices;
11      (3)  A physician's office building;
12      (4)  A sports medicine and research center; and
13      (5)  A birthing center.
14      (c)  In addition to the medical mall or other setting, the
15 health care community may include one or more of the following
16 health-related facilities:
17      (1)  An acute-care facility;
18      (2)  A conference center;
19      (3)  An Alzheimer's center;
20      (4)  A hospice;
21      (5)  A clinic;
22      (6)  A medical hotel;
23      (7)  A center for alternative medicine;

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 1      (8)  An adolescent mental health facility;
 2      (9)  A dental clinic;
 3     (10)  A medical education and research campus;
 4     (11)  A rehabilitation and wellness center;
 5     (12)  A geriatric center;
 6     (13)  A medical technology park;
 7     (14)  A cardiac hospital;
 8     (15)  A retirement community;
 9     (16)  A nursing home;
10     (17)  A skilled nursing facility;
11     (18)  An assisted living facility;
12     (19)  A blood bank;
13     (20)  Additional medical education space; and
14     (21)  A facility for health warehousing and distribution.
15      (d)  The health care community may also include medical
16 research, technology development, and education facilities, and
17 may include a medical school to provide student access to the
18 latest medical technology and facilities.
19      201G-   Health care community loan program; authorization.
20 (a)  The corporation may establish under this part, a loan
21 program for private sector entities for the construction of the
22 health care community.  A minimum of forty per cent of the health
23 care community development shall be directly related to the

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                                     H.B. NO.           H.D. 1
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 1 provision of health care.  A private developer who wishes to
 2 receive a loan under this part shall submit an application to the
 3 corporation on forms that the corporation may prescribe.  In
 4 order to be eligible for the award of a loan under this part, the
 5 developer applicant shall meet the following minimum
 6 requirements:
 7      (1)  Have a legal or equitable interest in the land to be
 8           developed;
 9      (2)  No land shall have been acquired by the developer
10           applicant by eminent domain for any portion of the
11           health care community development;
12      (3)  Have a minimum of twenty years of experience in the
13           health care industry;
14      (4)  Have at least ten years working experience with a major
15           health care provider in the area being served by the
16           development; and
17      (5)  Have a working relationship with and support of a
18           physicians health organization with a membership of not
19           less than fifty in the area being served by the
20           development.
21      (b)  The corporation may make loans or grants out of the
22 health care community revolving fund, either before or after
23 final subdivision approval, to cover planning, engineering,

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                                     H.B. NO.           H.D. 1
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 1 feasibility studies, construction, and other costs associated
 2 with the health care community.
 3      (c)  The corporation may invest in, make, purchase, take
 4 assignments of, or otherwise acquire or make commitments to do
 5 the same with respect to any eligible loans or any partial
 6 interest or participation held by or on behalf of the
 7 corporation.
 8      (d)  The corporation may sell, assign, or otherwise dispose
 9 of or enter into commitments to sell, assign, or otherwise
10 dispose of any eligible loans or any partial interest or
11 participation held by or on behalf of the corporation.
12      (e)  The corporation may acquire any obligation under
13 conditions that require the seller of such obligation to use the
14 proceeds of the sale for the purpose of financing eligible loans. 
15      (f)  The corporation may adopt rules pursuant to chapter 91
16 as may be necessary or convenient for the operation of the loan
17 program.
18      201G-   Health care community revolving fund.(a)  There
19 is created the health care community revolving fund to be
20 administered by the corporation.  All repayments of principal and
21 interest on loans or grants made by the corporation from the fund
22 shall be placed in the health care community revolving fund to be
23 used for the purposes of this part.

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                                     H.B. NO.           H.D. 1
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 1      (b)  The corporation may use, as needed, the aggregate
 2 principal sum and the accumulated earnings in the health care
 3 community revolving fund to make loans to businesses for the
 4 construction of the health care community as provided in section
 5 201G-D and for necessary expenses in administering this part.
 6      (c)  In managing the fund, the corporation may cooperate
 7 with other public and private nonprofit organizations and may
 8 enter into loan or grant agreements with them.  The necessity for
 9 and the nature and extent of security required for a loan or
10 grant shall be determined by the corporation.  The security may
11 include, but is not limited to, a borrowing resolution of the
12 nonprofit organization.
13      The foregoing powers are subject, however, to the following
14 restrictions and limitations:
15      (1)  No single loan or grant shall exceed two per cent of
16           the project cost;
17      (2)  The loan shall be repaid with simple interest not to
18           exceed six per cent per year; and
19      (3)  The moneys loaned shall be used only for the planning,
20           engineering, feasibility studies, construction, and
21           related costs of projects associated with the health
22           care community.
23      (d)  The aggregate principal sum in the health care

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                                     H.B. NO.           H.D. 1
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 1 community revolving fund, which may without limitation include
 2 sums made available from any government program or grant, from
 3 private grants or contributions, from the proceeds of any bond
 4 issue, or by appropriation, shall be invested by the corporation
 5 in a manner that will maximize the rate of return on investment
 6 of the fund; provided that any investment shall be consistent
 7 with section 201G-167 but need not comply with section 36-21.
 8      (e)  Except as to administrative expenditures, and except as
 9 otherwise provided by law, expenditures from the fund may be made
10 by the corporation without appropriation or allotment by the
11 legislature; provided that no expenditure shall be made from and
12 no obligation shall be incurred against the fund in excess of the
13 amount standing to the credit of the fund nor for any purpose for
14 which the fund may not lawfully expend moneys.  Nothing in
15 sections 37-31 and 37-41 shall require that the proceeds of the
16 fund be reappropriated annually. 
17      (f)  The corporation may adopt rules in accordance with
18 chapter 91 to carry out the purposes of this section.
19      201G-   Additional powers.  The powers conferred upon the
20 corporation by this part shall be in addition and supplemental to
21 the powers conferred upon it by any other law, and nothing herein
22 shall be construed as limiting any powers, rights, privileges, or
23 immunities so conferred upon it.

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                                     H.B. NO.           H.D. 1
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 1      201G-    Limitation of powers.  Notwithstanding any
 2 provision of this chapter or any other law to the contrary, a
 3 health care community development shall not be exempt from any
 4 statute, ordinance, charter provision, or rules of any state or
 5 county governmental agency relating to permitting, planning,
 6 zoning, construction standards, development and improvements of
 7 land, and the construction of structures on that land."
 8      SECTION 3.  The director of finance may issue general
 9 obligation bonds in amounts up to $          , and the same sum,
10 or so much thereof as may be necessary is appropriated for fiscal
11 year 1999-2000, and the same sum, or so much thereof as may be
12 necessary is appropriated for fiscal year 2000-2001, to finance
13 the cost of acquiring, developing, improving, and constructing
14 infrastructure for a health care community as provided in this
15 Act, to be expended by the housing and community development
16 corporation of Hawaii.  The corporation may take other action as
17 it deems necessary pursuant to its powers under chapter 201G,
18 Hawaii Revised Statutes, to finance those costs.  The corporation
19 may utilize contributions of money, labor, materials, and
20 property that may be otherwise available from any person or
21 instrumentality.  The corporation, in its discretion, may
22 establish a separate entity within the corporation to implement
23 this section.

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 1      SECTION 4.  The director of finance is authorized to issue
 2 general obligation bonds in the sum of $          , or so much
 3 thereof as may be necessary, and the same sum is appropriated for
 4 fiscal year 1999-2000, and the same sum, or so much thereof as be
 5 necessary is appropriated for fiscal year 2000-2001, to finance
 6 the cost of the acquisition, development, improvement, and
 7 construction of infrastructure for a health care community as
 8 provided in this Act.  
 9      The sum appropriated shall be expended by the housing and
10 community development corporation of Hawaii for the purposes of
11 this Act.
12      SECTION 5.  It is the intent of this Act not to jeopardize
13 the receipt of any federal aid nor to impair the obligation of
14 the State or any agency thereof to the holders of any bond issued
15 by the State or by any such agency, and to the extent, and only
16 to the extent, necessary to effectuate this intent, the governor
17 may modify the strict provisions of this Act, but shall promptly
18 report any such modification with reasons therefor to the
19 legislature at its next session thereafter for review by the
20 legislature.
21      SECTION 6.  If any provision of this Act, or the application
22 thereof to any person or circumstance is held invalid, the
23 invalidity does not affect other provisions or applications of

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                                     H.B. NO.           H.D. 1
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 1 the Act which can be given effect without the invalid provision
 2 or application, and to this end the provisions of this Act are
 3 severable.
 4      SECTION 7.  Statutory material to be repealed is bracketed.
 5 New statutory material is underscored.
 6      SECTION 8.  This Act shall take effect on July 1, 1999, and
 7 shall be repealed on July 1, 2006.