Report Title:

Appropriation; Primary Health Care

Description:

Appropriates funds to the Department of Health to pay for primary health services for uninsured Hawaii residents through nonprofit, community-based primary health care. (SB1243 HD1)

THE SENATE

S.B. NO.

1243

TWENTY-SECOND LEGISLATURE, 2003

S.D. 2

STATE OF HAWAII

H.D. 1


 

A BILL FOR AN ACT

 

making an appropriation for primary health care for the uninsured.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that the estimated number of Hawaii residents who do not have health insurance has nearly doubled from sixty-eight thousand, two hundred in 1996 to one hundred thirty-five thousand, nine hundred in 2001, creating a serious concern for the State. The increase in the number of uninsured individuals generates a considerable economic impact on the State's hospitals, community health centers, and other health care providers, and threatens their ability to effectively serve the whole community.

According to the Kaiser Commission on Medicaid and the Uninsured:

(1) Four out of five uninsured persons belong to working families;

(2) Uninsured persons are more likely than those with insurance to be hospitalized for conditions that could have been avoided;

(3) Uninsured persons with various forms of cancer are more likely to be diagnosed with late-stage cancer, resulting in higher rates of death and disability; and

(4) Nearly forty per cent of uninsured adults skipped a recommended medical test or treatment, and twenty per cent say they needed but did not get care for a serious problem in the past year.

The legislature further finds that it is in the best interests of the State to ensure access to primary and preventive health care for its residents. In addition to giving rise to a healthier population, providing access to care reduces state expenditures attributable to hospital and emergency room services for preventable injuries or illnesses.

The most effective means to encourage access to primary health care for the uninsured is through Hawaii's system of community health centers that:

(1) Are nonprofit, community-based organizations whose purpose is to serve people who otherwise have limited access to care;

(2) Provide culturally and linguistically appropriate health care, including a broad range of primary care and preventive services, and are located in areas where people have limited access to other health care providers because of geographic and socioeconomic barriers;

(3) Contribute greatly to the economies and livability of the communities they serve; and

(4) Are cost-effective providers whose care results in healthier patients and decreased emergency, specialty, and in-patient services.

The legislature further finds that, while community health centers represent the best system of community-based primary care for uninsured people, financial support for community health centers is inadequate to meet increasing demands. More specifically, community health centers have experienced a forty-one per cent increase in uninsured visits since 1997.

The purpose of this Act is to provide cost-effective care for Hawaii residents who are uninsured, while ensuring that the community health center system remains financially viable and stable in the face of a growing population of uninsured.

SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $1 or so much thereof as may be necessary for fiscal year 2003-2004 and the sum of $1 or so much thereof as may be necessary for fiscal year 2004-2005 to the department of health to provide resources to nonprofit, community-based healthcare providers to care for the uninsured. This appropriation shall pay for providing direct care, which includes primary medical, dental, and mental health care, and may pay for the purchase of prescription drugs. The department of health may distribute moneys on a per-visit basis, considering the needs on all islands.

The sums appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 3. This Act shall take effect July 1, 2003.