HO1752USE OF REPRESENTATIVES

H.B.  NO.

 

TWENTY-SEVENTH LEGISLATURE, 2014

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO HEALTH.

 

 

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

 


     SECTION 1.  (a)  The legislature finds that community health centers serve uninsured, underinsured, and low-income patient populations with demographic complexities and co-morbidities.  In addition, community health centers serve one-fourth of the State's medicaid members, and a substantial percentage of the State's homeless individuals and families, considering that forty-six per cent of the State's population is below two hundred per cent of the federal poverty level.  Community health centers:

     (1)  Are nonprofit, community-based organizations whose purpose and expertise is in providing quality person-centered health care to underserved populations and areas;

     (2)  Provide culturally and linguistically appropriate health care and a broad range of integrated primary care and preventive services;

     (3)  Operate in medically-underserved areas where people have limited access to other health care providers because of geographic and socio-economic barriers;

     (4)  Contribute greatly to the economies and livability of the communities they serve; and

     (5)  Are cost-effective quality health care providers whose care results in healthier patients and the decreased use of emergency, specialty, and in-patient services.

     Community health centers save the health care system $1,263 per patient annually due to timely, effective care and care management that reduces unnecessary emergency room and in-patient visits as well as the utilization of specialty care services.  This translated to savings of more than $182,000,000 in 2012.  Their patient-centered delivery system features: comprehensive primary medical, behavioral health, and dental services; care management and enabling services that enhance access, compliance, and patient engagement; and focus on quality outcomes supported by electronic health records that conform to meaningful use requirements.  Community health centers are also a smart investment that results in healthier communities while saving the state money.

     Implementation of the Patient Protection and Affordable Care Act has resulted in uncertainty for many individuals and has increased the number of uninsured patients.  Furthermore, as seen in Massachusetts following implementation of that state's landmark health reform law, Hawaii community health centers have similarly seen a twenty-five per cent increase in uninsured patients at their centers in 2012 as a result of the implementation of the Patient Protection and Affordable Care Act.  Over the past ten years, Hawaii community health centers have experienced a twenty-six per cent increase in uninsured patients and have endured a twelve per cent decrease in state health care funding for the uninsured.

     For the reasons set out above, it is imperative that the State provide support and resources that will synchronize the trajectory of community health center growth with the State's implementation of the Patient Protection and Affordable Care Act.

     The legislature also finds that it is in the best interests of the State to ensure access to primary, behavioral, dental, and preventive health care for its residents.  In addition to facilitating a healthier population, improving access to health care reduces state expenditures attributable to hospital and emergency room services for preventable injuries or illnesses.

     (b)  The legislature finds that the State's federally-matched medicaid and Med-QUEST programs form an essential support for underserved individuals and for community health centers.  Among the medicaid programs that need to be fully funded are dental benefits for adults and outreach and enrollment services.

     Oral health is as important as any other physical or mental health need, and dental diseases contribute to cardiac health and premature births.  Unaddressed dental needs affect the ability of individuals to obtain and keep employment.

     Med-QUEST programs offer insurance options for low-income, uninsured citizens.  Under the Patient Protection and Affordable Care Act, such programs will expand to accommodate additional uninsured adults.  It is in the best interests of the State to ensure that community programs reach out to and assist individuals and families with children to enroll in Med-QUEST and other social support programs for which they are eligible.

     (c)  Accordingly, the purpose of this Act is to provide quality, cost-effective health care for Hawaii residents who are uninsured, newly insured, underinsured, potential medicaid enrollees, or medicaid enrollees.

     SECTION 2.  There is appropriated out of the general revenues of the State of Hawaii the sum of $6,000,000 or so much thereof as may be necessary for fiscal year 2014-2015 for the provision of direct health care for the uninsured and underinsured, which may include primary medical, dental, and behavioral health care; provided that distribution of funds may be on a "per visit" basis and may include an additional per member per month quality incentive payment, taking into consideration the need on all islands.

     The sum appropriated shall be expended by the department of health to provide resources to federally qualified community health centers for the provision of health care for uninsured and underinsured persons.

     SECTION 3.  There is appropriated out of the general revenues of the State of Hawaii the sum of $4,800,000 or so much thereof as may be necessary for fiscal year 2014-2015 to restore basic adult dental benefits to medicaid enrollees; provided that no funds appropriated under this section shall be expended unless the department obtains the maximum federal matching funds available for this expenditure.

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

     SECTION 4.  There is appropriated out of the general revenues of the State of Hawaii the sum of $800,000 or so much thereof as may be necessary for fiscal year 2014-2015 to provide outreach and eligibility services, including medicaid and children's health insurance programs eligibility, for children, families, and individuals at federally qualified health centers; provided that no funds appropriated under this section shall be expended unless the department obtains the maximum federal matching funds available for this appropriation.

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

     SECTION 5.  There is appropriated out of the general revenues of the State of Hawaii the sum of $2,000,000 or so much thereof as may be necessary for fiscal year 2014-2015 to establish health care homes in medicaid as provided in the Patient Protection and Affordable Care Act; provided that no funds appropriated under this section shall be expended unless the department obtains the maximum federal matching funds available for this appropriation.

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

     SECTION 6.  There is appropriated out of the community health centers special fund the sum of $2,000,000 or so much thereof as may be necessary for fiscal year 2014-2015 to be transferred to the department of human services to establish health care homes for medicaid enrollees at federally qualified community health centers as provided in the Patient Protection and Affordable Care Act; provided that no funds appropriated under this section shall be expended unless the department obtains the maximum federal matching funds available for this appropriation.

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

     SECTION 7.  There is appropriated out of the general revenues of the State of Hawaii the sum of $           or so much thereof as may be necessary for fiscal year 2014-2015 to provide behavioral health services at federally qualified community health centers.

     The sum appropriated shall be expended by the department of health for the purposes of this Act.

     SECTION 8.  This Act shall take effect on July 1, 2014.

 

INTRODUCED BY:

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Report Title:

Quality, Cost-Effective Healthcare; Appropriations

 

Description:

Appropriates funds to provide primary medical, dental, and behavioral healthcare to uninsured and underinsured patients and restores basic adult dental benefits to medicaid enrollees.  Appropriates moneys to community health centers to provide outreach and eligibility services as well as behavioral services and to establish health care homes for medicaid enrollees.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.