Streamlined process could boost healthcare
 |
StoryChat: Comment on this story |
The governor and the state House have achieved a much-needed meeting of the minds on improving state regulation of new healthcare services.
A revised version of House Bill 1067, one that includes elements of the Lingle administration's proposed fixes to the certificate of need process, has crossed over to the Senate and has garnered support from important constituencies.
Most important among these are Neighbor Island elected leaders and grassroots backers who rightly believe that rural communities frequently are left out in the cold when key decisions are made about their health services.
The push to reform the certificate of need arose largely from the battle over a proposed second hospital for Maui, Malulani Health & Medical Center. But the focus of this bill properly shifts to a broader statewide concern: Review of new health services bogs down in red tape and ultimately becomes disconnected from the communities affected the most.
The bill would immediately establish a panel, appointed by the governor and legislative leadership, to study ways of reforming the certificate process. Its report is due before the next session.
Failing the enactment of the panel's proposals, the bill also proposes fixes that would take effect in 2009. These short-term improvements, culled from the governor's own legislation, were added:
Most importantly, the process would be winnowed by narrowing the categories of equipment and services requiring a certificate. Critics of the process point to cases where the equipment needing approval becomes obsolete by the time that approval is secured.
Emergency rooms, freestanding emergency care facilities and surface ambulance services would still need a certificate under this proposal.
All of these ideas have potential. The consumer who would be served by a new facility should be given full access to the decisionmakers and extraneous review should be eliminated, wherever possible.
The State Health Planning and Development Agency, which reviews certificate applications, should be well represented on the panel evaluating these and other ideas.
But let's get the examination of this system under way. The quality of health services available for rural communities has been in free fall for years. These people shouldn't be left languishing endlessly in the "waiting room."
