Honorable Robert Bunda

President of the Senate

Twenty-Second State Legislature

Regular Session of 2003

State of Hawaii

Sir:

Your Committee on Human Services, to which was referred S.C.R. No. 10 entitled:

begs leave to report as follows:

The purpose of this measure is to request an audit of the quality assurance system implemented by the Developmental Disabilities Division of the Department of Health, for providers of services to individuals with developmental disabilities.

Testimony in support of this measure was submitted by the Hawaii Government Employees Association; Opportunities for the Retarded, Inc.; and the Hawaii Disability Rights Center. Oral testimony in support of this measure was presented by the Research Center of Hawaii-Special Needs Network. The Department of Health submitted comments on this measure.

Your Committee finds that the Developmental Disabilities Division (Division) of the Department of Health (Department) oversees the developmental disabilities system mandated by section 333F-2, Hawaii Revised Statutes, including a comprehensive system of supports and services for individuals with developmental disabilities or mental retardation, with services provided in accordance with a client-centered plan incorporating client choices and self-determination; the provision of an array of individually appropriate services and care; and the maximization of funds for community services, using state matching funds to access federal and other governmental and private finance programs.

Your Committee further finds that, as recently as 2001, the Department had no formal quality assurance program in place to monitor and improve services. The Centers for Medicare and Medicaid Services (formerly known as the Health Care Financing Administration) issued new federal quality assurance protocols, which required states to monitor the implementation of individual planning processes and to assure the health and welfare of individuals with disabilities in Medicaid Home and Community-Based Services Waiver Programs.

Your Committee further finds that the absence of a viable quality assurance program within the Developmental Disabilities Division not only jeopardizes federal matching grants for the State's developmentally disabled programs, but it also places persons with developmental disabilities at risk. The recent trend away from institutionalization, in favor of community-based services and programs, underscores the need to adequately monitor the quality of services provided under purchases of service contracts, and to protect the health and safety of the individuals with developmental disabilities or mental retardation receiving the services.

Your Committee further finds that, given the considerable amount of Medicaid spending on home and community-based waiver services for persons with developmental disabilities, it is imperative for the the Department of Health to ensure that state funds are properly spent, and that the programs are achieving the intended outcomes. Such quality assurance initiatives also address federal requirements for continued Medicaid waiver funding.

Accordingly, your Committee has amended the measure to expand the scope of the audit to include:

Your Committee has further amended this measure to correct the internal citation to the Auditor's Report and to make other technical, nonsubstantive amendments for the purposes of clarity, consistency, and style.

In conducting the audit, the Auditor is requested to focus on the level of funding to ensure that Hawaii is in compliance with federal mandates, and to ensure that individuals with developmental disabilities are receiving the highest quality of care and support.

As affirmed by the record of votes of the members of your Committee on Human Services that is attached to this report, your Committee concurs with the intent and purpose of S.C.R. No. 10, as amended herein, and recommends its adoption in the form attached hereto as S.C.R. No. 10, S.D. 1.