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The Honolulu Advertiser
Updated at 11:20 a.m., Thursday, February 14, 2008

Home rule over healthcare could improve in Hawaii

By CLAUDINE SAN NICOLAS
The Maui News

HONOLULU — The state House Health Committee unanimously approved legislation Wednesday that would give more home rule to island communities affected by proposed medical facilities and services, The Maui News reported.

The measure advances to the House Finance Committee.

House Bill 3326, co-sponsored by state Reps. Joe Bertram III of Kihei and Angus McKelvey of Lahaina, was inspired by efforts to obtain new hospitals in South Maui and West Maui and aimed at improving the county's overall health care system by giving more influence over decision-making to county residents.

The bill would establish regional governing panels to review proposed health care facilities and services and it would eliminate subarea councils, the Statewide Health Planning Council and the Certificate of Need Review Panel.

The current Oahu-based, multilayered system has come under fire over the past 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.

Under existing rules, the State Health Planning and Development Agency administrator seeks the advice of the three separate panels before determining whether a new medical facility or service should receive the certificate to operate. Bill 3326 would eliminate those panels and replace them with regional oversight groups.

When Malulani's proposal was reviewed in 2006, the majority of the subarea council members recommended support for the Kihei facility, which Maui Memorial Medical Center officials opposed because, among other reasons, it would siphon patients away from the island's only acute-care hospital, which is in Wailuku.

Later, support for Malulani also came from Maui residents on two other review panels, but in each case they were outvoted by panel members who don't live on Maui.

Advocates for reform of the certificate of need statute said they believe Malulani would have had a stronger chance for approval if a regional council had been in place.

However, the SHPDA administrator makes the final decision on certificate approvals and is not required to follow any of the reviewing panels' recommendations.

Hermine Harman, a Maui Meadows resident, Malulani supporter and now a leader with People United to Support Superior Health Care, traveled to Oahu to testify in support of House Bill 3326.

"I believe the regionalization of the certificate of need is the best way to go," Harman said. "It needs to be local home rule."

On Wednesday, former state Sen. Jan Yagi Buen, a member of the Maui Health Initiative Task Force who worked on the certificate of need regional council recommendation, applauded the Health Committee's actions.

"I'm really glad," she said. "I believe it'll streamline the process and give the local people a voice. It's so important that we have a strong voice on our own health care."

While House Bill 3326 received a favorable review by the House committee Wednesday, another bill supported by some Maui residents — House Bill 2867 — failed to advance through the health panel. It would have repealed the certificate of need process and the law governing state health planning in the development of new hospitals and facilities.

Jan Shields of the Association for Improved Health Care on Maui said she's still hopeful that legislation to repeal the certificate of need process can be redrafted into another bill.

Shields encouraged residents to contact their House representatives and House Health Committee Chairman Dr. Josh Green to lobby for the legislation.

"It's going to depend on community support," she said.

Last month, the Maui Health Initiative Task Force issued findings and recommendations to the Legislature for improvements to Maui's overall health care system. Maui lawmakers in both the House and the Senate have drafted bills enact the task force's recommendations, including more home rule in House Bill 3326.

For more Maui news, visit The Maui News.