Establishes a breast and cervical cancer treatment program for individuals who are diagnosed by the Hawaii breast and cervical cancer control program who are not eligible to receive Medicaid benefits for treatment, and for other underinsured or uninsured individuals with breast or cervical cancer, or both. Appropriates funds for the program.

A BILL FOR AN ACT

SECTION 1. In 1990, Congress passed the Breast and Cervical Cancer Mortality Act (Act), leading to the creation of cancer screening programs in all fifty states. No federal funds were authorized under the Act for treatment, only diagnostic services were funded. In 1998, the department of health launched Malama I Ke Ola O Na Wahine, Hawaii's version of the National Breast and Cervical Cancer Early Detection Control Program under the Act. Approximately two thousand women have been screened through the Hawaii breast and cervical cancer control program since its inception. Thirty-one breast cancers have been diagnosed through the Hawaii breast and cervical cancer control program for a rate of cancer of 1.4 per cent, as compared with the national rate of 0.6 per cent for all other programs combined. Every year, the number of women screened increases dramatically. Native Hawaiian women with breast cancer have a disproportionately high rate of mortality; they also have the highest rate of new cancer cases in the United States. In addition, one case of cervical cancer has been recently detected.

One of the problems with the current program is that while the screening is free, there are no funds for treatment for certain individuals diagnosed with breast or cervical cancer, or both, in this State. This has caused significant problems in diagnosing uninsured and underinsured patients with cancer:

In recognition of these difficulties, President Clinton signed into law the Breast and Cervical Cancer Treatment Act, P.L. 106-354, recently passed by Congress. The Breast and Cervical Cancer Treatment Act gives states the option, through federal matching funds, to provide Medicaid coverage to women diagnosed with breast or cervical cancer. The Breast and Cervical Cancer Treatment Act does not provide for treatment of individuals not eligible for Medicaid. The purpose of this Act is to address the needs of individuals who do not qualify for Medicaid who are diagnosed through the Hawaii breast and cervical cancer control program and also the uninsured and underinsured residents of Hawaii with breast or cervical cancer, or both, who are not diagnosed through the program, by establishing a program to provide the treatment they need.

SECTION 2. Chapter 321, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and read as follows:

§321-A Purpose. The State has established a program to screen uninsured and underinsured persons for breast and cervical cancer. The program has discovered cancer in state residents at a rate that exceeds the national average. However, no funds have been set aside under the Breast and Cervical Cancer Treatment Act for treatment of individuals who are not eligible to receive Medicaid benefits for the treatment of their breast or cervical cancer. This is a serious source of concern for people faced with this diagnosis who do not have the resources for treatment. The purpose of this part is to provide funds for treatment for breast and cervical cancer to complete the cycle of diagnosis and treatment.

§321-B Definitions. As used in this part:

"Advisory committee" means the breast and cervical cancer treatment advisory committee established in this part.

"Program" means the breast and cervical cancer treatment program established in this part.

§321-C Provision of services. (a) The department shall establish a breast and cervical cancer treatment program for the purpose of providing funding for uninsured and underinsured persons in the State with breast or cervical cancer, or both, and for clients participating in the department’s Hawaii breast and cervical cancer control program after care program who are uninsured and unable to qualify for supplemental health care insurance. The program shall establish a review panel of representatives from community organizations involved in cancer and health issues, particularly relating to ethnic groups with the highest rates of breast cancer and cervical cancer. The members of the advisory committee shall be appointed by the director for three-year terms to provide oversight for the allocation of funds. The program shall set up an expedited process by which uninsured and underinsured persons who have been diagnosed with breast or cervical cancer, or both, are designated as qualified to receive funding from the program. The program shall issue a written notice of qualification or non-qualification and will include the reason for any non-qualification.

The program shall be funded with state funds and any private contributions or grants received by the department for this purpose. Once a person is qualified, the program shall pay the out of pocket medical costs for the treatment of the cancer directly to the person’s medical providers, using Medicaid rates, guidelines and procedures as defined by the recently passed Breast and Cervical Cancer Treatment Act.

(b) By applying for qualification, an applicant gives the State permission to verify the necessary medical information with the applicant’s medical providers to ensure that the funds are being properly used.

§321-D Appeal. If a person has been denied qualification under section 321-C, the person’s medical provider may appeal the denial directly to the director of Med/QUEST, who shall review the application on an expedited basis and give a written ground for the director’s decision."

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $1, or so much thereof as maybe necessary for fiscal year 2001-2002, for the breast and cervical cancer treatment program. The sum appropriated shall be expended by the department of human services for the purposes of this Act.

SECTION 4. In codifying the new sections added by section 2 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act.

SECTION 5. This Act shall be effective on July 1, 2001.