Honolulu, Hawaii
                                                     , 1999

                                   RE:  H.B. No. 172
                                        H.D. 1
                                        S.D. 1

Honorable Norman Mizuguchi
President of the Senate
Twentieth State Legislature
Regular Session of 1999
State of Hawaii


     Your Committee on Health and Human Services, to which was
referred H.B. No. 172, H.D. 1, entitled: 


begs leave to report as follows:

     The purpose of this measure is to require that hospice homes
be considered as a residential use of property for purposes of
county zoning, and to authorize the Department of Health (DOH) to
license hospice service agencies.

     Your Committee received testimony in support of this measure
from the Department of Health (DOH), Executive Office on Aging,
Hospice Hawaii, Healthcare Association, and Hawaii Nurses'

     This measure is intended to increase the supply of hospice
homes in Hawaii and to allow the DOH to license hospice service
agencies that operate hospice homes or are otherwise engaged in
providing hospice services at the homes of clients.  This measure
is a recommendation, in part, of the Governor's Blue Ribbon Panel
on Living and Dying, that hospice care be made more available and
offered more expediently.  The Panel also recommended effective
pain management programs, which your Committee intends to be
included in this measure in the definition of "hospice service"
as a program of palliative and supportive care for terminally ill

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     Your Committee believes that the "living process" in the
transition to death should be made as available and as
comfortable as possible.  This can be accomplished with more
hospice service agencies and hospice homes to provide palliative
and supportive care for terminally ill persons and their families
or caregivers.

     Your Committee has amended this measure by inserting
provisions of S.B. No. 851, S.D. 2, that:

     (1)  Revise section 1 of the measure to reflect legislative
          intent and the measure's purpose, as amended;

     (2)  Insert "section 46-4" in place of "zoning" in the new
          section in chapter 46, Hawaii Revised Statutes (HRS),
          that allows hospice homes to have no more than five
          unrelated persons; 

     (3)  Delete section 3, relating to licensing of hospice

     (4)  Insert two new HRS sections to require hospice coverage
          by health insurers and mutual benefit societies; and

     (5)  Revise section 432D-23, HRS, relating to health
          maintenance organization coverage, to insert a cross
          reference hospice coverage.

     Your Committee has retained section 3 of the H.D. 1 version
which authorizes the DOH to license hospice agencies.

     As affirmed by the record of votes of the members of your
Committee on Health and Human Services that is attached to this
report, your Committee is in accord with the intent and purpose
of H.B. No. 172, H.D. 1, as amended herein, and recommends that
it pass Second Reading in the form attached hereto as H.B.
No. 172, H.D. 1, S.D. 1, and be referred to the Committee on Ways
and Means.

                                   Respectfully submitted on
                                   behalf of the members of the
                                   Committee on Health and Human

                                   SUZANNE CHUN OAKLAND, Chair

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