Report Title:

Medicaid Programs; Appropriations

 

Description:

Appropriates funds for the Residential Alternative Community Care Program (RACCP), the Chore Services Program, and Medicaid- waiver programs, under the Department of Human Services.

THE SENATE

S.B. NO.

884

TWENTY-SECOND LEGISLATURE, 2003

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

MAKING APPROPRIATIONS FOR MEDICAID PROGRAMS.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that the cost of providing long-term care in an institution can be prohibitive; as a result, the department of human servicesí adult and community care services branch seeks alternative community-based treatment milieus that provide individuals with appropriate levels of care at a cost savings of about 50% per person per year. The residential alternative community care program (RACCP) under the department of human services provides qualified individuals with placements in community-based residential facilities, including adult foster homes, adult residential care homes, and assisted-living facilities, as a less costly alternative to institutional care. These individuals are medicaid-eligible adults who require nursing-facility level care and are not able to benefit from in-home services because they have no caregiver or residence. RACCP provides a broad array of services, including personal care, homemaker services, transportation, respite, and day health services. RACCP is a federally-approved medicaid home and community-based waiver program that is jointly funded by the federal government and the State.

The legislature further finds that the lack of State match dollars has resulted in the State's inability to provide services to the maximum approved client limits, leaving a portion of the federal funding unused. Because the RACCP has grown rapidly, from 284 individuals served in fiscal year 1999-2000, to 814 individuals in fiscal year 2002-2003, Hawaii has received federally-approved funding to serve 1,268 individuals in fiscal year 2003-2004, and 1,902 individuals per year in fiscal years 2004-2005 and 2005-2006. However, with no projected increase in state funds, the projected target population would be 782 in fiscal year 2003-2004 and 1,032 individuals per year in fiscal years 2004-2005 and 2005-2006. The additional funds would allow RACCP to provide services to an additional 1,740 individuals, thereby satisfying the waiver client limits, maximizing federal reimbursements, and negating potential litigation resulting from unnecessary institutionalization.

The legislature further finds that the department of human services is designated the single state agency to administer funds for the federal medicaid program, including medicaid home and community-based waiver services programs such as RACCP. The federal Centers for Medicare and Medicaid (formerly known as the Health Care Financing and Administration) now requires the State to process all medicaid payments through a federally approved claims system. To address the federal requirement, the department of human services, in November 2002, implemented the Hawaii prepaid medicaid management information system for the purpose of processing medicaid waiver claims, at an annual cost of $500,000.

The legislature further finds that the department of human services administers the chore services program (program) that provides essential housekeeping services to enable eligible disabled clients to remain living in the community. Clients employ their own service providers who are paid minimum wage. The program is funded on a matching basis with federal moneys.

The legislature further finds that increases in the minimum wage in 2001 and 2002 have resulted in unanticipated program costs without a concomitant increase in funding levels. As a result, the program has been closed to new admissions since August 2001. Because no new clients have been admitted to the program in nearly eighteen months, an estimated 868 individuals are now on the wait list for chore services. These individuals may be forced to utilize more costly care options, including utilizing medical and hospital services or institutionalization. The legislature believes that it is imperative for the State to provide its share of matching dollars to enable the program to continue and to serve new applicants.

The purpose of this Act is to make appropriations for the residential alternative community care program, Hawaii prepaid medicaid management information system, and chore services program.

SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $5,616,844, or so much thereof as may be necessary, for fiscal year 2003-2004, and the same sum, or so much thereof as may be necessary, for fiscal year 2004-2005, for the residential alternative community care program.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $500,000, or so much thereof as may be necessary, for fiscal year 2003-2004, and the same sum, or so much thereof as may be necessary, for fiscal year 2004-2005, for the Hawaii prepaid medicaid management information system.

SECTION 4. There is appropriated out of the general revenues of the State of Hawaii the sum of $4,421,546, or so much thereof as may be necessary, for fiscal year 2003-2004, and the sum of $6,231,657, or so much thereof as may be necessary, for fiscal year 2004-2005, for the chore services program.

SECTION 5. The sums appropriated shall be expended by the department of human services for the purposes of this Act.

SECTION 6. This Act shall take effect on July 1, 2003.

INTRODUCED BY:

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