Bill Text: HI SB432 | 2019 | Regular Session | Introduced
Bill Title: Relating To Homelessness.
Spectrum: Partisan Bill (Democrat 4-0)
Status: (Introduced - Dead) 2019-02-08 - The committee on HMS deferred the measure. [SB432 Detail]
Download: Hawaii-2019-SB432-Introduced.html
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THE SENATE |
S.B. NO. |
432 |
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THIRTIETH LEGISLATURE, 2019 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
relating to homelessness.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that there is excessive utilization of hospital emergency department resources by homeless individuals for non-emergency needs. Many of these users are considered super utilizers if they visit the emergency department at least three times per week, are admitted to the hospital at least three times per month, or visit the emergency department at least twelve times per quarter, and suffer from mental health and substance abuse issues. According to 2015 data from the Hawaii Health Information Corporation, the billed charges for all homeless health care encounters that occurred in Hawaii hospitals was $146,000,000. These encounters included repeat visits of, on average, two to three times.
The legislature notes Act 209, Session Laws of Hawaii 2018, appropriated funds for the establishment of a one-year medical respite pilot program to be administered by the department of human services, in consultation with the Hawaii interagency council on homelessness and any appropriate agency. Under the program, a community service provider, in partnership with a participating hospital, provides emergency housing for eligible individuals experiencing homelessness who are discharged from the hospital. The community service provider also provides, at minimum, meals, case management, and medical, nursing, and psychiatric care. The medical respite facilities are required to comply with department of health standards.
The legislature further notes that this pilot program will sunset on June 30, 2019, and believes that such a medical respite program requires additional time for appropriate determination and coordination of services. Furthermore, additional time is necessary to study the results and coordinate any changes in the pilot program to best serve the pilot program's target population.
The legislature further finds Hawaii's QUEST Integration project is a statewide section 1115 demonstration project that provides medicaid coverage for medical, dental, and behavioral health services through competitive managed care delivery systems.
The legislature notes that the department of human services has a pending request for an extension and expansion of the QUEST Integration section 1115 demonstration project to enable the department to provide and coordinate supportive housing-related activities and services, as appropriate, with the goal of promoting community integration, optimal coordination of resources, and self-sufficiency for beneficiaries experiencing chronic homelessness who also have a disability, mental health condition, substance abuse disorder, or complex health needs. Services include outreach and engagement services, supported employment services, and other services identified as necessary to meet supportive housing goals for the beneficiary. Thus, the legislature believes that expanding the State's QUEST Integration demonstration project to include a medical respite pilot program will be beneficial in enabling the State to provide more comprehensive care and services to a greater number of homeless individuals or individuals who are at risk of being homeless.
Accordingly, the purpose of this Act is to:
(1) Require the department of human services to establish and implement a medical respite pilot program to offer short-term residential acute and post-acute medical care for homeless individuals after being discharged from a hospital;
(2) Require the department of human services to submit an application for an amendment to the QUEST Integration section 1115 demonstration project to expand its QUEST Integration project to provide for the medical respite pilot program; and
(3) Appropriate funds to the department of human services for the establishment and implementation of a medical respite pilot program.
SECTION 2. (a) The department of human services shall establish a medical respite pilot program. The medical respite pilot program shall provide short-term residential acute and post-acute medical care for individuals, primarily those who are homeless or those with unstable living situations, who are too ill or frail to recover from a physical illness or injury in their usual living environment, but are not ill enough to be in a hospital. The medical respite pilot program shall also provide services to improve transitional care for this population and end the cycle of homelessness by supporting patients in accessing benefits and housing while also gaining stability with case management relationships and programs.
(b) The department of human services shall establish procedures and requirements for participating hospitals and residential care facilities; provided that these facilities shall comply with the department of health's standards of accessibility, sanitation, and other requirements, as determined by the department of health for facilities of similar use.
(c) Pilot program enrollees shall include individuals:
(1) With repeated incidents of avoidable emergency use, hospital admissions, or nursing facility placement; two or more chronic conditions; or mental health or substance use disorders; and
(2) Who are experiencing homelessness or are at risk of homelessness, including individuals who may experience homelessness upon release from medical or mental health facilities or incarceration.
The department of human services shall establish eligibility requirements for pilot program enrollees. Beneficiaries of the State's QUEST Integration program shall be eligible to be enrolled in the pilot program. Individuals who are not beneficiaries of the State's QUEST Integration program may enroll in the pilot program only at the discretion of the department of human services, but funding in support of any services provided to these individuals shall not be eligible for federal financial participation.
(d) The department of human services, in consultation with the Hawaii interagency council on homelessness and any other appropriate agency, shall determine the types of services to be provided to pilot program enrollees; provided that such services are:
(1) Necessary to achieve or maintain medical stability, which may require behavioral health interventions;
(2) Directly linked to the overarching strategies and goals identified by the department of human services for pilot program enrollees;
(3) Not provided for more than ninety days in continuous duration;
(4) Not funded by moneys dedicated to building modification or building rehabilitation; and
(5) Not covered by medicaid.
(e) The department of human services shall develop and implement policies and procedures to require participating hospitals and residential care facilities to collect data related to the pilot program enrollee population and services provided, share data, coordinate appropriate care, and evaluate individual and pilot program enrollee population health progress.
(f) The department of human services shall submit progress reports, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular sessions of 2020 to 2023 and a final report, including any proposed legislation, no later than twenty days prior to the convening of the regular session of 2024.
(g) The medical respite pilot program shall cease to exist on June 30, 2024.
SECTION 3. The department of human services shall submit an application to the United States Secretary of Health and Human Services for an amendment to the QUEST Integration Section 1115 demonstration project to expand its QUEST Integration project to provide for the medical respite pilot program.
SECTION 4. There is appropriated out of the general revenues of the State of Hawaii the sum of $50,000,000 or so much thereof as may be necessary for fiscal year 2019-2020 and the same sum or so much thereof as may be necessary for fiscal year 2020-2021 for the establishment and implementation of the medical respite pilot program.
The sums appropriated shall be expended by the department of human services for the purposes of this Act.
SECTION 5. This Act shall take effect on July 1, 2019.
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INTRODUCED BY: |
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Report Title:
Homelessness; Medical Respite Pilot Program; Medicaid; Section 1115 Demonstration Project; Department of Human Services; Appropriation
Description:
Establishes and appropriates moneys for a medical respite pilot program to offer medical, nursing, psychiatric, and other care for homeless individuals after being discharged from a hospital. Requires the department of human services to submit an application for an amendment to the QUEST Integration section 1115 demonstration project to expand its QUEST Integration project to provide for the medical respite pilot program.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.
