HOUSE OF REPRESENTATIVES

H.C.R. NO.

71

TWENTY-SECOND LEGISLATURE, 2003

  

STATE OF HAWAII

  
   

HOUSE CONCURRENT

RESOLUTION

 

REQUESTING AN AUDIT OF THE DEPARTMENT OF HEALTH'S QUALITY ASSURANCE FOR PROVIDERS OF SERVICES TO THE DEVELOPMENTALLY DISABLED AND TO RECOMMEND A LEVEL OF BUDGET FUNDING TO ENSURE COMPLIANCE WITH FEDERAL MANDATES.

 

WHEREAS, the State Department of Health (DOH) is required under section 333F-2, Hawaii Revised Statutes, to provide for a developmental disabilities system, including:

(1) A comprehensive system of support and services for persons with developmental disabilities or mental retardation;

(2) An array of individually appropriate services and care to persons with developmental disabilities or mental retardation through the utilization of existing resources within the community; and

(3) Maximization of funding for community services using funds such as state matching funds for Title XIX programs; and

WHEREAS, Title XIX is part of the Social Security Act that provides grants to states for various medical assistance programs, including the disabled; and

WHEREAS, Act 177, Session Laws of Hawaii 2002, reduced the appropriation for the developmental disabilities of the DOH for fiscal year 2002 to $35,531,322, a reduction of $5,132,192, from fiscal year 2001, with an explanation given for the reduction in the administration budget variance report for fiscal years 2001 and 2002 that more federal funding was received; and

WHEREAS, program memoranda on the developmental disabilities program submitted to the legislature in 2001 states:

"A comprehensive evaluation of the division's service system by nationally recognized consultants evidenced a lack of a quality assurance system to monitor and improve division services. Compounding the situation, recently issued Health Care Finance Administration (HCFA) quality assurance protocols mandate states to monitor implementation of individual planning process and assure the health and welfare of persons in the Home and Community Base Services Medicaid Waiver Program. Given the need to implement a quality assurance system while faced with limited resources, the division will transition out of the current system of being a provider of direct services. This will enable the division to begin implementation of a quality assurance system that addresses the health and safety of individuals and focuses alignment of the division's goals, activities, resources and outcomes.";

and

WHEREAS, the Auditor conducted an audit in 1992 of the DOH's administration of contracts for purchase of service for persons with developmental disabilities (Report No. 92-31), and a follow up audit in 1995 (Report No. 95-12), but neither report focused on the quality of services provided by contractors of purchase of service contracts; and

WHEREAS, the trend in providing services to the developmentally disabled has been to move away from institutional care and into community programs, making quality assurance more critical as evidenced by the recent federal mandate; and

WHEREAS, the DOH's transitioning out of a system of providing direct services into a system of provider of services contracts makes budgetary considerations more critical because of the difficulty of predicting the cost of the contracts and the size and needs of the target population;

WHEREAS, the Legislature believes that the DOH must meet the recent federal requirements for quality assurance, because failure to do so could jeopardize federal matching grants for the State's developmentally disabled program; now, therefore,

BE IT RESOLVED by the House of Representatives of the Twenty-Second Legislature, Regular Session of 2003, the Senate concurring, that the Auditor conduct an audit of the DOH's developmental disabilities division concerning planning, development, effectiveness, adequacy, and funding of the developmental disabilities division's system of providing services to the developmentally disabled and mentally retarded, including compliance with recent federal mandates of the HCFA as quoted above, and addressing any lack of a quality assurance system to monitor and improve division services; and

BE IT FURTHER RESOLVED that the audit address problems concerning:

(1) The criteria or guidelines to make changes to client programs, including developing a program budget for each client;

(2) The amount and level of training given to recently hired targeted case managers;

(3) The justification for allowing targeted case managers who are not qualified mental retardation professionals (possessing a bachelor's degree in the human service field and having a minimum of one year work experience with the mentally retarded) the authority to make program recommendations; and

(4) The criteria or guidelines used to refer clients to the various service providers; and

BE IT FURTHER RESOLVED that the Auditor recommend the level of funding for the State's share of the matching federal funding, to serve as a guide to the Legislature for budgetary planning; and

BE IT FURTHER RESOLVED that the Auditor report to the Legislature on the Auditor's findings and recommendations no later than twenty days before the convening of the Regular Session of 2004; and

BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Auditor and the Director of Health.

 

 
 

OFFERED BY:

_____________________________

Report Title:

Developmental Disabilities; Audit