STAND. COM. REP. NO. 1729

 

Honolulu, Hawaii

                  

 

RE:    H.C.R. No. 161

 

 

 

Honorable Ronald D. Kouchi

President of the Senate

Twenty-Ninth State Legislature

Regular Session of 2017

State of Hawaii

 

Sir:

 

     Your Committee on Ways and Means, to which was referred H.C.R. No. 161 entitled:

 

"HOUSE CONCURRENT RESOLUTION REQUESTING THE CONVENING OF A WORKING GROUP RELATING TO COMPLEX PATIENTS,"

 

begs leave to report as follows:

 

     The purpose and intent of this measure is to request the MedQUEST Administrator to convene a working group relating to complex patients.

 

     More specifically, the working group is requested to:

 

     (1)  Evaluate the issue of complex patients who are waitlisted in hospitals because of medical or behavioral health issues; and

 

     (2)  Consider solutions that include incentive or add-on payments to encourage the transfer of those patients out of hospitals and into more appropriate settings.

 

     Your Committee received written comments in support of this measure from The Queen's Health Systems, Kaiser Permanente, the Healthcare Association of Hawaii, Hawaii Pacific Health, the American Organization of Nurse Executives Hawaii, and Castle Medical Center.

 

     Your Committee finds that there are hospitalized individuals who have recovered sufficiently to no longer need the acute level of care that a hospital provides, but who still have complex medical or behavioral health needs that require intensive services.  These patients remain in hospitals for many weeks or months after the appropriate date of discharge because, due to insufficient reimbursements from Medicaid, necessary intensive services are often too costly for long-term care facilities to provide.  Therefore, these patients become "waitlisted" patients.  Your Committee also finds that according to a 2014 report, there were 7,055 waitlisted patients in Hawaii hospitals in 2011, who required care at an average cost of $1,404 per day, which resulted in a loss to hospitals of approximately $62,700,000 for that year. 

 

     Your Committee believes that transferring waitlisted patients to long-term care facilities would make more hospital beds available to patients who actually need acute care services, while also freeing hospitals from the obligation to provide lower-reimbursement, long-term care services.  Your Committee therefore finds that it is appropriate to consider possible solutions that would facilitate the transfers.

 

     As affirmed by the record of votes of the members of your Committee on Ways and Means that is attached to this report, your Committee concurs with the intent and purpose of H.C.R. No. 161, and recommends its adoption.

 

Respectfully submitted on behalf of the members of the Committee on Ways and Means,

 

 

 

________________________________

JILL N. TOKUDA, Chair