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HB725
HOUSE OF REPRESENTATIVES
H.B. NO.
725
THIRTY-THIRD LEGISLATURE, 2025
STATE OF HAWAII
A BILL FOR AN ACT
relating
to Medicaid
.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
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SECTION
1.
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The legislature finds there is a
strong demand for community-based care options for kupuna.
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In a 2021 quantitative research study conducted
by AARP, among Hawaii residents aged forty-five years and older, seventy-five
per cent said that having affordable long‑term care options in their
community was an important independent living issue.
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Maintaining a connection with family and
friends and the ability to continue to visit familiar health care providers is
much easier when the State's kupuna can be cared for close to home.
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The
legislature further finds that reimbursement rates that do not have medicare
rates for equivalent services, such as all community‑based waiver
services, are reviewed and determined by the department of human services at
least every five years.
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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.
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The study developed benchmark
comparison rates for certain home and community-based services, including residential
services provided in community care foster family homes and expanded adult
residential care homes, in-home services, and case management services for home
and community-based case management agencies.
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The
legislature additionally finds that, for all provider types included in the study
conducted by Milliman, current median direct care wages paid by the home and
community-based services providers fell below the United States 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.
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Providers face significant
wage pressures for registered nurses and certified nursing assistants and are
competing with facilities, which are reimbursed at higher rates by medicaid,
and private pay services for the same labor force.
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Most providers therefore relied on contracted
registered nurses.
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Providers were not
able to offer benefits, including health insurance, to their employees and
relied on substitute caregivers who were sometimes unpaid, including families
and friends of the providers.
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High
inflation has also further increased costs for operators providing residential
services in community care foster family homes and expanded adult residential care
homes.
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The
purpose of this Act is to appropriate funds to increase the long-term care
reimbursement from medicaid to fund certain medicaid homes and community-based
services, including licensed developmental disability domiciliary homes,
community care foster family homes, certified adult foster homes, and Type II
expanded adult residential care homes.
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It is the intent of the legislature that funding for services in this
Act, when combined with the maximum federal matching funds available for this
expenditure, increases by $2,127 per client per month, for a new total payment
equivalent of $3,824 per client per month for service providers.
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SECTION 2.
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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 2025-2026 and the same sum or so
much thereof as may be necessary for fiscal year 2026-2027 to increase the
funding of certain medicaid home and community-based services, including adult
day programs and residential services offered in community care foster family
homes and expanded adult residential care homes; provided that the department
of human services shall obtain the maximum federal matching funds available for
this expenditure.
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The sums
appropriated shall be expended by the
department of human services for the purposes of this Act.
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SECTION 3.
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This Act shall take effect on July 1, 2025.
INTRODUCED BY:
_____________________________
Report Title:
DHS;
Medicaid; Home and Community-Based Services; DDDOM; CCFFH; ARCH; Adult Foster
Care; Appropriation
Description:
Appropriates
funds to increase the funding of certain Medicaid home and community-based
services, including adult day programs and residential services offered in
community care foster family homes and expanded adult residential care homes.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.