STAND. COM. REP. NO.209

Honolulu, Hawaii

, 2003

RE: S.B. No. 884

 

 

Honorable Robert Bunda

President of the Senate

Twenty-Second State Legislature

Regular Session of 2003

State of Hawaii

Sir:

Your Committee on Human Services, to which was referred S.B. No. 884 entitled:

"A BILL FOR AN ACT MAKING APPROPRIATIONS FOR MEDICAID PROGRAMS,"

begs leave to report as follows:

The purpose of this measure is to make appropriations to the Department of Human Services (DHS) for residential alternative community programs, the Hawaii prepaid Medicaid management information system, and chore services.

Testimony in support of this measure was received from DHS, The Queen's Medical Center, Catholic Charities Hawaii – Elderly Services, Kokua Council, Case Management Council, Case Management, Inc., Eldercare Resources, Inc., nine individuals, and a petition signed by seventeen individuals.

The cost of providing long-term care in an institution can be prohibitive; as a result, the Department of Human Services’ Adult and Community Care Services Branch seeks alternative community-based treatment milieus that provide individuals with appropriate levels of care at a cost savings of about fifty per cent per person per year. The Residential Alternative Community Care Program (RACCP) under the Department of Human Services provides qualified individuals with placements in community-based residential facilities, including adult foster homes, adult residential care homes, and assisted-living facilities, as a less costly alternative to institutional care. These individuals are Medicaid-eligible adults who require nursing-facility level care and are not able to benefit from in-home services because they have no caregiver or residence. RACCP provides a broad array of services, including personal care, homemaker services, transportation, respite, and day health services.

The DHS is the designated the single state agency to administer funds for the federal Medicaid program, including Medicaid home and community-based waiver services programs such as RACCP. The federal Centers for Medicare and Medicaid (formerly known as the Health Care Financing and Administration) now requires the State to process all Medicaid payments through a federally approved claims system. To address the federal requirement, the Department of Human Services, in November 2002, implemented the Hawaii prepaid Medicaid management information system for the purpose of processing Medicaid waiver claims, at an annual cost of $500,000.

The DHS administers the Chore Services Program (program) that provides essential housekeeping services to enable eligible disabled clients to remain living in the community. Clients employ their own service providers who are paid minimum wage. The program is funded on a matching basis with federal moneys. Increases in the minimum wage in 2001 and 2002 have resulted in unanticipated program costs without a concomitant increase in funding levels. As a result, the program has been closed to new admissions since August 2001, forcing eligible disabled clients to utilize more costly care options, including utilizing medical and hospital services or institutionalization. Your Committee believes that it is imperative for the State to provide its share of matching dollars to enable the program to continue and to serve new applicants.

As affirmed by the record of votes of the members of your Committee on Human Services that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 884 and recommends that it pass Second Reading and be referred to the Committee on Ways and Means.

 

Respectfully submitted on behalf of the members of the Committee on Human Services,

____________________________

SUZANNE CHUN OAKLAND, Chair