Hana Community Health Center

Appropriates $952,000 in FY 2000-2001 to the Hana Community
Health Center to allow the center to continue its current level
of operations.

HOUSE OF REPRESENTATIVES                H.B. NO.           
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  The legislature finds that the State transferred
 2 the Hana medical center to the Hana Community Health Center in
 3 July 1997 with a guarantee to continue providing needed financial
 4 support for the center's essential medical programs.  This
 5 commitment is part of Act 263, Session Laws of Hawaii 1996, which
 6 provided for the transfer.  The Hana community would not have
 7 accepted this transfer without the commitment to assure the
 8 center's continued viability.
 9      Hana is one of the most isolated areas in the State.  During
10 the rainy season from October to March, the frequent storms often
11 wash out the roadways and disrupt electricity and telephone
12 service.  Hana town is fifty-seven miles from Wailuku and the
13 trip takes two hours along a single lane road with six hundred
14 seventeen turns and fifty-six one-lane bridges.  The district is
15 made up of small, isolated settlements scattered over more than
16 two hundred square miles.  Many of the villages are located a
17 minimum of forty-five minutes from the main town of Hana.
18      The Hana Community Health Center provides a hybrid of
19 services.  Unlike most clinics, the center must also coordinate

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                                     H.B. NO.           

 1 activities with the ambulance services and provide assistance in
 2 stabilizing patients with life threatening illness or traumatic
 3 injury.  This needs to be done twenty-four-hours a day because
 4 the center is the only health care provider in the district.  The
 5 coordination of emergency services and provision of life support
 6 care is absolutely essential to the three thousand residents of
 7 Hana and the 500,000 tourists who visit annually.
 8      Hana also has the dubious distinction of consistently having
 9 some of the worst health and socio-economic indicators in the
10 State.  Native Hawaiians account for sixty-five per cent of all
11 the center's patients.  Hana is federally designated both as a
12 medically underserved population and as a health professional
13 shortage area.  The center currently provides prevention oriented
14 health care, acute and chronic care, urgent care, limited
15 laboratory testing, limited x-ray services, and pre-packaged
16 medications in lieu of a full pharmacy.  Home health care is also
17 provided and seniors and those with mobility problems have
18 benefitted from this program.  In fiscal year 1997-1998, the
19 center provided services to 2,300 individual patients who made
20 over 6,000 patient visits, a fourteen per cent increase over the
21 previous year.
22      When the Hana Community Health Center was operating as the
23 Hana Medical Center as part of the State's community hospitals

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                                     H.B. NO.           

 1 system, it required a subsidy of approximately $1,500,000
 2 annually.  Immediately upon transfer of the Hawaii health systems
 3 corporation, in fiscal year 1997-1998, the legislature reduced
 4 its appropriation for the center's operations to $1,064,000.
 5 This was a thirty per cent reduction in funding in its first year
 6 of operation.  At the same time, patient visits increased by
 7 fourteen per cent.  In fiscal year 1998-1999, the legislature
 8 appropriated $800,000 for the operation of the center, $264,000
 9 less than the amount appropriated the year before, or a second
10 reduction of twenty-five per cent in the center's second year of
11 operation.  In the following year, the legislature appropriated
12 $750,000 for operations, a further reduction of six per cent
13 during the center's third year of operation.  This amount is at
14 least fifty per cent less than the cost of operations before the
15 transfer to the Hana Community Health Center, or $617,300 less
16 than what it cost the State to operate.  Furthermore, no
17 appropriation at all was made for fiscal year 2000-2001.
18      In fiscal year 1998-1999, the Hana Community Health Center
19 provided services to approximately 1,600 unduplicated patients,
20 who contributed to 4,343 patient visits.  This is a decline of
21 approximately thirty per cent over the previous year and can be
22 directly attributed to a twenty-five per cent reduction in
23 funding from fiscal year 1997-1998.  The Hana Community Health

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                                     H.B. NO.           

 1 Center operated at a $127,000 deficit last fiscal year, which was
 2 covered by a $100,000 bank loan.  The Hana Community Health
 3 Center is projected to have an operating deficit of $68,551 in
 4 fiscal year 2000-2001, even with continued reductions in
 5 operations.
 6      The Hana Community Health Center requires a minimum of
 7 $952,000 in fiscal year 2000-2001 to maintain its current level
 8 of operations.  The purpose of this Act is to appropriate funds
 9 to the Hana Community Health Center to allow it to continue its
10 current operations.
11      SECTION 2.  There is appropriated out of the general
12 revenues of the State of Hawaii the sum of $952,000, or so much
13 thereof as may be necessary for fiscal year 2000-2001, to allow
14 the Hana Community Health Center to continue its current level of
15 operations.
16      SECTION 3.  The sum appropriated shall be expended by the
17 department of health for the purposes of this Act.
18      SECTION 4.  This Act shall take effect on July 1, 2000.
20                              INTRODUCED BY:______________________