Hospital reforms
on hold pending
more discussion
Testimony on the subject
By Helen Altonn
'raised more questions and
confusion than answers'
Star-BulletinBills seeking changes in operation of the state hospitals have been deferred by the House Health Committee, with Chairman Alex Santiago suggesting "a step back." Hearing testimony on the measures yesterday, he said it raised "more questions and confusion than answers and clarification."
Santiago said he anticipates passing some bills this session, but more discussion is needed first.
The Hawaii Health Systems Corp. is seeking an additional $15.5 million in state funding for the next year on top of $8 million in emergency money provided by the last Legislature.
Thomas Driskill Jr., corporation president and chief executive officer, said the first words said at legislative hearings are: "Don't ask for money." But additional state funding is necessary to maintain services at the 13 state hospitals.
Salaries are paid every two weeks, Driskill said. After meeting the $5.5 million payroll Monday, he said the corporation "had about $1 million in wiggle room."
The corporation didn't have enough money for salaries in December and went into deficit, he said.
Driskill said the hospital system is "a safety net" for rural residents and all the services are needed. But, "the money isn't there."
"Everybody's got to take a good hard look and tell me what we can afford," he said. "We're not talking about selling cars. We're talking about saving lives."
The corporation also is seeking more flexibility and autonomy, including authority to manage its personnel system. It can't establish or control positions and has no voice in collective bargaining, Driskill said.
The corporation must have autonomy to deal more directly with labor issues so it can control labor costs -- about 60 percent to 65 percent of expenses, Driskill said.
But a bill allowing the creation of seven new bargaining units for hospital employees ran into a union wall.
Gary W. Rodrigues, United Public Workers state director, said in written testimony that the HHSC "was given the responsibility to manage the entire statewide health system, not to divide the system. If the HHSC cannot perform as required, the corporation should be dismantled."
Wayne Yamasaki, deputy director of the Hawaii Government Employees Association, said:
"It was never intended that the corporation would have the authority to negotiate directly from the executive branch, and particularly not for newly created bargaining units."
Yamasaki, state Budget Director Earl Anzai and others urged that the Legislature continue to oversee the hospital system.
More lives saved if defibrillator users are
By Pat Omandam
freed of liability, bill's proponents say
Star-BulletinA Senate bill that would exempt from liability anyone who uses an automatic external defibrillator during emergencies could lead to more people saving more lives, say Hawaii's doctors. Dr. Stephen J. Wallach, legislative committee chairman of the Hawaii Medical Association, said the bill would expand the use of defibrillators by enabling people such as lifeguards, flight attendants and security guards to use the device.
Advanced technology has brought a new wave of defibrillators that are much easier to use, and therefore, make extensive training unnecessary, he said.
"There are many more people who could and should be trained to use AEDs so that more lives can be saved," Wallach said in written testimony.
Senate Bill 2389, heard yesterday by the Senate Health and Environment Committee, would grant immunity to people who, after completing a training program administered by a Hawaii licensed physician, use the lifesaving device in good faith to render aid during an emergency situation.
The committee will vote on the measure sometime next week.
Dr. William M. Dang Jr., a cardiologist and president-elect of the American Heart Association-Hawaii, said ventricular fibrillation -- the most common arrhythmia that causes cardiac arrest -- is a condition in which the heart's electrical impulses become chaotic, causing the heart to stop.
Victims die within five to seven minutes unless responders restore a normal heart rhythm.
Lawmakers urged
By Debra Barayuga
to reduce class sizes
Star-BulletinState lawmakers should look at reducing class size for special education students, a teachers union representative said. The Senate Education Committee on Wednesday heard testimony on a bill that would revert the student-teacher ratio in grades K through 2 to what it was the year before -- 20 to 1 -- and appropriate funds for implementation. The bill also asks that the student-teacher ratio for grades 3 through 12 not exceed 26 to 1.
The bill would also count special education students, regardless of how much time they spend outside of a regular education classroom, as one full-time student.
The Legislature last year raised the ratio for grades K through 2 to 21 to 1.
Staffing for special education students is based on the department's standard ratio of staffing regular education classrooms: at 26 to 1, said Eric Nagamine, chairman of the Hawaii State Teachers Association's state political action committee. There needs to be equity in accommodating special education students, particularly if federal law requires they be educated in the least restrictive environment, he said.
Schools chief Herman Aizawa said the department supports the measure and is encouraged that it also gives special education students equal weight as regular education students in determining allocation of teachers.
"This measure will provide the staffing resources needed to adequately service special education students in regular education classes," he testified.
Aizawa estimated the department will need at least $3.4 million to pay teachers to accommodate the reduced student-teacher ratio.
The measure states that funding will not be used for administrative purposes. If schools do not have extra rooms for additional classes created by the reduced student- teacher ratio, the money will go to the schools to decide how best to reduce class size.
$4 million from state could buy
By Pat Omandam
some disabled more freedom
Star-BulletinLike many teen-agers, Joshua Smalley-Bower wants a job and maybe a girlfriend; but mainly, he wants a chance to lead a better life. Unlike most 17-year-olds, however, the Honolulu resident suffers from spina bifida, a disability that makes him unable to turn or lift himself, leaving him bound to a wheelchair.
"Right now, the only people who help me are my mother and father," Smalley-Bower told the Senate Health and Environment Committee yesterday.
"They do all they can for me, and I am grateful, but I want my own life," he said.
Smalley-Bower is among hundreds of people on a waiting list to enter a support program that allows those with developmental disabilities to be independent, productive and an active part of the community.
He urged lawmakers to forward two bills that would provide $4 million in state matching money to the federal Medicaid Home and Community-Based Services waiver program. Passage of Senate bills 2348 and 2455, he said, would help him lead a fuller life, as well as give his parents some much deserved help.
"We love Joshua with all our heats and wouldn't trade him for the world, but we would love a break so we can breathe again," said his mother, Helen Smalley-Bower.
Health co-chairman Andrew Levin (D, Volcano) said the two bills will be voted on at a hearing next Tuesday.
While it may be easy to pass it through his committee, Levin said the hard part will be to secure funding in the Senate money committee, where it must compete for limited state dollars.
The state departments of Health and Human Services implemented the waiver program in 1983.
Today, there are 1,200 people in Hawaii who are eligible for the program, and a minimum of 430 people on the waiting list.
Services provided include supported employment, respite care, skilled nursing, specialized services and habilitation.
Diana C. Tizard, executive director of the State Planning Council on Developmental Disabilities, said 976 people with developmental disabilities will be served by the program in fiscal year 1998-99 -- an increase of 206 from this fiscal year.
