HOUSE OF REPRESENTATIVES

H.C.R. NO.

221

TWENTY-NINTH LEGISLATURE, 2018

H.D. 1

STATE OF HAWAII

 

 

 

 

 

HOUSE CONCURRENT

RESOLUTION

 

 

REQUESTING THE DEPARTMENT OF HEALTH TO PRIORITIZE HAVING EACH OF ITS DISTRICT HEALTH OFFICERS BE A PHYSICIAN LICENSED TO PRACTICE MEDICINE UNDER PART I OF CHAPTER 453, HAWAII REVISED STATUTES.

 

 

 


     WHEREAS, a physician's knowledge and experience facilitate the day-to-day responsibilities of the Department of Health's district health officer position and allow the physician to serve as a dedicated community resource; and

 

WHEREAS, prioritizing the appointment of district health officers of the Department of Health who are physicians is extremely critical to the Department's ability to provide adequate community support, educate the community, and recognize the community's needs and concerns in the face of pressing public health issues; and

 

     WHEREAS, the Department of Health has long recognized that the district health officer in each of the three neighbor island counties should be a physician and, ideally, a physician with experience in community medicine who is also well-versed in public health; and

 

WHEREAS, for many years, the Department of Health's district health officers met these requirements, but at some point the County of Hawaii district health officer position was filled by a non-physician without medical experience or a master's degree in public health, who served as an acting district health officer for six years; and

 

     WHEREAS, by that point, rather than attempting to recruit a physician district health officer, the Department of Health created the new position of district health officer II (non-M.D.) to accommodate the existing non-M.D. district health officer; and

 

     WHEREAS, when the Department of Health's response to health problems in the County of Hawaii is compared to its response to health problems in the County of Maui, it is evident that health issues, including disease outbreaks, were addressed much more proficiently and with greater community satisfaction in the County of Maui, where the district health officer was a physician with a master's degree in public health; and

 

     WHEREAS, this disparity was clearly demonstrated in the Department of Health's response to two major public health issues: the 2002 dengue fever outbreak in the County of Maui versus the 2004 outbreak in the County of Hawaii; and the rat lungworm disease outbreak in Hana, Maui, versus the current crisis centered around the Puna district of the County of Hawaii, and in both instances, the Department's attention to and engagement with community members was much more effective in the County of Maui than in the County of Hawaii; and

 

WHEREAS, the Office of the Auditor conducted an audit of the Disease Outbreak Control Division of the Department of Health and the Division's responses to three disease outbreaks within the State, including the dengue fever outbreak in the County of Hawaii, and in Report No. 17-14, dated December 2017, concluded that the Disease Outbreak Control Division and the Department exhibited "an absence or a lack of adherence to plans, policies, and protocols, all of which provide disease response agencies with clarity and direction during the emergency conditions of an outbreak"; and

 

     WHEREAS, the Auditor also noted that the Disease Outbreak Control Division and the Department of Health were unable to provide "sufficient documentation of the analysis and discussions that occurred during the selected outbreaks.  Absent such information, we interviewed staff, as well as other key individuals involved, but found inconsistencies in their recollections of events and the details of their efforts during the selected outbreaks."; and

 

     WHEREAS, the members of the Hawaii County Council, recognizing the importance of having a physician in its district health officer position, have petitioned the Legislature to require that district health officers of the Department of Health be physicians; and

 

WHEREAS, the lack of a dedicated physician district health officer within the County of Hawaii may have contributed to some of the discrepancies and errors in the Department of Health's response to the 2004 dengue fever outbreak; now, therefore,

 

     BE IT RESOLVED by the House of Representatives of the Twenty-ninth Legislature of the State of Hawaii, Regular Session of 2018, the Senate concurring, that the Legislature requests the Department of Health to reinstitute the long-standing practice of having a physician in the role of district health officer by requiring that each district health officer of the Department be a physician licensed to practice medicine under part I of Chapter 453, Hawaii Revised Statutes; and

 

     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Director of Health and the Chairperson of the Hawaii County Council.

Report Title: 

Department of Health; District Health Officers; Physicians