HOUSE OF REPRESENTATIVES

H.B. NO.

1937

TWENTY-SEVENTH LEGISLATURE, 2014

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO HEALTH.

 

 

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

 


     SECTION 1.  Prior to the establishment of the Hawaii health systems corporation, the State's community hospitals system was a division of the department of health.  Rapid changes in the health industry and impending implementation of national and local health care reform prompted legislative action to permanently allow the community hospitals system to gain greater control over operations to compete and remain viable.  In 1996, the Hawaii health systems corporation was created to provide improved health care for all persons in the State, including those served by small rural facilities by coordinating and overseeing statewide health policy and services.

     Today, the Hawaii health systems corporation is the fourth largest public health system in the United States, the largest provider of health care on every island except Oahu and Molokai, and the only acute care provider on Lanai and Maui.  The corporation is also the safety net for neighbor island acute care and for long-term care in the State.

     Ongoing financial challenges faced by the Hawaii health systems corporation are a risk to the public health care services provided by the corporation.  Under current conditions, the Hawaii health systems corporation continues to face financial challenges, including budget shortfalls, increased operational and capital improvement costs, declining government and third-party payer subsidies, and inadequate reimbursements, among other challenges.

     Structural reform to the Hawaii health systems corporation provides an opportunity to improve the delivery of health care services and resources in the community.  Eliminating the corporation board and the centralized authority of the Hawaii health systems corporation, and instead establishing regional health care systems, each to be headed by a regional system board, will give the regional health care systems administrative and operational autonomy.  Establishing autonomous regional health care systems will also streamline government operations and allocate greater resources directly to the respective regional health care systems for the provision of public health care services.

     However, such an undertaking is complex.  It requires well-coordinated and careful planning to provide a seamless transition to ensure continuity of health care services in the community and to maintain the viability of the State's health care delivery system.

     Many of the issues to be considered in the transition are finance- and budget-related.  Other considerations are the impact on the types of health services offered statewide, the additional responsibilities and greater roles that will be absorbed by the regional system boards, and the status of employees in the new structure.

     The purpose of this Act is to ensure continuity of health care services to the community and maintain the viability of the health care delivery system in the State by requiring the governor to establish a task force to develop an organizational and functional plan that:

(1)  Eliminates the corporation board and the centralized authority of the Hawaii health systems corporation;

(2)  Establishes autonomous regional health care systems, each to be headed by a regional system board; and

(3)  Gives the regional system boards complete administrative and operational oversight over their respective regional health care systems.

     SECTION 2.  (a)  The governor shall establish a task force to develop an organizational and functional plan that:

(1)  Eliminates the corporation board and centralized authority of the Hawaii health systems corporation;

(2)  Establishes autonomous regional health care systems, each to be headed by a regional system board; and

(3)  Gives the regional system boards complete administrative and operational oversight over their respective regional health care systems.

     (b)  As part of the organizational and functional plan, the task force shall, among other things:

(1)  Establish clear and consistent roles and responsibilities for the regional system boards in overseeing their respective regional health care systems;

(2)  Develop appropriate transition plans;

(3)  Review personnel classifications and position descriptions for employees of the State's public health care system;

(4)  Develop an organizational structure for the regional health care systems and their boards;

(5)  Prepare proposed budgets for each of the regional health care systems; and

(6)  Attend to other administrative details necessary to complete the transition.

     (c)  The task force shall consist of representatives of the departments of health, budget and finance, human resources development, accounting and general services, and attorney general; the chairperson of the Hawaii health systems corporation; the respective chairs of the current regional health care system boards; the designated collective bargaining representatives of current employees of the Hawaii health systems corporation; representatives of the hospital industry; representatives of insurers and health maintenance organizations; and community members from each county.

     (d)  The task force shall submit the organizational and functional plan, including any proposed legislation necessary to implement the transition from the Hawaii health systems corporation structure to a regional health care systems structure, to the legislature no later than thirty days prior to the convening of the regular session of 2015 as part of the biennial executive budget request.

     (e)  Upon completion of the organizational and functional plan, the governor shall appoint a management team to develop transition plans, finalize position descriptions and revise personnel classifications, establish a personnel records system, develop accounting and fiscal controls, and attend to other administrative details so that by January 1, 2016:

(1)  The transition from the Hawaii health systems corporation structure to a regional health care systems structure is complete; and

(2)  The transfer of functions of the Hawaii health systems corporation to the respective regional health care systems and all other actions necessary in the transfer are complete.

     (f)  Members of the task force shall not be considered employees of the State for purposes of chapter 84, Hawaii Revised Statutes, based solely upon their participation on the task force.

     (g)  The task force shall be exempt from the requirements of chapter 92, Hawaii Revised Statutes.

     SECTION 3.  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 2014-2015 for the purposes of this Act.

     The sum appropriated shall be expended by the office of the governor for the purposes of this Act.

SECTION 4.  This Act shall take effect upon its approval; provided that section 3 shall take effect on July 1, 2014.

 

INTRODUCED BY:

_____________________________

 

 


 


 

Report Title:

Hawaii Health Systems Corporation; Structural Reform

 

Description:

Requires the Office of the Governor to establish a task force to develop an organizational and functional plan that eliminates the corporation board and centralized authority of the Hawaii Health Systems Corporation and establishes autonomous regional health care systems headed by a regional system board by January 1, 2016.  Makes appropriation.

 

 

 

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