Honolulu, Hawaii
                                                     , 1999

                                   RE:  S.B. No. 102
                                        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 S.B. No. 102 entitled: 


begs leave to report as follows:

     The purpose of this measure is to improve the provision of
adequate health care services and related public transportation
services for rural communities.

     Your Committee received testimony in support of this measure
from the Department of Health (DOH), Department of Transportation
(DOT), Hawaii State Primary Care Association, Bay Clinic, Ka`u
Rural Health Task Force which submitted a petition with numerous
signatures, the Office of Hawaiian Affairs, ILWU Local 142, and
two private citizens.  Informational testimony was received from
Hawaii Health Systems Corporation.

     The intent of this measure is to qualify Hawaii for federal
Medicare rural hospital flexibility grants through the
development of a statewide rural health plan, a new certification
category for small rural hospitals, and to create a rural health
fund.  Your Committee finds that adequate health care for rural
districts, particularly the Big Island, are sorely lacking.  This
measure is an outgrowth of the DOH's rural health plan for the
island of Hawaii, particularly Puna and Ka`u, to ensure the
improvement of health facilities and to make available sufficient
medical services.

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                                   STAND. COM. REP. NO. 456
                                   Page 2

     Your Committee has amended this measure on the
recommendations of the DOH and the DOT, by:

     (1)  Deleting language requiring the DOH to have a new
          certification category for rural critical access
          hospitals, since current licensing and certification
          arrangements are sufficient;

     (2)  Requesting each county to create a position for rural
          transportation coordinator, rather than requiring the
          DOH to create one since it is not a DOH or DOT function
          to provide county rural transportation services;

     (3)  Clarifying that the coordinator should develop the plan
          with the assistance of the DOH, county public
          transportation agencies, and private nonprofit agencies
          that provide transportation services to the elderly and
          disabled to enable affordable and convenient access to
          health care services; and

     (4)  Deleting the requirement that the DOH incorporate the
          plan into its rules, since a plan would now be
          developed by each county.

     Your Committee has also made technical, nonsubstantive

     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 S.B. No. 102, as amended herein, and recommends that it pass
Second Reading in the form attached hereto as S.B. No. 102,
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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