Daily Archives: March 17, 2009

Representative Jon Riki Karamatsu

Written Remarks into the House Journal

March 10, 2009; 26^th Day

Stand Comm. Report No. 906, H.B. 1782, H.D. 2, Relating to Health Information Exchange

I rise in support of House Bill 1782, House Draft 2, Relating to Health Information Exchange.  Mr. Speaker, we live in the digital age.  Technology has provided us with so many opportunities to better our knowledge, services that we provide, and even time management.   Likewise, technology has the ability to help us improve the quality and access to Hawaii’s healthcare.  By establishing a statewide health information technology system, we will be giving physicians tools such as immediate electronic access to patient medical records, which will allow them to read a patient’s full medical history, including medications, lab reports, and other relevant medical information that will ultimately lower the rate of medical errors and result in better patient care.

Both former President George W. Bush and President Barack Obama have publicly stated that every state needs to have a health information technology system by 2014.  The growing importance of health information technology is even evidenced in the 2004 creation of the Office of National Coordinator for Health Information Technology within the U.S. Department of Health and Human Services. 

Earlier this month President Obama appointed Vivek Kudra to be the Federal Chief Information Officer (CIO) for the United States of America.  Mr. Kundra was named by InfoWorld as one of the top 25 Chief Technology Officer (CTO) and was the 2008 Information Technology Executive of the Year.  In his role as the Federal CIO, Mr. Kundra hopes to change the federal government’s use of information technology by adopting consumer technology and ensuring that government data is open and accessible, while finding a balance of openness and accessibility with information security.

By establishing an Office of National Coordinator for Health Information Technology and a Federal CIO to take a role in the development and implementation of health information technology, the federal government is demonstrating their commitment to improving our country’s healthcare system.

Furthermore, the American Recovery and Reinvestment Act of 2009 appropriated $35 billion for information technology, $20 billion of which is dedicated to health information technology alone.  With the upcoming availability of the federal economic stimulus funds for health information technology, it would be in our best interest to take advantage of these funds to implement a program that the federal government has mandated us to be on within the next five years.

Because of the 2014 deadline and the availability of the federal economic stimulus monies for health information technology beginning in 2011, it is even more critical that we take action to implement a health information technology system now.  By taking action on this measure and moving health information technology forward, we will be able to take advantage of a ten to one federal dollar match.  There is no better time to do this.

The private sector has already begun to make strides in the field of health information technology.  But in order to take advantage of these federal funds they will need the collaborative partnership of the state.  Introduction of this bill has begun to bring the public and private sector stakeholders together to further the dialogue on this new area of partnership and the commitment from all parties is strong.

Health information technology is an essential component to quality healthcare.  Passage of this measure will be one of the most important actions that we as a legislature take this year because we will be making new strides in healthcare, creating new jobs, and bringing in new federal funds.

The private sector and the federal government have recognized the value in health information technology.  It is time that we do too.  Together, in a collaborative partnership with the federal government and the private sector we can make the bold step of modernizing our healthcare system.

I want to thank all of the involved state agencies and private sector partners for their enthusiasm and commitment to making health information a reality in Hawaii and for their continued partnership as this bill moves forward.  Thank you.

Representative Jon Riki Karamatsu

Written Remarks into the House Journal

March 10, 2009; 26^th Day

Stand Comm. Report No. 885, H.B. 617, H.D. 2, Relating to Mass Transit Route Economic Zones

I rise in support of House Bill 617, House Draft 2, Relating to Mass Transit Route Economic Zones.  This bill would create a task force to recommend parameters for the creation of mass transit route economic zones including eligibility, benefits, and incentives such as tax credits.  The task force shall report to legislature on their recommendation of the process to designate mass transit route economic zones and incentives to attract businesses and affordable housing to encourage ridership.  The policy goal is to make it very convenient for people who use mass transit to reside and do their errands, business, and social activities in the area of the mass transit stations.  With such an incentive, we can achieve a sufficient amount of mass transit ridership that will patronize businesses near the mass transit stations.  Thank you.

Representative Jon Riki Karamatsu

Written Remarks into the House Journal

March 10, 2009; 26^th Day

Stand Comm. Report No. 811, H.B. 625, H.D. 1, Relating to Surcharge for Indigent Legal Services

            I rise in support of House Bill 625, House Draft 1, Relating to Surcharge for indigent Legal Services.  The legislature finds that in the 2007 Assessment of Civil Legal Needs and Barriers of Low- and Moderate-Income People of Hawai‘i, four out of five low- and moderate-income residents did not have their legal needs met and that legal service providers are only able to assist one in three who contact them for assistance.

The legislature also finds that to increase the delivery of legal service, more funding is necessary.  Additional funds could be generated by increasing the surcharge for indigent legal services, as recommended by the Access to Justice Hui in its Community Wide Action Plan:  Ten Steps to Increase Access to Justice in Hawai‘i by 2010.

The legislature further finds that the Hawaii Consortium of Legal Services Providers has been working diligently to strengthen and increase outreach and services to low-income residents, and that each unique legal service provider requires a certain minimum amount of funding to meet basic expenses necessary to operate the respective non-profit organization or program.  Therefore, the purpose of this bill is to change the allocation formula so that thirty per cent of all funds distributed shall be provided equally to all organizations or programs that meet the qualifications for receipt of the funds, in addition to a seventy per cent distribution of all funds pro rata under the current formula.  Thank you.

Representative Jon Riki Karamatsu

Written Remarks into the House Journal

March 10, 2009; 26^th Day

Stand Comm. Report No. 723, H.B. 1784, H.D. 2, Relating to Medical Torts

I rise in support of House Bill 1784, House Draft 2, Relating to Medical Torts.  Mr. Speaker, there has been a disturbing trend over the years as more and more doctors either leave the islands or retire, leaving our residents with inadequate access to healthcare, if at all.  Our neighbor island residents especially suffer the unfortunate consequences of our growing lack of physicians.  There are several factors contributing to this mass exodus of doctors, including a high cost of living, low reimbursement rates, and high medical malpractice insurance premiums.

House Bill 1784, House Draft 2 attempts to address one of the main reasons that doctors claim is forcing them to leave our state.  This tort reform proposal originally offered a $250,000 cap on noneconomic damages, with a $3 million cap for gross negligence cases.  However, after careful consideration of the concerns expressed by the medical community, legal community and patient advocates, the Judiciary Committee has amended this measure to better reflect a more balanced approach to addressing tort reform.  More specifically we removed the specific award amount for noneconomic damages, included a provision to exclude the cap on noneconomic damages in cases where the economic damages are less than $1.5 million, removed the sections on attorney fees, periodic payments, admissible evidence, and the $3 million cap in cases of gross negligence, clarified the language in the adverse notification section, and established a medical malpractice task force and a medical malpractice rate and awards cap commission in order to best determine and regularly maintain the most reasonable, yet realistic medical malpractice insurance premiums and noneconomic damage caps possible.

And while your committee recognized the importance that the physician profile section brings in encouraging consumer awareness and protection, we felt that it was best not to jeopardize passage of this measure because of a potential title problem that the profiling section posed, and therefore, with the prior consent of your Health Chair, chose to delete that section.

The measure before us today is a well-thought out compromise that attempts to address the concerns of all affected parties based on factual research and best practices from other states, while keeping in mind the unique situation of our island state.  This measure also strives to bring all the affected stakeholders together to develop realistic solutions to the impending medical crisis we are facing.  Medical tort reform is a very complex and emotional issue that has gone unaddressed for years.  It is time that we bring the affected stakeholders and experts together to have an open and candid discussion about the actual reasons that are forcing our doctors to leave and what we can do to keep them here.  Without that discussion we will never truly find the solutions we need, which is why the establishment of this task force is so important.

In short Mr. Speaker, your Judiciary Committee recognizes the sensitive divide on this issue, the need to bring the affected stakeholders together for an open and honest discussion, and that even though this is only one of many different components affecting our state’s healthcare system, the critical need to move this measure forward for further discussion.

This measure in its current draft provides us with the opportunity to continue the meaningful policy discussions regarding doctor recruitment and retention and therefore, I ask my colleagues to support this measure so that these discussions may continue on in the Senate.  Thank you.