Women’s Health and Other Health Matters
By Hawaii State Senator Will Espero
I’ve talked before about how during Interim – the period between the Sessions when bills are deliberated and acted on – is the time when legislators meet with businesses, agencies and individuals to hear what you think should be done to improve life in Hawaii. The subject of health demonstrates the spectrum of problems the community brings to our attention and how they think the issue should be addressed. These are some of the many ideas that my colleagues and I heard about and supported this past Session.
Health Specific
Cancer. Acknowledging that breast and cervical cancer are leading causes of death among women, and ones that can be treated successfully if diagnosed early, the Legislature asked the Governor’s Office to create a cancer screening program for women aged 50 to 64 years who are low income or have no or insufficient health insurance. Most women have these screenings as part of their insurance plan’s preventive health benefits. Senate Resolution (SR) 137 / Senate Concurrent Resolution (SCR) 213.
Perinatal Care. The Legislature gave $200,000 to create a pilot perinatal clinic to promote healthy babies. SB 1115
Shaken Baby Syndrome. Senate Bill (SB) 1750 / Act 216 authorizes hospitals to provide parents with educational materials produced by nonprofit organizations about the dangers of shaken baby syndrome and how to prevent it.
Pneumococcal Vaccination. The Legislature asked the Department of Health to consider whether immunization for pneumococcal disease should be required for children entering child care. SCR 202 / SR 129
Access to Care
Rural Areas. Many physicians have their practices in cities where they can expect a high number of patients. This leaves rural areas with chronic shortages of doctors, and residents in these areas with lack of access to medical care they need. The Legislature appropriated $1.5 million to the John A. Burns School of Medicine’s Family Medicine Residency Program to train doctors in rural areas, making medical care available and giving new doctors the chance to experience practicing and living in these parts of islands. Another $2.5 million for the following year will be used to expand the program statewide. House Bill (HB) 1477 — The Legislature also encouraged the counties to form partnerships with the private sector and the state to cover health care infrastructure and overhead costs for primary care and specialty physicians who practice medicine in rural areas. SCR 197 / SR 126
Continued access to physicians. Many physicians feel they cannot afford to accept Medicare patients because the federal reimbursement is so much lower than their customary charges for the services they render. To keep doctors from turning away patients for this reason, the Legislature asked Congress to re-evaluate the formula for computing Medicare payments to doctors or to take other measures to avert future reductions in Medicare funding. SCR 33 – The Legislature also asked Congress to evaluate the computation of payments to factor in regional differences in the costs of living and reduce the disparity in reimbursement rates between areas with comparable costs of living. SCR 217 / SR 141
Mental health. Mental health services are also in short supply in rural areas. To try to improve the availability of treatment, the Legislature granted the authority to prescribe medicines for treating mental illness to staff psychologists working at federally qualified health centers in rural areas. This prescriptive authority will be given after a strenuous series of patient safeguards is satisfied, among them, a rigorous training and practicum program, and medical supervision of the treatment regimen. The Governor, however, vetoed this bill. SB 1004 — She did sign into law, however, the bill that grants Advanced Practice Registered Nurses in public assistance programs the authority to prescribe medicine to treat mental illness. HB 426 / Act 39 — To increase the numbers of practitioners available to treat patients, the Legislature allowed alternatives for satisfying the practicum and post-graduate requirements for licensing qualified mental health providers. SB 667 / Act 252 — Alcohol and drug abuse treatment or mental health treatment rendered by licensed marriage and family therapists will now be covered insurance benefits. SB 53 / Act 38
Affordability
The affordability of medical services and prescriptions is a prime issue, but one set within the complexities of private insurance plans, government programs, and private sector interests dealing with actuarial predictions, actual costs paid, industry growth and other factors.
Insurance Premiums. Health insurance is the primary means of affordability. Our market is still not as wide open as it is on the mainland. To protect businesses and residents against rates that are excessive or burdensome, the Legislature re-established regulation of insurance premium rates. SB 12 / Act 175
Congress. The Legislature asked Congress to evaluate and take action on payment aspects of the Medicaid and Medicare programs. HCR 141 urged Congress to authorize the federal Department of Health & Human Services to negotiate lower prescription drug prices for Medicare patients. SCR 33 / SR 15 requests Congress to ensure that government payments for doctor’s services keep up with inflation so that doctors can still afford to treat Medicare patients.
Prescription prices. The RX Plus Program is intended to provide Hawaii residents the medicine they need at reasonable prices. Drug manufacturers or labelers participating in the Rx Plus Program are required to enter into agreements with the State so that prescriptions are priced equal to or less than prices provided to the federal government. HB 10
You can reach the office of Senator Will Espero by telephone at 586-6360, fax at 586-6361, or e-mail at senespero@capitol.hawaii.gov. Senator Will Espero represents Ewa through lower Waipahu. He is the Chair of the Public Safety Committee, the Vice Chair of the Economic Development and Taxation Committee, and a member of the committees on Commerce, Consumer Protection, & Affordable Housing, and Transportation & International Affairs.