Health reform bills may miss deadlines and fail to advance

‘Persistent, consistent effort’ needed for change — Bertram

By CLAUDINE SAN NICOLAS, Staff Writer
HONOLULU — It appears none of the legislative proposals recommended by a special Maui health care panel will be approved this year.

Although some of the bills cleared an initial committee hurdle in the House, those measures have not made it through the key House Finance Committee. In the Senate, none of the bills has met a deadline to advance in this session.

“I’m sad,” said South Maui state Rep. Joe Bertram III, who crafted bills based on a more than 100-page report by the Maui Health Initiative Task Force.

On the Senate side, Maui Sens. Roz Baker, Shan Tsutsui and J. Kalani English also introduced several pieces of legislation based on four months of work by the special task force.

“I know the folks are disappointed,” Baker said.

The Maui Health Care Initiative Task Force was established during the last leg-

islative session in an effort to identify the county’s pressing health care needs and possible solutions to address them.

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The special panel was made up of 15 citizens, some of them with expertise in health care and others who have become vocal advocates for improved medical services and facilities in Maui County.

“It’s disappointing that we haven’t had a chance to explain our work,” said task force Chairwoman Rita Barreras.

The panel had recommended a variety of legislative proposals to address a number of issues, such as tort reform, health insurance reimbursements for medical services and a revamping of the controversial certificate of need process to allow greater home rule in island communities.

A group of Maui residents has been particularly vocal about amending or doing away with the current system of reviewing proposed medical facilities and services through the certificate of need process, which is managed by the Oahu-based State Health Planning and Development Agency.

The Maui task force recommended legislation that would give more home rule to island communities affected by proposed medical facilities and services.

To accomplish that, Bertram and West Maui state Rep. Angus McKelvey co-sponsored House Bill 3326. But it stalled after advancing to the Finance Committee.

This past week, Bertram reported the proposal was stalled in the House Finance Committee without a chance of moving, in part, because the Senate version of the same idea introduced by Baker, English and Tsutsui, never got a hearing by the Senate’s Health Committee.

House Bill 3326 proposed to establish regional governing panels to review proposed health care facilities and services. The regional panels would eliminate the current subarea councils representing the various counties, the Statewide Health Planning Council and the Certificate of Need Review Panel.

The current multilayered system has come under fire during the last two years because of the state’s rejection of a permit that would have allowed the proposed Malulani Health and Medical Center to proceed in Kihei. When the certificate of need was denied, the proposed private 150-bed hospital project was abandoned.

This past week, members of the Association for Improved Healthcare on Maui continued to push hard with hundreds of e-mails, personal appearances and telephone calls into the Capitol for a Senate hearing on a separate measure that called for the repeal of the certificate of need law. They were unsuccessful.

The certificate of need regional panel idea was sort of a compromise, and what Baker called “a reasonable approach” to adjusting the certificate process so that islands could be more empowered with decisions affecting new health care proposals.

“Every county deserves to decide its own fate,” said Elaine Slavinsky, the chairwoman of the Tri-Isle Subarea Health Council for Maui County. She said she was “very disappointed” that the regional certificate of need panels proposal did not gain widespread legislative support.

Barreras said she hopes she and her fellow task force members get a chance to at least provide a briefing to the state legislators, given that the lawmakers charged them with compiling a Maui health care report for the Legislature.

“We’re still expecting a communication from Senator (David) Ige,” Barreras said, referring to the chairman of the Senate Health Committee. Ige did not respond to a Maui News telephone call or e-mail seeking comment.

Bertram said he appreciates the work the task force has put into researching the county’s health care problems and studying its possible solutions, including change in legislation. “I can say, ‘Thank you very much.’”

(The task force’s report is available for viewing at the State Health Planning and Development Agency Web site at http://http://hawaii.gov/health/shpda.'>http://hawaii.gov/health/shpda.)

Bertram said he hopes the health task force, which by law remains as an official state panel until June 30, will continue to try to make in-roads with changes in the certificate of need process, perhaps working with the subarea councils or the State Health Planning and Development Agency in reviewing possible changes in the criteria for a certificate.

“It’s better than crying,” Bertram said. “At this point, it our best chance at any kind of reform.”

A legislative change could still come in the future, Bertram said. “I just think it’s going to take a persistent, consistent effort.”

• Claudine San Nicolas can be reached at claudine@mauinews.com'>claudine@mauinews.com.