CONFERENCE COMMITTEE REPORT NO. 154

                            Honolulu, Hawaii
                                            , 2000

                            RE:   H.B. No. 3016
                                  H.D. 1
                                  S.D. 1
                                  C.D. 1




Honorable Calvin K.Y. Say
Speaker, House of Representatives
Twentieth State Legislature
Regular Session of 2000
State of Hawaii

Honorable Norman Mizuguchi
President of the Senate
Twentieth State Legislature
Regular Session of 2000
State of Hawaii

Sir:

     Your Committee on Conference on the disagreeing vote of the
House of Representatives to the amendments proposed by the Senate
in H.B. No. 3016, H.D. 1, S.D. 1, entitled:

    "A BILL FOR AN ACT RELATING TO MEDICAL ASSISTANCE TO LOW-
    INCOME PERSONS,"

having met, and after full and free discussion, has agreed to
recommend and does recommend to the respective Houses the final
passage of this bill in an amended form.

     The purpose of this bill is to appropriate funds to the
Department of Human Services to raise the income eligibility for
the medically needy program.

     Your Committee on Conference finds that the "medically needy
program" is a Medicaid option that Hawaii has chosen to
implement.  The program is designed for aged and disabled persons
who are ineligible for the standard Medicaid program because
their income levels exceed one hundred per cent of the federal
poverty level.  Your Committee on Conference finds that this is a

 
a                                                       
 
                            CONFERENCE COMMITTEE REPORT NO. 154
                            Page 2



gap group that is not income qualified but has significant
medical expenditures.

     Your Committee on Conference further finds that the
medically needy program utilizes a "spend-down" provision and a
"medically needy" income standard.  The dollar amount by which
net countable monthly income exceeds that income standard is the
spend-down requirement, so that a person who incurs monthly
medical expenses that are more than the spend-down requirement
will be provided medical coverage for the remainder of the month. 

     A typical situation is a person who is disabled from a
terminal illness and whose income exceeds the maximum amount
allowable to qualify for Medicaid.  That person has medical bills
that would reduce the person's income to below the qualifying
amount for Medicaid, but that person would still not qualify for
medical assistance unless the State has implemented the medically
needy program.

     Your Committee on Conference has amended this bill by:

     (1)  Deleting the appropriation to the Department of Human
          Services;

     (2)  Adding a new section to chapter 321, Hawaii Revised
          Statutes, to require the State to cover medical
          assistance according to a statutory formula to certain
          medically needy persons who derive their income solely
          or not less than eighty per cent from Social Security,
          if they have a terminal or life threatening illness;
          and

     (3)  Making technical, nonsubstantive changes for the
          purposes of clarity and consistency.

     As affirmed by the record of votes of the managers of your
Committee on Conference that is attached to this report, your
Committee on Conference is in accord with the intent and purpose
of H.B. No. 3016, H.D. 1, S.D. 1, as amended herein, and
recommends that it pass Final Reading in the form attached hereto
as H.B. No. 3016, H.D. 1, S.D. 1, C.D. 1.


 
a                                                       
 
 
 
 
                            CONFERENCE COMMITTEE REPORT NO. 154
                            Page 3



                                   Respectfully submitted on
                                   behalf of the managers:

  ON THE PART OF THE SENATE          ON THE PART OF THE HOUSE




_____________________________     _______________________________
SUZANNE CHUN OAKLAND, Co-chair    DENNIS A. ARAKAKI, Co-Chair



_____________________________     _______________________________
CAROL FUKUNAGA, Co-chair          DWIGHT Y. TAKAMINE, Co-Chair



_____________________________                                    
ANDREW LEVIN, Co-Chair

 
a