| 47 | | - | SECTION 1. The legislature finds that many Hawaii residents are unable to obtain timely and appropriate health care due to shortages of health care providers in the State. These shortages threaten individual health and cumulatively adversely affect the State's health care costs. The State's neighbor islands, which have been designated by the federal government as medically underserved areas, have been disproportionately adversely affected by shortages of physicians in all areas of practice. The John A. Burns school of medicine at the University of Hawaii at Manoa has engaged in strategies to increase the number of physicians in Hawaii by enrolling more students; rotating medical students to the neighbor islands for preclinical, up to twelve-week, rotations; developing longitudinal third-year rotation sites where a small number of students are in the same location for five months; developing a small number of sites for four-week fourth year clinical rotations; developing residency or fellowship rotations; and administering the Hawaii state loan repayment program that places recipients in medically underserved communities, especially the neighbor islands, among other endeavors. The legislature further finds that, according to the most recent data from the Hawaii physician workforce assessment project, the State has a shortage of five hundred thirty-seven full-time equivalent physicians. However, when island geography and unmet specialty-specific needs by county are examined, the estimated unmet need for full-time physicians increases to seven hundred thirty-two. Primary care, internal medicine, and some specialty physician shortages represent Hawaii's greatest area of need. Without these physicians, the people of Hawaii do not have access to the health care they need. At the John A. Burns school of medicine, eighty per cent of graduates who complete their medical school and residency training, also known as their graduate medical education, in the State remain in Hawaii to practice. The legislature also finds that medical residents who train on the neighbor islands are more likely to remain and subsequently practice on the neighbor islands. Expanding capacity for year-round neighbor island graduate medical education will therefore create a pipeline of new physicians positioned to initiate neighbor island practices. With a fully developed graduate medical education program for the neighbor islands, it will be possible to expand the State's neighbor island primary care, family medicine, internal medicine, and some specialty residencies. Current primary care residencies hosted in health systems on the neighbor islands would be leveraged for expansion of graduate medical education. The logistics of expanding medical school and residency training to the neighbor islands require that dedicated teaching faculty be hired to deliver and lead medical school and residency training. Funding is also required for student and resident support, including travel, housing, and other coordinated activities across all sites. The legislature notes that in Hawaii, graduate medical education costs are largely borne by the University of Hawaii and its affiliated health systems. Although some federal dollars have been used by the health systems to cover a portion of graduate medical education costs, the State can invest and expand medical school and residency training using newly available American Rescue Plan Act money. The legislature also recognizes the beneficial public outcomes that can be achieved by expanding capacity for training medical students and residents on the neighbor islands with the goal of having these students and residents ultimately remain in Hawaii to practice. The legislature also recognizes that ongoing funding of graduate medical education is vital to address the physician shortage in the State. The purpose of this Act is to appropriate funds to the University of Hawaii John A. Burns School of Medicine to expand graduate medical education programs to the neighbor islands. SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2022-2023 for the expansion of graduate medical education programs to the neighbor islands. The sum appropriated shall be expended by the John A. Burns school of medicine at the University of Hawaii at Manoa for the purposes of this Act. SECTION 3. This Act shall take effect on July 1, 2060. |
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| 47 | + | SECTION 1. The legislature finds that many Hawaii residents are unable to obtain timely and appropriate health care due to shortages of health care providers in the State. These shortages threaten individual health and cumulatively adversely affect the State's health care costs. The State's neighbor islands, which have been designated by the federal government as medically underserved areas, have been disproportionately adversely affected by shortages of physicians in all areas of practice. The John A. Burns school of medicine at the University of Hawaii at Manoa has engaged in strategies to increase the number of physicians in Hawaii by enrolling more students; rotating medical students to the neighbor islands for preclinical, up to twelve-week, rotations; developing longitudinal third-year rotation sites where a small number of students are in the same location for five months; developing a small number of sites for four-week fourth year clinical rotations; developing residency or fellowship rotations; and administering the Hawaii state loan repayment program that places recipients in medically underserved communities, especially the neighbor islands, among other endeavors. The legislature further finds that, according to the most recent data from the Hawaii physician workforce assessment project, the State has a shortage of five hundred thirty-seven full-time equivalent physicians. However, when island geography and unmet specialty-specific needs by county are examined, the estimated unmet need for full-time physicians increases to seven hundred thirty-two. Primary care, internal medicine, and some specialty physician shortages represent Hawaii's greatest area of need. Without these physicians, the people of Hawaii do not have access to the health care they need. At the John A. Burns school of medicine, eighty per cent of graduates who complete their medical school and residency training, also known as their graduate medical education, in the State remain in Hawaii to practice. The legislature also finds that medical residents who train on the neighbor islands are more likely to remain and subsequently practice on the neighbor islands. Expanding capacity for year-round neighbor island graduate medical education will therefore create a pipeline of new physicians positioned to initiate neighbor island practices. With a fully developed graduate medical education program for the neighbor islands, it will be possible to expand the State's neighbor island primary care, family medicine, internal medicine, and some specialty residencies. Current primary care residencies hosted in health systems on the neighbor islands would be leveraged for expansion of graduate medical education. The logistics of expanding medical school and residency training to the neighbor islands require that dedicated teaching faculty be hired to deliver and lead medical school and residency training. Funding is also required for student and resident support, including travel, housing, and other coordinated activities across all sites. The legislature notes that in Hawaii, graduate medical education costs are largely borne by the University of Hawaii and its affiliated health systems. Although some federal dollars have been used by the health systems to cover a portion of graduate medical education costs, the State can invest and expand medical school and residency training using newly available American Rescue Plan Act money. The legislature also recognizes the beneficial public outcomes that can be achieved by expanding capacity for training medical students and residents on the neighbor islands with the goal of having these students and residents ultimately remain in Hawaii to practice. The legislature also recognizes that ongoing funding of graduate medical education is vital to address the physician shortage in the State. The purpose of this Act is to appropriate funds to the University of Hawaii John A. Burns School of Medicine to expand graduate medical education programs to the neighbor islands. SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $6,700,000 or so much thereof as may be necessary for fiscal year 2022-2023 for the expansion of graduate medical education programs to the neighbor islands. The sum appropriated shall be expended by the John A. Burns school of medicine at the University of Hawaii at Manoa for the purposes of this Act. SECTION 3. This Act shall take effect on July 1, 2022. INTRODUCED BY: _____________________________ |
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