RELATING TO DISABILITY HEALTH DISPARITY.

HB819

HOUSE OF REPRESENTATIVES

H.B. NO.

819

THIRTY-THIRD LEGISLATURE, 2025

STATE OF HAWAII

A BILL FOR AN ACT

relating
to disability health disparity
.

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

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SECTION 1.
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The
legislature finds that adults with intellectual or developmental disabilities
experience disproportionate health disparities compared to those without
disabilities.
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Individuals with
intellectual or developmental disabilities are more likely than their peers
without disabilities to have fair or poor health, be considered obese, and be
diagnosed with chronic diseases, such as diabetes.
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Intellectual and developmental disabilities
are life-long differences that typically arise before adulthood and can
uniquely influence the trajectory of an individual's life, including their
physical, intellectual, behavioral, and emotional development.
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The state council on developmental
disabilities was created to advocate for and improve and protect the lives of
individuals with intellectual or developmental disabilities in the State.

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Decades of research has clearly established
that people of minority groups living in the United States receive poor health
care and have poor health outcomes resulting from social determinants of
health.
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On a national level, racial and
ethnic disparities in access to health care and health outcomes are a
persistent, pervasive public health problem.
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In the State, underserved populations, such as Native Hawaiian and
Pacific Islanders, have been historically underrepresented in health care, as
data does not accurately reflect the health disparities currently faced by this
group.
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Additionally, individuals from
the neighbor islands are also underrepresented and underserved, as access to
health care resources and services are limited.
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However, even less is known about the extent of racial and ethnic health
disparities among adults with intellectual or developmental disabilities.
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Accordingly, there is an urgent need to
create an updated, accurate set of data that reflects the State's unique needs
to assist certain agencies to better understand the needs of individuals with
intellectual or developmental disabilities in their communities.

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The legislature further finds troubling
gaps in the health disparities of people with intellectual or developmental
disabilities and their social determinants of health in the State.
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Certain recent health surveys in the State
and existing related initiatives do not segregate data pertaining to
individuals with intellectual or developmental disabilities, nor is the data
publicly available.
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Presently, the State
relies on prevalence rate data from the federal government published in
1994-1995 that does not reflect the State's population and its specific
needs.
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The State's prevalence rate is
1.58 per cent, which equals approximately twenty-two thousand people who have
an intellectual or developmental disability.
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Additionally, the only substantial data the state council on
developmental disabilities collects on intellectual or developmental
disabilities is through the medicaid waiver program, which serves approximately
three thousand people.
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As there is a gap
of approximately nineteen thousand people who may have an intellectual or
developmental disability in the State, there is little information on quality
of life, health care access, and health care outcomes for unaccounted individuals
with intellectual or developmental disabilities.

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Accordingly, further research is needed to
understand the health disparities of people with intellectual or developmental
disabilities and their social determinants of health.
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It is therefore imperative for the State to
establish fundamental baseline data for service evaluation, policy development,
and research to serve the current and future needs of individuals with
intellectual or developmental disabilities.
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Accurate, current data will also help the State provide culturally
appropriate health care, address barriers to health care access, reduce health
disparities, increase employment opportunities, and support individuals with
developmental or intellectual disabilities to live healthy lives in the community.

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Therefore, the purpose of this Act is to
appropriate funds and require the state council on developmental disabilities
to study the health disparities experienced by individuals with intellectual or
developmental disabilities in the State to yield much needed results to help
guide the future of public health policy and practice.

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SECTION 2.
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(a)
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The state council on developmental
disabilities shall
collect comprehensive data to
identify gaps in social determinants of health, especially in the areas of
health care access and quality and economic stability, that affect health
outcomes and health disparities experienced by individuals with intellectual or
development disabilities in the State that can be addressed with policy,
legislative, or stakeholder action, and shall submit a report to the
legislature no later than twenty days prior to the convening of the regular
session of
202
7
.
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The report shall include:

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(1)
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A
definition of the State's intellectual or developmental disability population
for public health administration purposes, including the health conditions,
duration, and level of severity required to qualify for disability status;

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(2)
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A
definition of the social determinants of health as used by the United States
Department of Health and Human Services;

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(3)
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Population-level
differences in the State between individuals with and without intellectual or
developmental disabilities on health indicators and social determinants of
health, including:

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(A)
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Access
to necessary health care;

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(B)
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Access
to preventive health care, including wellness programs and emotional support
services;

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(C)
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Health
behaviors, including the percentage of individuals who engage in physical
activities or smoke cigarettes;

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(D)
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Health
status and outcomes, including the percentage of individuals who are considered
obese or diagnosed with chronic diseases, including diabetes, hypertension, and
cardiovascular diseases;

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(E)
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Drivers
of health outcomes, including the impetus to seek health care and how
individuals seek health care;

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(F)
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Emergency
preparedness, including evacuation planning and ability;

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(G)
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Health
insurance coverage;

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(H)
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Social
determinants of health and health outcomes, including household income,
employment status, education level, access to health information technology
tools and systems, access to transportation, and the social and community
environment; and

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(I)
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Other
indicators and determinants that contribute to an individual's physical and
mental health;

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(4)
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Factors
contributing to the population-level differences, including race, ethnicity,
gender, age, county of residence, and economic and social disadvantages and
discrimination;

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(5)
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A
determination of the population-level differences and contributing factors that
are preventable or avoidable;

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(6)
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Any
other information that would assist the State in determining safe, equitable,
and culturally appropriate public health actions that would improve health care
and address the health disparities experienced by individuals in the State with
developmental or intellectual disabilities; and

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(7)
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Proposed
legislation, including best practices, for the State to reduce the health
disparities experienced by individuals in the State with developmental or
intellectual disabilities.

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(b)
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In preparing the report, the state council on developmental disabilities
may consult with community stakeholders on the following:

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(1)
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Improvements
to provider training about intellectual or developmental disabilities;

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(2)
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Life
experiences of individuals with intellectual or developmental disabilities;

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(3)
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Accessibility
mandates for health infrastructure that include the needs of individuals with
intellectual or developmental disabilities;

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(4)
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Communication
guidelines and standards for health care providers to communicate with
individuals with intellectual or developmental disabilities; and

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(5)
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Other
topics as deemed relevant by the state council on developmental disabilities.

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(c)
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For the purposes of this Act:

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"Health disparities"
means population-level differences in health outcomes that are related to a
history of social, economic, or environmental disadvantages that are avoidable
and not primarily caused by underlying health conditions that led to the
disability.

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"Intellectual or developmental
disabilities" means a lifelong difference that typically arises before
adulthood that uniquely influences the trajectory of the individual's physical,
intellectual, behavioral, and emotional development and impacts how individuals
experience the world around them.

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SECTION 3.
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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 for the state council
on developmental disabilities to collect comprehensive data and compile and
submit to the legislature a report focused on the health disparities
experienced by individuals with developmental or intellectual disabilities in the
State prior to the convening of the regular session of 2027.

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The sums

appropriated shall be expended by the department of health for the
purposes of this Act.

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SECTION 4.
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This Act shall take effect on July 1, 2025.

INTRODUCED BY:

_____________________________

Report Title:

SCDD; Developmental Disabilities; Intellectual
Disabilities; Health Disparities; Health Equity; Report; Appropriations

Description:

Requires the State Council on Developmental Disabilities to
collect data and submit to the Legislature a report focused on the health
disparities experienced by individuals with intellectual or developmental
disabilities in the State prior to the convening of the Regular Session of 2027.
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Appropriates funds.

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not legislation or evidence of legislative intent.