H.B. NO.



H.D. 1
















     SECTION 1.  The legislature finds that there is a shortage of health care professionals in the State and that this shortage is especially acute in rural areas.  According to the federal Health Resources and Services Administration, an entity of the United States Department of Health and Human Services, there were 17,657 geographic areas, populations, and facilities designated as having too few primary care, dental, and mental health care providers.

     In Hawaii, the Health Resources and Services Administration reported that the counties of Hawaii and Maui each have an average deficiency of twenty-five full-time health care service professionals, while the county of Kauai has a shortage of thirteen full-time health care service professionals.  These shortages are expected to worsen as physicians and nurses working in rural areas retire faster than new health care recruits can replace them.  Simultaneously, the population in the State's rural areas has increased in recent years, even as the State's overall population has seen a decline.  These two factors combined will lead to a worsening of the ratio between health care professionals to patients.  The legislature recognizes that as this ratio worsens, so may the quality of care for patients.

     To counteract this trend, there is a demand for an increase in health care facilities in the State's rural areas.  However, each new health care facility that opens must hire qualified health care professionals to staff the facility.  Unfortunately, this situation often results in the new facility seeking to hire professionals from existing facilities in the local area.

     The legislature finds that recruitment of this nature may adversely affect the quality of medical care at existing facilities by increasing the ratio of health care professionals to patients and forcing the facility to increase overtime or hire temporary staff to cover the resulting staffing shortfall.  The legislature recognizes that there is a demand for expanded health care services in rural areas; however, the legislature also recognizes that policies must be adopted to protect the viability and quality of existing health care services while not restricting the ability of new health care facilities to open in rural areas.

     The purpose of this Act is to require the state health planning and development agency to consider the relationship to the existing health care system of an area, including workforce availability, as part of its certificate of need review.

     SECTION 2.  Section 323D-43, Hawaii Revised Statutes, is amended by amending subsection (c) to read as follows:

     "(c)  The state agency may adopt criteria for certificate of need review [which] that are consistent with this section.  Such criteria may include but are not limited to need[,]; cost[,]; quality[,]; accessibility[,]; availability[,]; relationship to the existing health care system of the area, including the availability of workforce; and acceptability.

     Each decision of the state agency to issue a certificate of need shall, except in an emergency situation that poses a threat to public health, be consistent with the state health services and facilities plan in effect under section 323D-15.  Each certificate of need issued shall be valid for a period of one year from the date of issuance unless the period is extended for good cause by the state agency and expenditures for the project shall not exceed the maximum amount of the expenditures approved in the certificate of need."

     SECTION 3.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 4.  This Act shall take effect on July 1, 2050.



Report Title:

DOH; SHPDA; Health; Hospitals; Certificate of Need; Rural Areas; Workforce Availability



Includes the relationship to the existing health care system of an area, including the availability of workforce, as a criterion that the State Health Planning and Development Agency may adopt as part of its certificate of need review.  Effective 7/1/2050.  (HD1)





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