STAND. COM. REP. NO. 488

                                   Honolulu, Hawaii
                                                     , 1999

                                   RE:  S.B. No. 157
                                        S.D. 1




Honorable Norman Mizuguchi
President of the Senate
Twentieth State Legislature
Regular Session of 1999
State of Hawaii

Sir:

     Your Committee on Health and Human Services, to which was
referred S.B. No. 157 entitled: 

     "A BILL FOR AN ACT MAKING AN APPROPRIATION TO PROVIDE
     PREVENTIVE DENTAL SERVICES TO ADULTS,"

begs leave to report as follows:

     The purpose of this measure is to appropriate funds to
provide preventive dental services to adults on a fee for service
or capitated basis through the MedQuest program.

     Your Committee received testimony in support of this measure
from the Department of Human Services (DHS), Department of Health
(DOH), State Planning Council on Developmental Disabilities, The
Arc in Hawaii, Arc of Kauai, Hawaii State Primary Care
Association, Kona Krafts, Kalihi-Palama Health Center, Kokua
Kalihi Valley, Waianae Coast Comprehensive Health Center, The Arc
of Hilo, AlohaCare, Hawaii Island MobileCare, and thirteen
individuals.

     Preventive dentistry services for adults covered by Medicaid
and QUEST were discontinued on February 1, 1996, as a result of
cutbacks in the state budget.  At the present time, these clients
can only receive emergency dental services.  This measure
provides matching funds for federal grants under the Medicaid and
QUEST programs to restore preventive dental services.

     As a society, we still fail to recognize dental care as an
essential medical service.  No one in public health today

 
a                                                     SB157 SD1  
                                   STAND. COM. REP. NO. 488
                                   Page 2


disputes the need for regular attention to the diseases of the
mouth.  New studies are now verifying the impact of dental plaque
on the heart, lungs, and other internal organs.  Diseases of the
gums and tooth decay have a direct relationship to general health
and morbidity.  At a time when the United States Public Health
Service is increasing its efforts to deal with dental diseases
nationally, Hawaii has placed nearly ninety thousand residents at
health risk by only addressing emergency dental interventions for
adults in QUEST and Medicaid.

     Your Committee has amended this measure by:

     (1)  Deleting the option of providing preventive dental
          services on a capitated basis, thereby requiring
          services be provided on a fee for service basis;

     (2)  Clarifying that only preventive dentistry is covered;
 
     (3)  Requiring the DHS to consult with the DOH on what
          services constitute preventive dentistry; and

     (4)  Adding an unspecified appropriation amount for fiscal
          year 2000-2001.

     As affirmed by the record of votes of the members of your
Committee on Health and Human Services that is attached to this
report, your Committee is in accord with the intent and purpose
of S.B. No. 157, as amended herein, and recommends that it pass
Second Reading in the form attached hereto as S.B. No. 157,
S.D. 1, and be referred to the Committee on Ways and Means.

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



                                   ______________________________
                                   SUZANNE CHUN OAKLAND, Chair

 
a                                                     SB157 SD1