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

                     HOUSE RESOLUTION


 1        WHEREAS, breast cancer is the most commonly occurring
 2   cancer among women in Hawaii, with 500 to 600 new cases
 3   diagnosed every year; and
 5        WHEREAS, breast cancer causes more deaths among women in
 6   Hawaii than any other form of cancer, with 100 to 150 deaths
 7   occurring every year; and
 9        WHEREAS, mammograms are the most effective screening test
10   available to date for the early detection of breast cancer; and
12        WHEREAS, Pap smear tests are the most effective screening
13   test available for the early detection of cervical cancer and
14   pre-cancerous cell changes in the cervix; and
16        WHEREAS, early detection of breast and cervical cancer
17   greatly improves the long-term survival from these otherwise
18   fatal diseases and significantly reduces the costs of treatment
19   of them; and
21        WHEREAS, the federal Breast and Cervical Cancer Mortality
22   Prevention Act of 1990, P.L. No. 101-354, (Act) was enacted to
23   "authorize grants to states to carry out programs to provide
24   preventive screening and referral services for breast and
25   cervical cancer and to support other public health activities
26   related to the detection and control of these diseases..."
27   (House Report No. 101-543); and
29        WHEREAS, the Hawaii Breast and Cervical Cancer Control
30   Program of the State Department of Health provides free
31   mammograms, Pap smear tests, and related diagnostic tests to
32   medically underserved women who are of low income or uninsured;
33   and
35        WHEREAS, the federal Act does not provide for treatment of
36   breast and cervical cancer, as explained in House Report No.
37   101-543:

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 1        "Although the purpose of this Program is not to
 2        provide (or to support the provision of) medical
 3        treatment (such as surgical procedures or intensive
 4        chemotherapy requiring hospitalization) to women who
 5        are determined to be in need of such care as a result
 6        of a positive mammogram or Pap smear, the Committee
 7        is concerned that these women not go unserved.
 8        Further testing, if recommended, should be offered
 9        and provided; and all necessary steps should be taken
10        to ensure that appropriate follow-up treatment is
11        made available.  Preventive screening technologies
12        like mammography and the Pap smear cannot be promoted
13        in good faith if access to these services cannot be
14        assured.  The Committee intends, therefor, that
15        grantees take all appropriate measures to ensure the
16        provision of any additional services required by
17        women who receive a positive test result.";
19   and
21        WHEREAS, there is no provision in federal or state law to
22   cover the costs of treatment of breast and cervical cancer,
23   other than through health insurance, if available; and
25        WHEREAS, the actual costs for treatment of breast and
26   cervical cancer in Hawaii have never been compiled or
27   estimated; now, therefore,
29        BE IT RESOLVED by the House of Representatives of the
30   Twentieth Legislature of the State of Hawaii, Regular Session
31   of 1999, that the Legislative Reference Bureau conduct a study
32   to determine the costs for treatment of breast and cervical
33   cancer in Hawaii, including but not limited to data and
34   information on:
36        (1)  The costs of surgery, chemotherapy, and other
37             treatment modalities;
39        (2)  The costs that are reimbursed by private health
40             insurance and public medical assistance programs such
41             as QUEST, and the costs of out-of-pocket deductibles
42             or co-payments;
44        (3)  The availability of treatment of breast and cervical
45             cancer for women who are uninsured, and how the costs
46             of that treatment are paid for, if treatment is
47             provided; and

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                                  H.R. NO.              H.D. 1

 1        (4)  An estimate of the number of women in Hawaii who go
 2             undiagnosed or untreated, or both, for breast and
 3             cervical cancer in Hawaii;
 5   and
 7        BE IT FURTHER RESOLVED that the Legislative Reference
 8   Bureau confer with the Department of Health, the American
 9   Cancer Society, Hawaii-Pacific Division, and the Cancer
10   Research Center of Hawaii for purposes of this study; and
12        BE IT FURTHER RESOLVED that the Legislative Reference
13   Bureau submit its findings and recommendations to the
14   Legislature no later than twenty days before the convening of
15   the Regular Session of 2000, based on data and information from
16   the study, so as to provide universal access to breast and
17   cervical cancer treatment in Hawaii; and
19        BE IT FURTHER RESOLVED that certified copies of this
20   Resolution be transmitted to the Acting Director of the
21   Legislative Reference Bureau, the Director of Health, and the
22   Executive Directors of the American Cancer Society, Hawaii-
23   Pacific Division, and the Cancer Research Center of Hawaii.