STAND. COM. REP. NO. 1146
RE: S.R. No. 110
Honorable Donna Mercado Kim
President of the Senate
Twenty-Seventh State Legislature
Regular Session of 2013
State of Hawaii
Your Committees on Health and Human Services, to which was referred S.R. No. 110 entitled:
"SENATE RESOLUTION URGING THE ESTABLISHMENT OF A WORK GROUP TO EXAMINE SOCIAL DETERMINANTS OF HEALTH AND RISK ADJUSTMENT FOR MEDICAID, GAP-GROUP, AND UNINSURED INDIVIDUALS,"
beg leave to report as follows:
The purpose and intent of this measure is to request the establishment of a work group to examine the social determinants of health and risk adjustment for Medicaid, gap-group, and uninsured individuals.
Your Committees received testimony in support of this measure from the Governor, Department of Commerce and Consumer Affairs, West Hawaii Community Health Center, Waimanalo Health Center, and Community Alliance for Mental Health.
Your Committees find that health is affected by social determinants of health, which have considerable bearing on individual and population health, more so than genetic disposition and traditional medical care. Many people are subject to multiple determinants, or risks, such as homelessness, language barriers, abuse, unemployment, poverty, and lack of transportation at any given time, and social determinants of health complicate the ability to address individual and community health concerns and pose challenges to patients and providers in identifying, assessing, and treating health problems.
Your Committees also find that social determinants of health and other enabling services, including care coordination, often result in costlier preventable health care costs such as hospitalizations and emergency department utilization. Health care costs can be reduced with improved access to primary care services and risk adjustment for social determinants of health and other enabling services. Your Committees further find that the Medicaid, gap-group, and uninsured populations have significant socio-economic pressures, and addressing them will show measurable improvement in preventable health care costs. As a result, your Committees request the establishment of a work group to examine the social determinants of health and risk adjustment for Medicaid, gap-group, and uninsured individuals.
Your Committees have amended this measure by:
(1) Adding a description of the gap-group that was created on July 1, 2012, when individuals and families with incomes between one hundred thirty-three and two hundred percent of the poverty level were dropped from Medicaid coverage;
(2) Adding a representative from a consumer health advocacy organization to the work group;
(3) Expressly directing the work group to examine Medicaid services and health plans; and
(4) Making technical, nonsubstantive amendments for the purposes of clarity and consistency.
As affirmed by the records of votes of the members of your Committees on Health and Human Services that are attached to this report, your Committees concur with the intent and purpose of S.R. No. 110, as amended herein, and recommend that it be referred to the Committee on Ways and Means, in the form attached hereto as S.R. No. 110, S.D. 1.
Respectfully submitted on behalf of the members of the Committees on Health and Human Services,
SUZANNE CHUN OAKLAND, Chair
JOSH GREEN, Chair