This year's administration bill allows the agency to cut red tape and streamline it's processes. It allows the agency to evolve with the health care environment to one more adaptable to a managed care environment. It will bring into greater balance the agency's focus on cost containment, access and quality or care issues in the State's health planning activities. Access and quality of care become increasingly important policy concerns for government as health care moves more into managed. care. This bill also reflects the increased emphasis on primary care which accompanies the managed care environment. The bill liberalizes certain provisions of the certificate of need (CON) program while promoting accountability and retaining meaningful community input so vital to the CON's function as an implementation tool for the planning and development of Hawaii's health care system.
This bill incorporates the recommendations of the SHPDA Task Force established by the Legislature in 1995. The specific language of the bill was generated in meetings between the administrator and a group of the agency's "customers" -- health providers which included representatives from: the Queen's Healthcare System, Kaiser Permanente, the Kapiolani Healthcare System, the St. Francis Healthcare System, Straub Hospital and Clinic, the Kuakini Healthcare System and the Rehabilitation Hospital of the Pacific.
The Chairpersons of the agency's councils are the pointpersons for legislation. All were briefed on legislation, discussed agency "housekeeping" matters, Hawaii health trends and other matters at a Chairs' meeting held in January by the administrator. Please contact your chairperson or the SHPDA administrator for updates on legislation.
We've moved.....the SHPDA office moved in December. We are now located in Capitol Center at 1177 Alakea Street in Suite 402. We apologize for any delays in response to your requests -- we were operating out of boxes for a few weeks and having a challenging adventure getting ourselves situated in our new surroundings.
* In October, the SHCC reviewed a standard application from PhyCor to merge with Straub. An administrative application was reviewed from Straub to form a new entity. Both received recommendations for approval.
* In November, the SHCC reviewed two MRI CON applications from Kauai. The Metecon application was recommended for approval. The Wilcox application was not.
* At the January meeting the SHCC reviewed an administrative application for Interim Health to re-acquire their Hawaii franchise. The SHCC recommended approval of this CON application. Review was waived on the KVMH CON application for a CT Scan as the application has received unanimous recommendations for approval at the SAC and CON Review Panel meetings.
* Hawaii Health Services and Facilities Plan (HSFP) -- the SHCC also receive a detailed overview of the complete overhaul of this document. The HSFP is making a significant shift in order to more effectively address the current health care environment. The SHCC's Plan Development Committee (PDC) is heading up this effort. The PDC is chaired by David Hill, administrator, Wahiawa General Hospital, and vice-chaired by Harvey Smith, chief operating officer, Kapiolani Healthcare System. Lead staffperson is Patricia Hunter. She may be reached at 587-0784.
* The SHCC also were updated on the activities of the subarea health planning councils (SACs) statewide.
The following are updates from the SAC chairpersons of their activities since the September SHPDA Update News.
Tri-Isle SAC Update -- Catherine Nobriga-Kim, Chairperson
* October 1996: Held a joint meeting between the Tri-Isle SAC and the Tri-Isle SAC Plan Development Committee to review the Health Services and Facilities Plan (HSFP) update of September 1996. Recommendations forwarded to the SHCC Plan Development Committee.
* November 1996:
- CON Administrative Review - Kahi Mohala - Licensure change from a therapeutic group home to a special treatment facility. Recommended approval.
- Reviewed and made recommendations to the October revision of the HSFP, which were forwarded to the SHCC PDC.
* January 1997: CON Administrative Review - The Maui Farms, Inc. - Licensure change from group foster home to a special treatment facility. Recommended approval.
* Continue review of revised HSFP.
Kauai County SAC Update -- Debbie Aipoalani, Chairperson
* October 1996:
- CON Review - Wilcox Memorial Hospital for a stationary magnetic resonance imaging (MRI) system. No recommendation.
- CON Review - Metecon, Inc. and Kauai Veterans Memorial Hospital for a mobile MRI system. No recommendation.
* November 1996:
- Reviewed and made recommendations to the October revision of the HSFP, which were forwarded to the SHCC PDC.
- Discussion about the Kauai SAC process in CON reviews.
* January: CON Review - Kauai Veterans Memorial Hospital (KVMH) for the establishment of X-Ray Computerized Tomography (CT) imaging services at KVMH. Recommended unanimous approval.
* Health Services and Facilities Plan (HSFP): Discussion by the Kauai SAC and the Kauai SAC Plan Development Committee on the HSFP is ongoing. Recommendations forwarded to the SHCC Plan Development Committee.
* The Garden Island Health Planning Committee (also serving as the Kauai SAC Plan Development Committee) completed work on Kauai's Health Priorities booklet, which was sent to the Kauai legislators and other key people. There are three legislative requests for the 1997 session, including two on dental health.
Windward Oahu SAC Update -- Ronald Hayashi, Chairperson
* No meeting in October 1996
* November 1996: Presentations by Dr. Susan Forbes of the Hawaii Health Information Corporation and Ken Yoshida of SHPDA on the types of data and information that are available for SAC planning efforts. Description of activities and interests in children with special needs by Kapiolani Medical Center's Dr. Louise Iwaishi and Willow Morton.
* January 1997: Presentation by Patricia Hunter of SHPDA on the Revised Health Services and Facilities Plan (HSFP) and the activities of the task group that is working on the Maternal and Child Health prototype chapter. Recommendations from SAC members on the revised HSFP forwarded to the SHCC PDC.
* Continue review of revised HSFP.
Oahuwide SAC Update
* CON Applications at the Oahuwide CON Review Committee from Pacific Medical Limited Partnership for the establishment of a mobile extracorporeal shock wave lithotripsy service on Oahu (recommended approval) and Hawaii Center for Children to establish and operate special treatment facilities for children and adolescents with mental/behavioral/developmental disorders on Kauai, Oahu, Maui, Molokai, and Hawaii (recommended disapproval).
[Note: There were no meetings held in December.]
Hawai'i County SAC Update -- Marni Herkes, Chairperson
1. CON reviews. October, recommended approval of Hawaii Center for Children, following lengthy public testimony; November, recommended approval of Bay Clinic's proposal for a community health center in Na'alehu, after public testimony unanimously in support of the application.
2. The Chair and members also discussed new clarifications regarding CON-related communications outside the context of public meetings.
3. Members reviewed the second draft of HSFP materials and made specific suggestions regarding a narrower focus for the document and discussed how to mesh Council plans with HSFP development.
4. In October and November, the Mental Health/Substance Abuse Committee discussed at length and made recommendations for approval of both the applications noted above; continued work on their legislative agenda; worked to ensure uninterrupted implementation of Kona Hospital plans for inpatient psychiatric services; heard reports regarding the interest of Kahi Mohala in starting a program for partial (day) hospitalization in Hilo; and learned of efforts by HMSA/Biodyne/CCS to develop a short stay urgent care residential facility (SSURF House). In December and January, the Committee arranged for update presentations on the Kona Hospital, day hospital and SSURF House projects, and learned of frustrations being experienced by the Hawai'i Island Psychologists' Association in working with QUEST requirements. They also finalized their legislative Findings and forwarded these to the SAC for review.
5. In January (no December meeting,) the SAC reviewed and endorsed the Committee's Findings, requesting that the Agency forward them to the legislature. Members also planned a series of informational presentations on selected aspects of health care, to increase their knowledge in conjunction with PDC updating of the HSFP. Chair M. Herkes also attended the Chairs' meeting on Jan. 15.
Central O'ahu SAC Update -- Jake Ng, Chairperson
1. In October, the Council followed up on the Honolulu City Council resolution regarding the Emergency Services System, which had passed all readings and would proceed to the Mayor for his signature.
2. A. Anderson and D. Hill represented the Council at the November 12 meeting of the O'ahuwide CON Review Committee.
3. In December (no November meeting,) members discussed informally their concern over social and health issues arising from recent cutbacks in QUEST enrollment and benefits. In January (no meeting,) A. Anderson represented J. Ng at the Chairs' meeting on the 15th.
Honolulu SAC Update -- Lane Uchimura, Chairperson
1. In November, (no October meeting,) members reviewed the second draft of the HSFP materials and expressed endorsement for the changes made. J. Walsh noted the interest of the PDC Task Group in focusing on two specific areas of healthcare and developing chapters for each according to the new guidelines.
2. Members discussed the implications of restrictions regarding CON-related communications outside the context of public meetings.
3. S. Kula and J. Walsh represented the Council at the November 12 meeting of the O'ahuwide CON Review Committee.
4. In January, (no December meeting,) members reviewed progress of the HSFP revision. Currently the task group is working to relate Hawai'i standards to national standards. The input of Kapi`olani Medical Center responds to the PDC's interest in having contributions from professionals with expertise in the subject area.
Wai'anae SAC Update -- Bette Larrabee, Chairperson
1. In October, (no November meeting,) members discussed the implications of restrictions regarding CON-related communications outside the context of public meetings.
2. B. Larrabee represented the Council at the November 12 meeting of the O'ahuwide CON Review Committee.
3. In December, (no January meeting,) members reviewed the progress and plans of the PDC relating to revision of the HSFP. B. Larrabee attended the Chairs' meeting on Jan. 15.
This initiative is in high-gear. As a result of intense brainstorming, the Plan Development Committee has designed an innovative and future oriented approach to the plan which places Hawaii miles ahead of any other state.
The Kapiolani Healthcare System is to be commended for volunteering their resources to develop the Plan's first prototype chapter. The enthusiasm of Harvey Smith and Creighton Liu and other staff is incredible. The chapter focuses on Maternal and Child Health Care. The prototype elegantly triangulates national performance indicators with the Hawaii experience and local concerns to arrive at performance monitors for the chapter.
Other providers have also volunteered their resources to develop other chapters. They are: Straub Clinic and Hospital -- Chapter on Heart disease; Kaiser Permanente -- Chapter on Diabetes and Chronic Disease; the Queen's Healthcare System -- Chapter on Cancer.
Once these chapters are drafted they will be distributed to the SACs for vital local area input.
Attached to this report is the schedule of meetings occuring.
CON Letters of Intent
1. Hilo Medical Center - medicare-certified hospice program. (Big Island)
2. Island Crisis Help - crisis shelter and short-stay residential facility in West Hawaii for serious mental illness persons. (Big Island)
3. St. Francis Medical Center - operation of Gamma Knife, a cobalt application for non-invasive treatment of brain tumors. (Oahu)
4. Therapists On Call and HomeCare On Call - for home care services. (statewide)
5. Ann Pearl Nursing Facility and Adult Day Health Center - redesignate a portion of existing ICF beds to SNF beds. (Oahu)
Undergoing CON Completeness Review
1. #97-04 Hawaii Radiologic Associates, Ltd. for an outpatient CT at Ponahawai Medical Center. (Big Island)
Scheduled for Review
1. #97-02A Consolidation of Hawaii Air Ambulance and Mercy's Ambulance Operations re-scheduled for review by the SHCC on April 24.
Review Completed
1. #96-43 Wilcox Hospital addition of Magnetic Resonance Imaging (MRI)
Kaua'i County SAC: no recommendation
CON Review Panel: recommend approval
SHCC: recommend disapproval
Administrator's decision: approved
2. #96-48 Hawaii Center for Children for therapeutic group homes statewide
Tri-Isle SAC: recommend disapproval
Kaua'i County SAC: recommend approval
O'ahuwide Review Committee: recommend disapproval
CON Review Panel: recommend approval
SHCC: recommend approval
Hawai'i County SAC: recommend approval
Administrator's decision: approved
3. #96-49 Metecon, Inc/Kauai Veterans Memorial Hospital addition of MRI
Kaua'i County SAC: no recommendation
CON Review Panel: no recommendation
SHCC: recommend approval
Administrator's decision: disapproved
4. #96-51 Kauai Veterans Memorial Hospital addition of CT Scan
Kaua'i County SAC: recommend approval
CON Review Panel: recommend approval
Administrator's decision: approved
5. #96-52A Leeward Nursing Home conversion of ICF beds to swing beds
O'ahuwide Review Committee: recommend approval
Administrator's decision: approved
6. #96-53 Kahi Mohala/Sutter Health/CHS Maui Therapeutic Group Home
Tri-Isle SAC: recommend approval
Administrator's decision: approved
7. #96-55A Kaiser Permanente to replace angiography equipment at Moanalua
O'ahuwide Review Committee: recommend approval
Administrator's decision: approved
8. #96-56A Bay Clinic, Inc. for a community health center in Na'alehu
Hawai'i County SAC: recommend approval
Administrator's decision: approved
9. #96-57A Straub Clinic & Hospital Spin-Off Transaction
O'ahuwide Review Committee: recommend approval
Administrator's decision: approved
10. #96-58 Merger of Straub, Inc. and PhyCor, Inc.
O'ahuwide Review Committee: recommend approval
CON Review Panel: recommend approval
Administrator's decision: approved
11. #96-59A Hospice Hawaii Honolulu Home
SHCC: recommend approval
Administrator's decision: approved
12. #96-60A Hospice Hawaii Central Home
SHCC: recommend approval
Administrator's decision: approved
13. #96-61 Hanamatsu-Queen's 32-ring PET Imaging Services
CON Review Panel: public information meeting
Administrator's decision: approved
14. #96-62A DASH - addition of methadone clinic in West Hawai'i.
Hawai'i County SAC: recommend approval
Administrator's decision: approved
15. #96-63A Maui Farm change in licensure to STF; add 15 beds
Tri-Isle SAC: recommend approval
Administrator's decision: approved
16. #97-01A Interim Home Health, Inc. acquisition
SHCC: recommend approval
Administrator's decision: approved
17. #96-64 Regency Care Center of Kahuku (aka) Alii Care - construction for a 120-bed SNF/ICF facility in Punalu`u.
Windward SAC: recommended approval with conditions
CON Panel: recommended approval
SHCC: recommended approval
Administrator's decision: pending
18. #97-03A Acquisition of International Life Support, Inc. (ILS) by way of merger of American International Life Support, Inc. and American Medical Response West, Inc.
SHCC: recommended approval
Administrator's decision: pending
Applications Withdrawn
1. #96-46 Lanakila Education and Development Services, Inc. (LEADS) ICF/MRC for DD/MR adults. (Maui)
2. #96-50 Aloha Certified Home Health Services, Inc. to establish a home health care agency. (Oahu)
3. #96-54 Mercy Air and Ambulance Joint Venture.
Reconsiderations
1. Request from Tomscott, Inc. dba Aloha Surgical Center, Kahului, Maui, regarding CON #96-16.
Request for reconsideration: approved
Result of reconsideration hearing: application approved
2. Request from Pacific Medical Limited Partnership Mobile Lithotripsy regarding CON #96-22 for mobile lithotripsy services on Oahu.
Request for reconsideration: approved
Result of reconsideration hearing: application approved
SURF the world wide web to our Web page at:
http://www.hawaii.gov/health/index.htm
* Home Health Care In Hawaii: 1995 Utilization and Estimation of Need, May 1996
* A Home Health Care Data Table
* State of Hawaii Utilization of Inpatient Facilities
by County - 1995
* State of Hawaii Certificate of Need Manual
* The Health Services and Facilities Plan for the State of Hawaii
* Big Island Health Care Needs Assessment and Recommendations
* Central Oahu Health Care Needs Assessment and Recommendations
* Garden Island Health Care Needs Assessment and Recommendations
* Tri-Isle Health Care Needs Assessment
* Acute Care Bed Projections for Year 1995 - 2010
* Long Term Care Bed Projections 1995 - 2010
* Certificate of Need - A Hawaii Review
* Kauai's Health Priorities - Legislative Requests
for the 1997 Session and Kauai's Health Service Priorities
Copies of the above publications are available for purchase or loan from the SHPDA office.
This newsletter and its back issues are available on our web page.
Confused by all the acronyms:
SHCC or HSHCC: Hawaii Statewide Health Coordinating Council
SAC: Subarea Health Planning Council
PDC: Plan Development Committee - a standing committee of the SHCC.
CON: Certificate of Need
SHPDA: State Health Planning and Development Agency
Marilyn Matsunaga, Administrator 587-0788
Amy Ichiyama, Secretary 587-0787
Ellyn Ortiz, Clerk-typist 587-0788
Patrick Boland, Regulatory Branch Chief 587-0785
Patricia Hunter, Health Planner 587-0784
John McCarthy, Health Planner 587-0850
Leatrice Tsubota, Health Planner 587-0851
Kenneth Yoshida, Research Statistician 587-0852
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© Wednesday, April 9, 1997 - 8:00 AM