Long-term Care; Demo. $

Appropriates funds to establish a long-term care managed care
waiver. (SD1)

THE SENATE                              S.B. NO.           S.D. 1
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  The legislature finds that long-term care is a
 2 critical issue of particular importance to Hawaii, where there is
 3 a shortage of nursing home beds, and where home and
 4 community-based programs are fragmented and non-existent in some
 5 areas.  To address these growing concerns, the State needs to
 6 examine alternative ways to administer long-term care, which will
 7 minimize the need for new long-term care beds and control
 8 ever-increasing costs, while providing a more favorable
 9 environment for Hawaii's elderly.
10      The legislature further finds that one viable option is the
11 non-institutional means of providing long-term care.
12 Establishing such a long-term care demonstration project will
13 offer Medicaid recipients the opportunity for home and
14 community-based services, and address the need to decrease the
15 burden on the State, hospitals, nursing facilities, and the
16 elderly and their families.
17      The legislature believes that the State's MedQuest program
18 has demonstrated that savings can be accomplished in an acute
19 care Medicaid program by using managed care companies to deliver

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                                     S.B. NO.           S.D. 1

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

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                                     S.B. NO.           S.D. 1

 1           (A)  Identification of preliminary resource needs;
 2           (B)  Development of a workplan for the design and
 3                implementation of a Medicaid managed long-term
 4                care demonstration project; and
 5           (C)  Development of a list of changes to current
 6                infrastructure that may be necessary to
 7                accommodate a Medicaid managed long-term care
 8                demonstration project.
 9      SECTION 3.  The sum appropriated shall be expended by the
10 department of human services for the purposes of this Act.
11      SECTION 4.  This Act shall take effect on July 1, 1999.