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THE SENATE |
S.C.R. NO. |
81 |
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TWENTY-THIRD LEGISLATURE, 2006 |
S.D. 1 |
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STATE OF HAWAII |
H.D. 1 |
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RESOLUTION
URGING THE DEPARTMENT OF HUMAN SERVICES TO ADDRESS THE IMPACT OF POSITIVE ENROLLMENT IN THE RECENTLY ISSUED QUEST REQUEST FOR PROPOSAL.
WHEREAS, on March 13, 2006, the Department of Human Services issued a Request for Proposal regarding the QUEST program; and
WHEREAS, Section 30.500 of the Request for Proposal requires positive enrollment for all current QUEST beneficiaries, to occur between August 1 and August 20, 2006; and
WHEREAS, "positive enrollment" would require all 165,000 QUEST beneficiaries to select a QUEST plan and a Primary Care Provider; and
WHEREAS, current QUEST beneficiaries have already selected a QUEST plan and Primary Care Provider; and
WHEREAS, requiring these vulnerable populations to comply with the positive enrollment requirements may cause confusion, delay needed health care procedures, disrupt case management, or result in the loss of contact between patients and their current Primary Care Providers;
WHEREAS, positive enrollment may result in an indeterminate spectrum of negative outcomes, including additional costs and administrative burdens on QUEST providers; now, therefore,
BE IT RESOLVED by the Senate of the Twenty-third Legislature of the State of Hawaii, Regular Session of 2006, the House of Representatives concurring, that this body urges the Department of Human Services to address the impact of positive enrollment in the recently issued QUEST Request for Proposal; and
BE IT FURTHER RESOLVED that the Department of Human Services is requested to ensure the following safeguards and quality control measures to address previously stated concerns of potential disruption of service:
(1) Amending the Request for Proposal (RFP) so that each Medicaid QUEST recipient will have 60 days to positively choose their health plan;
(2) Granting each Medicaid QUEST recipient an additional 90 days, from October 1 through December 31, 2006 to change their health plan for any reason;
(3) Ensuring that if a person is auto-assigned to a new plan and it shows up by mistake for a visit at their previous plan's provider, there will be no disruption in receiving medical services, even if that physician is not in the new plan, and also ensuring that the client will receive treatment at that time, for which the Department will pay the bill;
(4) Ensuring that the client will also have the opportunity during a visit to a provider to immediately opt out of the auto-assigned health care plan and back into the previous plan or into another plan; and
(5) Ensuring that the Department will conduct a public awareness campaign and contract with advocacy, outreach, and other community groups to educate Medicaid QUEST recipients about their new plan options.
BE IT FURTHER RESOLVED that the Department of Human Services in addressing the impacts of positive enrollment, is hereby requested to present a report to the Legislature forthwith but not later than May 1, 2006 on the following possible impacts of positive enrollment:
(1) Accessibility and ease of use by QUEST clients, including possible disruption of service;
(2) Administrative problems which may result as a result of positive enrollment, including but not limited to:
(a) The possibility of administrative confusion in implementation of positive enrollment;
(b) The possibility of impeded integration of positive enrollment information systems, networks, and intake application forms;
(c) Loss of contact or impeded contact with primary care providers; and
(3) Overall degradation of health care in the State of Hawaii.
BE IT FURTHER RESOLVED that a certified copy of this Concurrent Resolution be transmitted to:
(1) The Governor of the State of Hawaii;
(2) The Director of the Department of Human Services; and
(3) The Chairpersons of the House and Senate Standing Committees on Health and Human Services.
Report Title:
Section 30.500 Quest RFP; DHS Address Impacts by May 1, 2006