Honolulu, Hawaii

                , 2023


RE:   H.B. No. 1356

      H.D. 1





Honorable Scott K. Saiki

Speaker, House of Representatives

Thirty-Second State Legislature

Regular Session of 2023

State of Hawaii




     Your Committees on Human Services and Health & Homelessness, to which was referred H.B. No. 1356 entitled:




beg leave to report as follows:


     The purpose of this measure is to appropriate funds to provide enhanced payments to Type I Adult Residential Care Homes and Developmental Disabilities Domiciliary Homes that are caring for Medicaid patients.


     Your Committees received testimony in support of this measure from the State Council on Development Disabilities, and ten individuals.  Your Committees received testimony in opposition to this measure from the Adult Foster Homecare Association of Hawaii, Untied Caregivers of Hawaii, Community Homecare Association of Hawaii, Alliance of Professional Primary Care Administrators, and Provider Helping Hands of Hawaii.  Your Committees received comments on this measure from the Department of Human Services.


     Your Committees find that according to the Office of Health Care Assurance, there are forty Developmental Disabilities Domiciliary Homes and over five hundred Type I Adult Residential Care Homes in Hawaii.  These homes were a key step in the Hawaii deinstitutionalization movement and allowed individuals with intellectual or developmental disabilities who need care to live in a community-based setting.


     Your Committees note the concerns raised in the testimony that the Department of Human Services does not set the rates or directly reimburse Developmental Disabilities Domiciliary Homes, as it is the Department of Health's Developmental Disabilities Division that determines those reimbursements and payments.  Further, Type I Adult Residential Care Homes do not qualify for Medicaid Home and Community Based payments for their residents, as they do not provide the required level of care. However, expanded Adult Residential Care Homes do provide the necessary level of care for professional health services and do qualify for Medicaid Home and Community Based payments for their residents.


     Your Committees have amended this measure by:


     (1)  Changing the effective date to June 30, 3000, to encourage further discussion; and


     (2)  Making a technical, nonsubstantive amendment for the purposes of clarity, consistency, and style.


     As affirmed by the records of votes of the members of your Committees on Human Services and Health & Homelessness that are attached to this report, your Committees are in accord with the intent and purpose of H.B. No. 1356, as amended herein, and recommend that it pass Second Reading in the form attached hereto as H.B. No. 1356, H.D. 1, and be referred to your Committee on Finance.



Respectfully submitted on behalf of the members of the Committees on Human Services and Health & Homelessness,