Bill Text: HI SB2678 | 2024 | Regular Session | Introduced

Hawaii Senate Bill 2678

Introduced

Bill Title: Relating To Human Services.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2024-01-24 - Referred to HHS, WAM. [SB2678 Detail]

Download: Hawaii-2024-SB2678-Introduced.html

THE SENATE	S.B. NO.	2678
THIRTY-SECOND LEGISLATURE, 2024
STATE OF HAWAII

A BILL FOR AN ACT

relating to human services.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that most of the State's kupuna would prefer to live in their own homes for as long as they can. In-home services are key to ensuring kupuna and people with disabilities stay in their own home; these services include helping with activities of daily living such as meal preparation, cleaning, bathing, mobility support, and other forms of personal care. In a 2021 quantitative research study among Hawaii residents forty-five years of age and older, sixty-five per cent were extremely or very concerned about being able to age in place and eighty-three per cent of those surveyed said it was extremely or very important to them to stay in their homes as they get older. Helping individuals live in their own home instead of in an institutional nursing facility is also far less costly.

The legislature further finds that reimbursement rates that do not have medicare rates for equivalent services, such as in-home care services, are reviewed and determined by the department of human services at least every five years. The last review of home and community‑based reimbursement rates for residential services by the department of human services' med-QUEST division was conducted through a third-party study by the actuarial firm Milliman and reported on December 30, 2022. The study developed benchmark comparison rates for in-home services, including homemaker/companion/chore, personal care/personal assistance/attendant care, and private duty nursing by registered nurse and licensed practical nurse.

The rate studies found there is tremendous wage pressure for direct care workers for home settings, given the highly competitive labor market in the State for similar paying jobs. For all in-home provider types included in the study, current median direct care wages paid by the operators fell below the United States Department of Labor Bureau of Labor Statistics twenty-fifth percentile for those occupation codes and titles, except for licensed practical nurses who fell just below the fiftieth percentile.

The purpose of this Act is to appropriate funds to increase funding of medicaid in-home services. The corresponding federal matching funds will also increase, resulting in a larger impact on reimbursement received by service providers.

SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2024-2025 to increase funding for medicaid in-home services; provided that the department of human services shall obtain the maximum federal matching funds available to this expenditure; provided further that the department of human services shall pursue all funding sources known to the State, including private grants, prior to expending any general revenues appropriated pursuant to this Act.

The sum appropriated shall be expended by the department of human services for the purposes of this Act.

SECTION 3. In accordance with section 9 of article VII of the Hawaii State Constitution and sections 37‑91 and 37‑93, Hawaii Revised Statutes, the legislature has determined that the appropriations contained in H.B. No. , will cause the state general fund expenditure ceiling for fiscal year 2024‑2025 to be exceeded by $ or per cent. In addition, the appropriation contained in this Act will cause the general fund expenditure ceiling for fiscal year 2024‑2025 to be further exceeded by $ or per cent. The combined total amount of general fund appropriations contained in only these two Acts will cause the state general fund expenditure ceiling for fiscal year 2024‑2025 to be exceeded by $ or per cent. The reasons for exceeding the general fund expenditure ceiling are that:

(1) The appropriation made in this Act is necessary to serve the public interest; and

(2) The appropriation made in this Act meets the needs addressed by this Act.

SECTION 4. This Act shall take effect on July 1, 2024.

INTRODUCED BY:	_____________________________

Report Title:

DHS; Medicaid; In-Home Services; Appropriation; Expenditure Ceiling

Description:

Appropriates funds to increase the funding for medicaid in-home services, conditioned on the Department of Human Services obtaining the maximum federal matching funds and pursuing all other funding sources.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.