HOUSE OF REPRESENTATIVES

H.C.R. NO.

203

TWENTY-SECOND LEGISLATURE, 2003

S.D. 1

STATE OF HAWAII

 
   


HOUSE CONCURRENT

RESOLUTION

 

requesting the departments of human services and health TO WORK WITH HAWAII'S CONGRESSIONAL DELEGATION and the federal centers for medicare and medicaid services TO IMPROVE ACCESS TO HEALTH CARE IN HAWAII.

 

WHEREAS, Hawaii's Prepaid Health Care law has propelled the State to the forefront of the nation by providing near universal health coverage for its residents by requiring the provision of employer-paid health coverage for workers; and

WHEREAS, through the Medicaid and Hawaii QUEST (QUEST) programs, the Department of Human Services (DHS) has sought to extend health coverage to more residents who are not covered by the Prepaid Health Care law; and

WHEREAS, hospitals in the State have always provided, and continue to provide, health care for the uninsured and have attempted to shift the cost of providing this care to consumers who are able to pay; and

WHEREAS, cost-shifting has been stretched to its limits and can no longer be depended upon to provide compensation for the provision of unreimbursed health care for the uninsured; and

WHEREAS, when the State obtained its QUEST waiver from the federal Centers for Medicare and Medicaid Services (CMS), the Disproportionate Share of Hospital payments, federal dollars provided to DHS for lump sum distribution to hospitals for compensation for care provided to the uninsured, were eliminated; and

WHEREAS, there is a great need to marshal resources to help compensate Hawaii's hospitals for their provision of health care for the uninsured; and

WHEREAS, the State of Hawaii has an interest in assuring a health care safety net for its citizens; and

WHEREAS, individuals with mental illness require the assistance of trained mental health professionals and appropriate mental health services in order to improve the quality of their lives; and

WHEREAS, mental health services for uninsured and low income individuals are currently provided through medical assistance programs such as Medicaid and QUEST; and

WHEREAS, the pool of licensed mental health professionals accessible to Medicaid and QUEST participants is limited; and

WHEREAS, many of the available licensed mental health professionals limit the number of new Medicaid and QUEST patients accepted, because of the low rates of reimbursement and significant administrative burden; and

WHEREAS, as a result, some Medicaid and QUEST participants, particularly participants with serious mental illness, report being unable to access mental health services; and

WHEREAS, the lack of access to appropriate mental health services increases health costs, economic costs, and human costs that are borne by patients, families, and society, in terms of increased unemployment, homelessness, domestic violence, crime, and unsafe schools, streets, and communities; now, therefore,

BE IT RESOLVED by the House of Representatives of the Twenty-Second Legislature of the State of Hawaii, Regular Session of 2003, the Senate concurring, that the Department of Human Services is requested to immediately solicit the active involvement of Hawaii's congressional delegation to aggressively advocate for the restoration of Disproportionate Share of Hospital payments from the federal Centers for Medicare and Medicaid Services to compensate Hawaii hospitals for care provided to the uninsured; and

BE IT FURTHER RESOLVED that the Department of Human Services, together with the Department of Health, is requested to review existing policies and procedures and to work with mental health provider and advocacy agencies, such as the Hawaii Healthcare Association, the Hawaii Medical Association, the Hawaii Psychiatric Medical Association, and others, in order to improve access to appropriate mental health services for Medicaid and QUEST participants; and

BE IT FURTHER RESOLVED that this review shall address the following:

(1) How existing policies and procedures are being operationalized;

(2) Whether the operational procedures enhance or hinder the accessibility of mental health treatment by Medicaid and QUEST participants;

(3) The impact of provider reimbursement schedules and documentation requirements on provider participation levels; and

(4) Options for providing mental health services to rural and isolated communities without compromising the quality of care for Medicaid and QUEST patients; and

BE IT FURTHER RESOLVED that the Departments of Human Services and Health shall jointly submit a report to the Legislature not later than twenty days prior to the convening of the 2004 Regular Session, of its findings and recommendations, including recommended actions by which the State may increase federal moneys received for the Medicaid and QUEST programs, and proposed legislation, if any; and

BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the members of Hawaii's congressional delegation; the Directors of the Departments of Human Services and Health; the Hawaii Healthcare Association; Hawaii Medical Association; and Hawaii Psychiatric Medical Association.

Report Title:

DHS; DOH; Restore Disproportionate Share of Hospital Payments; Access to Mental Health Services Under Medicaid/QUEST.