Honolulu, Hawaii



RE:    S.B. No. 2397

       S.D. 1




Honorable Ronald D. Kouchi

President of the Senate

Twenty-Eighth State Legislature

Regular Session of 2016

State of Hawaii




     Your Committees on Judiciary and Labor and Human Services, to which was referred S.B. No. 2397, S.D. 1, entitled:




beg leave to report as follows:


     The purpose and intent of this measure is to require hospitals to adopt and maintain discharge policies to ensure that patients continue to receive necessary care after leaving the hospital.


     Your Committees received testimony in support of this measure from the State Council on Developmental Disabilities; Self-Advocacy Advisory Council; The Queen's Health Systems; Healthcare Association of Hawaii; Hawaii Pacific Health; Project Dana; International Longshore and Warehouse Union, Local 142; Policy Advisory Board for Elder Affairs; Kokua Council; Faith Action for Community Equity, Oahu Chapter; AARP Hawaii; and sixteen individuals.  Your Committees received comments on this measure from one individual.


     Your Committees find that Hawaii's population of older adults continues to increase.  In 2012, it was estimated that Hawaii had the highest percentage of residents over the age of eighty-five in the United States.  Over the next twenty years the percentage of Hawaii's residents over the age of eighty-five is projected to grow even higher.  These individuals are the most likely to need long-term supports and services and will likely rely on family and friends as their caregivers due to financial and resource constraints.


     Your Committees further find that while strong home- and community-based resources, such as respite, non-medical transportation services, and home-delivered meals, are important to help caregivers and their loved ones, medical supports are also important.  Coordination among primary care providers along with preventive care will enable many seniors and other individuals with chronic or debilitating conditions to stay in their homes longer.  However, in the event of an acute episode, hospitals must provide assistance to patients and their caregivers in order to prepare them for discharge and help them transition back to their homes.  This measure ensures that all patients in an inpatient hospital have the opportunity to designate a caregiver who shall be notified prior to the discharge or transfer of the patients, involved in discharge planning, and provided instructional support, to enable patients to transition back to their homes.


     Your Committees understand that designation of a caregiver prior to discharge from a hospital is an important step in helping to ensure the ongoing health care of a patient.  However, your Committees note that this measure does not include a process to allow for a caregiver, once designated, to later resign from that role due to the caregiver's own change in health of other circumstances, or due to a change in the condition of the patient that might require more intense or complex caregiving procedures than the designated caregiver is able to provide.  For the benefit of both the caregiver and the patient, your Committees encourage that this issue be discussed as this measure continues to move through the legislative process, and that further discussion include a provision to allow for a designated caregiver to resign from that role as the caregiver deems necessary and give due notice to the hospital.


     Your Committees believe that a written discharge policy including a designation of a caregiver complements and is consistent with existing standards for accreditation adopted by The Joint Commission or other nationally recognized hospital accreditation organizations or the conditions of participation for hospitals adopted by the Centers for Medicare and Medicaid Services.


     As affirmed by the records of votes of the members of your Committees on Judiciary and Labor and Human Services that are attached to this report, your Committees are in accord with the intent and purpose of S.B. No. 2397, S.D. 1, and recommend that it pass Third Reading.


Respectfully submitted on behalf of the members of the Committees on Judiciary and Labor and Human Services,