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THE SENATE                           S.C.R. NO.            S.D. 1
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                    SENATE  CONCURRENT
                        RESOLUTION

  REQUESTING THE DEPARTMENT OF HUMAN SERVICES TO CONVENE A
    PUBLIC-PRIVATE INTERAGENCY GROUP TO EXAMINE WAYS TO
    ADVOCATE THE CAPTURE AND MAXIMIZATION OF FEDERAL FUNDS TO
    SUPPORT HAWAII'S HEALTH AND HUMAN SERVICES PROGRAMS.


 1        WHEREAS, federal moneys can be a significant source of
 2   funding to support Hawaii's health and human services programs
 3   but, unfortunately, these federal funds have not been maximized
 4   for a variety of reasons, thus causing a direct and unnecessary
 5   drain on Hawaii's taxpayers; and
 6   
 7        WHEREAS, for example, federal Medicare benefits for
 8   Hawaii's elderly, particularly homebound seniors who depend on
 9   Medicare home health coverage, has not been maximized and that
10   situation stimulated the initiation of a privately-funded
11   Medicare Advocacy Project of the Legal Aid Society of Hawaii to
12   work towards maximizing those federal Medicare benefits; and
13   
14        WHEREAS, according to Health Care Financing Administration
15   data for 1997, only 571 per 1,000 of Hawaii's elderly Medicare
16   beneficiaries received home health care and skilled nursing
17   care compared to 917 in Montana, 930 in Idaho, and 940 in Maine
18   -- all states with similar populations; and
19   
20        WHEREAS, in terms of Medicare home health care and skill
21   nursing facility care expenditures, Hawaii received the lowest
22   percentage of federal reimbursement from Medicare at only
23   $30,300,000 while Montana received $64,300,000, Idaho received
24   $106,000,000, and Maine received $128,900,000; and
25   
26        WHEREAS, compared to Connecticut, a state which has had a
27   state-funded Medicare advocacy project for over a decade,
28   Hawaii served only 571 per 1,000 Medicare beneficiaries
29   compared to 906 per 1,000 in Connecticut, and Hawaii received
30   sixteen times less than Connecticut in Medicare skilled nursing
31   care and home health care reimbursement, respectively -- only
32   $11,500,000 and $18,800,000, compared to $188,400,000 and
33   $294,800,000 received by Connecticut; and
34   
35        WHEREAS, in a second example, the federal earned income

 
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                                  S.C.R. NO.            S.D. 1
                                                        
                                                        


 1   tax credit, an important income supplement for the working
 2   poor, can also bring as much as $3,756 of federal money per
 3   eligible tax return to Hawaii, yet an estimated twenty-five per
 4   cent of those eligible are unaware of the credit and thus do
 5   not claim the federal refund, resulting in an Internal Revenue
 6   Service estimate of $12,000,000 in unclaimed earned income tax
 7   credits for Hawaii for 1996; and
 8   
 9        WHEREAS, in yet a third example, Supplemental Security
10   Income (SSI) is a federally-funded financial assistance program
11   for low-income elderly, blind, and disabled individuals, which
12   was extended in the early 1970s to encompass the childhood SSI
13   disability program for families, including foster care
14   families, caring for a disabled child; and
15   
16        WHEREAS, unfortunately, foster care children in Hawaii
17   have been traditionally overlooked for SSI benefits because of
18   high caseloads for state social workers, resulting in only
19   twenty-two children currently in the state foster care program
20   receiving approval for SSI benefits; and
21   
22        WHEREAS, a total of about one thousand children receive
23   benefits that are entirely state-funded while another one
24   thousand are funded equally by federal and state dollars --
25   each foster child can receive $529 monthly in foster care
26   payments which can increase to more than $1,000 for a child
27   with special needs who requires therapeutic home placement; and
28   
29        WHEREAS, a substantial number of foster children may be
30   eligible for SSI benefits but do not receive them because they
31   have not applied for them or did not appeal a denial of
32   benefits; and
33   
34        WHEREAS, in a final example, federal dollars with respect
35   to adoption assistance for persons or families who formalize
36   their caregiving relationships with children in need of stable,
37   permanent families often go unreceived which, when combined
38   with increased Social Security benefits (if an adoptive
39   grandparent draws Social Security retirement benefits, the
40   adopted child will be entitled to about half the grandparent's
41   benefit) may more than double a family's income; and
42   

 
 
 
 
 
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                                  S.C.R. NO.            S.D. 1
                                                        
                                                        


 1        WHEREAS, there is a need to evaluate and determine how
 2   best to maximize available federal funds to support Hawaii's
 3   health and human services programs in a way that uses the
 4   resources and abilities of both the public and private sectors;
 5   now, therefore,
 6   
 7        BE IT RESOLVED by the Senate of the Twentieth Legislature
 8   of the State of Hawaii, Regular Session of 2000, the House of
 9   Representatives concurring, that the Department of Human
10   Services is requested to act as the lead agency in convening a
11   public-private interagency working group to examine ways to
12   advocate the capture and maximization of federal funds to
13   support Hawaii's health and human services programs; and
14   
15        BE IT FURTHER RESOLVED that the working group is requested
16   to examine the methods used by the states of Connecticut,
17   Idaho, Maine, and Montana in these states' efforts to capture
18   and maximize federal Medicare funds for home health care and
19   skilled nursing facility care; and
20   
21        BE IT FURTHER RESOLVED that the working group is requested
22   to comprise individuals who represent the following
23   organizations:
24   
25        (1)  Department of Human Services;
26   
27        (2)  Department of Health;
28   
29        (3)  Department of Education;
30   
31        (4)  Executive Office on Aging;
32   
33        (5)  AARP;
34   
35        (6)  Hawaii Long-Term Care Association;
36   
37        (7)  Healthcare Association of Hawaii;
38   
39        (8)  Kokua Council;
40   
41        (9)  Legal Aid Society of Hawaii; and
42   

 
 
 
 
 
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                                  S.C.R. NO.            S.D. 1
                                                        
                                                        


 1       (10)  Welfare and Employment Rights Coalition;
 2   
 3   and
 4   
 5        BE IT FURTHER RESOLVED that the Department of Human
 6   Services report findings and recommendations of the working
 7   group, including any necessary proposed legislation, to the
 8   Legislature no later than December 15, 2000; and
 9   
10        BE IT FURTHER RESOLVED that certified copies of this
11   Concurrent Resolution be transmitted to the Directors of Human
12   Services, Health, and Education, and the Presidents or
13   Directors of the AARP, Hawaii Long-Term Care Association,
14   Healthcare Association of Hawaii, Legal Aid Society of Hawaii,
15   Welfare and Employment Rights Coalition, Director of the
16   Executive Office on Aging; and Kokua Council.