TWENTY-NINTH LEGISLATURE, 2017
STATE OF HAWAII
A BILL FOR AN ACT
RELATING TO MEDICAID.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that homelessness continues to be one of the State's most significant and challenging social problems. According to the 2016 Hawaii statewide homeless point-in-time conducted in January 2016, there are 7,921 homeless individuals in the State, an overall increase of four per cent from 2015. Homeless persons face a myriad of issues, including general health care, mental illness, substance abuse, loss of employment and income, and a lack of affordable housing.
The legislature further finds that many people who experience homelessness have high health care needs and costs. In fiscal years 2014 and 2015, The Queen's Medical Center reported treating 3,441 patients who were homeless, including an unsheltered patient who reportedly received treatment 12,271 times over two years, which cost The Queen's Medical Center more than $5,000,000 per year. For many of these individuals with complex health conditions, housing instability can be a significant barrier to regular health care access, which results in excessive use of expensive emergency department, inpatient treatment, and crisis services. By recognizing the importance of housing stability within the practice of health care for homeless individuals, and exploring creative and innovative solutions to address homeless individuals' health care needs through housing stability from traditional and non-traditional resources, the State may be able to recover the costs that homeless individuals incur over their lifetime.
The legislature recognizes that the department of human services and the department of health have piloted efforts to target supportive housing services for a small cohort of chronically homeless individuals through the Hawaii pathways project. The Hawaii pathways project has demonstrated early success in meeting the housing and health care needs of chronically homeless individuals, and the department of human services is working to expand supportive housing services through an amendment of the state 1115 medicaid waiver.
The purpose of this Act is to support current efforts being made by the department of human services and to require the department to report to the legislature in regard to its progress in expanding supportive housing services for a broader population of chronically homeless individuals.
SECTION 2. (a) The department of human services, in collaboration with the department of health, shall review the progress of the Hawaii pathways project pilot and continue to pursue efforts to utilize medicaid to provide supportive housing services for chronically homeless individuals.
(b) In planning for the expansion of supportive housing services provided through medicaid managed care plans, the department of human services shall consider the following:
(1) Benefit eligibility, including criteria related to:
(A) Health conditions;
(B) Housing status; and
(C) Current or potential system costs;
(2) Supportive housing services, including but not limited to:
(A) Outreach and engagement;
(B) Housing search assistance;
(C) Tenancy rights and responsibilities education;
(D) Eviction prevention;
(E) Service plan development;
(F) Coordination with primary care and health homes;
(G) Coordination with substance use treatment providers;
(H) Coordination with mental health providers;
(I) Coordination of vision and dental providers;
(J) Coordination with hospitals and emergency departments;
(K) Crisis intervention and critical time intervention;
(L) Independent living skills coaching; and
(M) Linkages to education, job skills training, and employment;
(3) Applying to the Centers for Medicare and Medicaid Services to pursue an amendment of the state 1115 medicaid waiver;
(4) Financing and reinvestment strategies, including:
(A) Health care costs and housing status of current medicaid beneficiaries;
(B) The degree to which accurate and up-to-date information on housing status is available for current medicaid beneficiaries;
(C) Health care costs of current residents of supportive housing;
(D) Health care costs of the medicaid-expansion population;
(E) Potential impact on costs to other systems, such as jails, long-term care, and treatment facilities;
(F) Affordable housing investments that can be leveraged to create new units of supportive housing; and
(G) Amount of flexible service dollars available to cover the costs that medicaid cannot; and
(5) Administration of the benefit, including:
(A) The role of managed care;
(B) The role of supportive housing service providers; and
(C) Coordination with existing and emerging systems.
(c) The department of human services shall submit a report to the legislature regarding the status of its efforts, including any proposed legislation, no later than twenty days prior to the convening of the regular session of 2018. The report shall include:
(1) The status of the proposed amendment to expand the state 1115 medicaid waiver;
(2) A description of supportive housing services to be provided to the chronically homeless population; and
(3) Proposed eligibility criteria to qualify for supportive housing services.
SECTION 3. 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 2017-2018 for the purposes of this Act; provided that no funds appropriated under this Act shall be expended unless matched dollar-for-dollar with federal funds.
The sum appropriated shall be expended by the department of human services for the purposes of this Act.
SECTION 4. This Act shall take effect on July 1, 2050.
Supportive Housing Services; Medicaid; Homelessness; Department of Human Services; Department of Health; Appropriation
Requires the department of human services, in collaboration with the department of health, to review the progress of the Hawaii pathways project pilot and continue to pursue efforts to utilize medicaid to provide supportive housing services for chronically homeless individuals. Provides considerations for the department in planning for the expansion of supportive housing services provided through medicaid managed care plans. Requires the department to report to the legislature. Makes an appropriation. Effective 7/1/2050. (SD2)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.