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THE SENATE                           S.C.R. NO.            S.D. 1
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
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                    SENATE  CONCURRENT
                        RESOLUTION

  REQUESTING A STUDY OF HEALTH CARE COSTS RELATED TO THE
    TREATMENT OF BREAST AND CERVICAL CANCER IN HAWAII.
 


 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
 4   
 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
 8   
 9        WHEREAS, mammograms are the most effective screening test
10   available to date for the early detection of breast cancer; and
11   
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
15   
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
20   
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
28   
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
34   
35        WHEREAS, the Act does not provide for treatment of breast

 
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 1   and cervical cancer, as explained in House Report No. 101-543:
 2   
 3        "Although the purpose of this Program is not to
 4        provide (or to support the provision of) medical
 5        treatment (such as surgical procedures or intensive
 6        chemotherapy requiring hospitalization) to women who
 7        are determined to be in need of such care as a result
 8        of a positive mammogram or Pap smear, the Committee
 9        is concerned that these women not go unserved.
10        Further testing, if recommended, should be offered
11        and provided; and all necessary steps should be taken
12        to ensure that appropriate follow-up treatment is
13        made available.  Preventive screening technologies
14        like mammography and the Pap smear cannot be promoted
15        in good faith if access to these services cannot be
16        assured.  The Committee intends, therefor, that
17        grantees take all appropriate measures to ensure the
18        provision of any additional services required by
19        women who receive a positive test result.";
20   
21   and
22   
23        WHEREAS, there is no provision in federal law or in state
24   law to cover the costs of treatment of breast and cervical
25   cancer, other than through health insurance, if available; and
26   
27        WHEREAS, the actual costs for treatment of breast and
28   cervical cancer in Hawaii have never been compiled or
29   estimated; now, therefore,
30   
31        BE IT RESOLVED by the Senate of the Twentieth Legislature
32   of the State of Hawaii, Regular Session of 1999, the House of
33   Representatives concurring, that the Legislative Reference
34   Bureau conduct a study to determine the costs for treatment of
35   breast and cervical cancer in Hawaii, including but not limited
36   to data and information on:
37   
38        (1)  The costs of surgery, chemotherapy, and other
39             treatment modalities;
40   
41        (2)  The costs that are reimbursed by private health
42             insurance and public medical assistance programs such

 
 
 
 
 
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 1             as QUEST, and the costs of out-of-pocket deductibles
 2             or co-payments;
 3   
 4        (3)  The availability of treatment of breast and cervical
 5             cancer for women who are uninsured, and how the costs
 6             of that treatment are paid for, if treatment is
 7             provided; and
 8   
 9        (4)  An estimate of the number of women in Hawaii who go
10             undiagnosed or untreated, or both, for breast and
11             cervical cancer in Hawaii;
12   
13   and
14   
15        BE IT FURTHER RESOLVED that the Legislative Reference
16   Bureau confer with the State Department of Health, the Cancer
17   Research Center of Hawaii, and the American Cancer Society,
18   Hawaii-Pacific Division, for purposes of this study; and
19   
20        BE IT FURTHER RESOLVED that the Legislative Reference
21   Bureau make recommendations, based on data and information from
22   the study, so as to provide universal access to breast and
23   cervical cancer treatment in Hawaii; and
24   
25        BE IT FURTHER RESOLVED that certified copies of this
26   Concurrent Resolution be transmitted to the Director of the
27   Legislative Reference Bureau, Director of Health, the Director
28   of the Cancer Research Center of Hawaii, and the American
29   Cancer Society, Hawaii-Pacific Division.