THE SENATE

S.B. NO.

2009

TWENTY-SEVENTH LEGISLATURE, 2014

S.D. 1

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO HEALTH.

 

 

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

 


     SECTION 1.  The legislature finds that community health centers serve uninsured, underinsured, and low-income patient populations with demographic complexities and co-morbidities, in addition to one-fourth of the State's medicaid members.  Community health centers:

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

     (2)  Provide culturally and linguistically appropriate health care and a broad range of integrated primary care and preventative 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 decreased use of emergency, specialty, and inpatient services.

     The legislature further finds that community health centers save the health care system $1,263 per patient per year due to timely, effective care and care management that reduces unnecessary emergency room, inpatient, and specialty utilization.  This translated to savings of more than $182,000,000 in 2012.  Community health centers' 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 a smart investment that results in healthier communities while saving the State money.

     Implementation of the federal Patient Protection and Affordable Care Act of 2010 has resulted in uncertainty for many individuals.  Furthermore, as seen in Massachusetts following implementation of that state's landmark health reform law, with the federal Patient Protection and Affordable Care Act of 2010 implementation, community health centers in Hawaii have seen a twenty-five per cent increase in uninsured patients in 2012.  Over the past ten years, Hawaii community health centers have experienced a twenty-six per cent increase in uninsured patients and weathered a twelve per cent decrease in state health care funding for the uninsured.

     For these reasons, 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 and its health care transformation efforts.

     The legislature further finds that it is in the best interests of the State to ensure access to primary, behavioral, dental, and preventative 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.

     The legislature additionally 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 issues 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 federal Patient Protection and Affordable Care Act of 2010, such programs expanded to accommodate additional uninsured adults.  It is in the best interest of the State to ensure that the 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.

     Accordingly, the purpose of this Act is to provide quality, cost-effective health care for Hawaii residents who are uninsured, newly uninsured, 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, including but not limited to 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 need on all the islands.

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

     SECTION 3.  There is appropriated out of the general revenues of the State of Hawaii the sum of $4,000,000 or so much thereof as may be necessary for fiscal year 2014-2015 to restore basic adult dental benefits to medicaid enrollees.  The department shall obtain 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 $320,000 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 program eligibility, for children, families, and individuals at federally qualified health centers.  The department shall obtain 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 5.  There is appropriated out of the general revenues of the State of Hawaii the sum of $2,016,000 or so much thereof as may be necessary for fiscal year 2014-2015 to establish health care homes in medicaid as provided by the federal Patient Protection and Affordable Care Act of 2010.  The department shall obtain 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 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 and expended to establish health care homes for medicaid enrollees at federally qualified community health centers as provided in the federal Patient Protection and Affordable Care Act of 2010.  The department shall obtain the maximum federal matching funds available for this expenditure.

     The sum appropriated shall be expended by the department of health 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.


 


 

 

Report Title:

Community Health Centers; Appropriations

 

Description:

Appropriates funds to the department of health for direct health care services for the uninsured and underinsured.  Appropriates funds to the department of human services to restore basic adult dental benefits to medicaid enrollees and to provide outreach and eligibility services for individuals and families at federally qualified health centers.  Appropriates funds from general revenues and the community health centers special fund to establish health care homes.  Appropriates funds to provide behavioral health services at federally qualified community health centers.  (SD1)

 

 

 

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