Honolulu, Hawaii


RE: S.B. No. 242

S.D. 1




Honorable Ronald D. Kouchi

President of the Senate

Thirtieth State Legislature

Regular Session of 2019

State of Hawaii




Your Committees on Human Services and Commerce, Consumer Protection, and Health, to which was referred S.B. No. 242 entitled:




beg leave to report as follows:


The purpose and intent of this measure is to:


(1) Require the State's Medicaid managed care and fee-for service programs to provide coverage for home and community-based services for individuals diagnosed as having autism, beginning January 1, 2020; and


(2) Require the Department of Human Services to seek a section 1115 waiver to amend the state Medicaid plan to include this coverage.


Your Committees received testimony in support of this measure from the Hawaii Psychological Association, Oahu County Committee on Legislative Priorities of the Democratic Party of Hawaii, and fifteen individuals. Your Committees received comments on this measure from the Department of Human Services, Department of Health, Hawaii Disability Rights Center, Autism Society of Hawaii, and Hawaii Medical Service Association.


Your Committees find that beneficiaries of home and community-based services must meet level of care assessment independent of their autism diagnosis. To meet the level of care criteria, an individual must be assessed to have some functional limitations that reflect the need for home and community-based services. Your Committees further find that many Medicaid beneficiaries with autism may function at a high level and therefore do not qualify for home and community-based services. This measure ensures that home and community services are provided to all individuals diagnosed with autism, regardless of the level of care needed.


Your Committees have amended this measure by:


(1) Removing references to the early and periodic screening, diagnosis, and treatment services benefit, as this is already covered through the QUEST Integration program;


(2) Amending the definition of "therapeutic care" for consistency with the existing definition in the Insurance Code;


(3) Specifying that the coverage provided also includes individuals diagnosed with fetal alcohol spectrum disorder; 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 Human Services and Commerce, Consumer Protection, and Health that are attached to this report, your Committees are in accord with the intent and purpose of S.B. No. 242, as amended herein, and recommend that it pass Second Reading in the form attached hereto as S.B. No. 242, S.D. 1, and be referred to your Committee on Ways and Means.


Respectfully submitted on behalf of the members of the Committees on Human Services and Commerce, Consumer Protection, and Health,