HCR45.DOC

WHEREAS, smoking remains a major health issue for Hawaii's diverse people and results in more than eleven hundred deaths in the State each year; and

WHEREAS, the Department of Health reports that in Hawaii, over seventeen per cent of adults and more than fourteen per cent of high school students smoke cigarettes; and

WHEREAS, Hawaii's smoking-related health and medical costs total $262,000,000 annually, of which $91,000,000 is estimated to be Medicaid-related; and

WHEREAS, the Centers for Disease Control and Prevention reports that smoking-attributable neonatal expenditures in Hawaii total $702,330 over one year and that these costs are completely preventable; and

WHEREAS, helping pregnant women quit smoking would have enormous health benefits, including reducing tobacco-related spontaneous abortions, rates of low-birthweight infants, admissions to neonatal intensive care units, infant deaths from

perinatal disorders, and sudden infant death syndrome; and

WHEREAS, although the smoking rate among pregnant women in Hawaii is a relatively low 7.1 per cent, this high-risk behavior still impacts the lives of 1,200 babies every year; and

WHEREAS, Native Hawaiian women were more likely than other ethnic groups to smoke in the three months before pregnancy and during the third trimester, according to the statewide Pregnancy Risk Assessment Monitoring System; and

WHEREAS, many of the State's Medicaid beneficiaries are members of ethnic groups with traditionally high smoking prevalence rates, such as Native Hawaiians; and

WHEREAS, the QUEST program, which provides health coverage through health plans for eligible Hawaii residents, provides medical coverage to pregnant women whose gross monthly household income is no more than 185 per cent of the Federal Poverty Level; and

WHEREAS, as of 2005, thirty-eight states' Medicaid programs offered program recipients at least one form of tobacco-dependence treatment, such as counseling or medication, but few states' Medicaid programs covered both medication and counseling as recommended by the 2000 Public Health Service clinical practice guidelines; and

WHEREAS, in order to achieve the 2010 National Health Objective, states, including Hawaii, should offer or increase Medicaid coverage for treatment of tobacco dependence; and

WHEREAS, the Legislature has considered a proposal to expand the scope of the QUEST program to include all Medicaid beneficiaries; and

WHEREAS, regardless of whether legislation is passed during the Regular Session of 2009, the Department of Human Services, which administers QUEST, should consider ways to provide smoking cessation counseling services to all Hawaii Medicaid beneficiaries; now, therefore,

BE IT RESOLVED by the House of Representatives of the Twenty-fifth Legislature of the State of Hawaii, Regular Session of 2009, the Senate concurring, that the Department of Human Services is requested to collect data and conduct a feasibility study of developing and implementing a program to provide counseling treatment to all QUEST beneficiaries wishing to quit smoking; and

BE IT FURTHER RESOLVED that the Department of Human Services is requested to report its finding and recommendations to the Legislature no later than twenty days prior to the convening of the Regular Session of 2010; and

BE IT FURTHER RESOLVED that a certified copy of this Concurrent Resolution be transmitted to the Director of Human Services and the Chairs of the Senate and House Human Services Committees.

	OFFERED BY:	_____________________________

Report Title:

Medicaid

HOUSE OF REPRESENTATIVES	H.C.R. NO.	45
TWENTY-FIFTH LEGISLATURE, 2009
STATE OF HAWAII