Honolulu, Hawaii
                                                   , 1999

                                 RE: S.B. No. 851
                                     S.D. 2
                                     H.D. 1

Honorable Calvin K.Y. Say
Speaker, House of Representatives
Twentieth State Legislature
Regular Session of 1999
State of Hawaii


     Your Committee on Health, to which was referred S.B. No.
851, S.D. 2, entitled: 


begs leave to report as follows:

     The purpose of this bill is to implement two of the seven
recommendations made by the Governor's Blue Ribbon Panel on
Living and Dying with Dignity.  These two recommendations
regarding hospice care, are as follows:

     (1)  Make the Medicare per diem rate, the current rate set
          by the Health Care Financing Administration, the base
          rate for hospice care, and to reimburse room and board
          expenses of hospice facilities; and

     (2)  Make hospice referral visits a reimbursable benefit,
          regardless of whether the patient is eventually
          admitted to a hospice or not.

     The Executive Office on Aging and Hospice Hawaii testified
in support of this bill.

     Upon consideration, your Committee has amended this bill by
deleting its substance and inserting the substance of H.B. No.
172, H.D. 1, a bill passed out of your Committee earlier this
session.  Your Committee also further amended this bill by making

                                 STAND. COM. REP. NO. 1194
                                 Page 2

technical, nonsubstantive amendments for clarity.  As amended,
this bill:

     (1)  Authorizes the Department of Health to license hospice
          service agencies; and

     (2)  Allows hospice homes with five or fewer beds in
          residential areas.

     Your Committee recognizes that the deletion of the
reimbursement provisions bear fiscal implications on hospice
care.  It is the intent of your Committee that subsequent House
committees consider these implications.  It is also your
Committee's belief that greater outreach and educational services
need to be provided to the community to educate them about
hospice, particularly that hospice is a strictly voluntary
option, regardless of the recommendations of physicians.

     As affirmed by the record of votes of the members of your
Committee on Health that is attached to this report, your
Committee is in accord with the intent and purpose of S.B. No.
851, S.D. 2, as amended herein, and recommends that it pass
Second Reading in the form attached hereto as S.B. No. 851, S.D.
2, H.D. 1, and be referred to the Committee on Consumer
Protection and Commerce.

                                   Respectfully submitted on
                                   behalf of the members of the
                                   Committee on Health,

                                   ALEXANDER C. SANTIAGO, Chair