LTC; Demo. Project

Appropriates funds to establish a long-term care managed care
waiver. (HB545 HD1)

HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 1
TWENTIETH LEGISLATURE, 1999                                     
STATE OF HAWAII                                                 

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  Due to a shortage of nursing home beds and
 2 fragmented, and sometimes non-existent, home- and community-based
 3 services, the legislature finds that long-term care is a critical
 4 issue of particular importance to Hawaii.  To minimize the need
 5 for new long-term care beds and control ever-increasing costs,
 6 while providing a more favorable environment for Hawaii's
 7 elderly, the State needs to examine alternative ways to
 8 administer long-term care.
 9      The legislature further finds that one viable option is to
10 establish a long-term care demonstration project which would
11 offer Medicaid recipients the opportunity for home- and
12 community-based services, and address the need to decrease the
13 burden on the State, hospitals, nursing facilities, and the
14 elderly and their families.
15      The legislature believes that the State's Med-QUEST program
16 has demonstrated that savings can be accomplished in an acute
17 care Medicaid program by using managed care companies to deliver
18 high quality care.  A comparable model for long-term care would
19 be based on an integration of:

Page 2                                                     545
                                     H.B. NO.           H.D. 1

 1      (1)  Home- and community-based services;
 2      (2)  Long-term nursing facility care;
 3      (3)  Acute care systems;
 4      (4)  Respect for the dignity of the elderly;
 5      (5)  Integration of financing;
 6      (6)  Delivery of services;
 7      (7)  Consumer involvement in planning and monitoring; and
 8      (8)  Improvements in the quality of care.
 9      The 1998 legislature appropriated $40,000 to begin the
10 development of a managed long-term care demonstration project,
11 with matching funds of $40,000 from the federal government.  Much
12 remains to be done on this vital project.
13      The purpose of this Act is to continue the design and
14 implementation of a managed long-term care demonstration project.
15      SECTION 2.  There is appropriated out of the general
16 revenues of the State of Hawaii the sum of $200,000 or so much
17 thereof as may be necessary for fiscal year 1999-2000 to
18 establish a long-term care managed care waiver; provided that:
19      (1)  The funds shall be used to:
20           (A)  Review and update current information gathered to
21                date on state Medicaid managed care programs for
22                the provision of long-term care services; and

Page 3                                                     545
                                     H.B. NO.           H.D. 1

 1           (B)  Develop a planning document for the design and
 2                implementation of a Medicaid managed long-term
 3                care demonstration project, to include but not be
 4                limited to:
 5                (i)  Identification of preliminary resource needs;
 6               (ii)  Development of a workplan for the design and
 7                     implementation of a Medicaid managed long-
 8                     term care demonstration project; and
 9              (iii)  Development of a list of changes to current
10                     infrastructure that may be necessary to
11                     accommodate a Medicaid managed long-term care
12                     demonstration project;
13           and
14      (2)  No funds shall be made available under this Act unless
15           the federal government provides a dollar-for-dollar
16           match of funds for which this sum is appropriated.
17      SECTION 3.  The sum appropriated shall be expended by the
18 department of human services for the purposes of this Act.
19      SECTION 4.  This Act shall take effect on July 1, 1999.