Report Title:

SECTION 1. Chapter 103F, Hawaii Revised Statutes, is amended by adding a new section to part I to be appropriately designated and to read as follows:

"§103F‑ Medicaid contracts; health care insurance plan contractors; reimbursements to home and community-based case management agencies. (a) In any contract entered into with a medicaid healthcare insurance plan contractor that provides reimbursement to home and community-based case management agencies, the department of human services shall include contract provisions that specify the duties and obligations of the medicaid health care insurance plan contractor to the home and community-based case management agency, as follows:

(1) When renewing a policy with a home and community-based case management agency, the medicaid healthcare insurance plan contractor shall not reduce reimbursement rates to the home and community-based case management agency in excess of ten per cent of the reimbursement rates in effect under the expiring policy with the home and community-based case management agency;

(2) Paragraph (1) shall not apply if the reduction in reimbursement rates is necessary to ensure the following:

(A) The clients' access to, or choice of, a home and community-based case management agency; or

(B) The prevention of a substantial and foreseeable risk of harm to clients; and

(3) The medicaid healthcare insurance plan contractor shall not enter into, or renew, any policy with a home and community-based case management agency unless the policy contains maximum reimbursement levels for chore services and non-emergency medical transportation.

(b) For the purposes of this section, the terms "client" and "home and community-based case management agency" shall have the same meanings ascribed to them under section 346-331."

Part II

SECTION 2. This Act prohibits the use of private contract and vendors for intake and eligibility of welfare and public assistance services in Hawaii.

SECTION 3. Prior to the reorganization of the Department of Human Services Benefits, Employment and Support Services Division; Social Services Division; and MedQUEST Division, including but not limited to the intake, maintenance, and eligibility services for public assistance, SNAP, and Medicaid services, a Task Force shall be convened to determine the feasibility of transferring services to the Eligibility Processing Operations Division (EPOD). The Task Force shall consist of the following:

a) The Director of the Department of Human Services or her designee;

b) At least one eligibility workers from each island;

c) A representative from the Investigations Office of the Department of Human Services;

d) At least five (5) representatives from organizations which work with DHS eligibility offices providing services for recipients, of which one shall be from Maui, Kauai, and the Big Island;

e) A request for review shall be submitted to the United States Department of Agriculture regarding the proposed plan of transferring services to EPOD to determine possible concerns or potential violations with federal regulations or policy.

f) The report of the Task Force's findings shall be submitted to the Legislature at least twenty (20) days prior to the convening of the 2011 Legislative session.

Part III

SECTION 4. Section 346-46, Hawaii Revised Statutes, is amended to read as follows:

"§346-46 Certified nurse aides; training programs and recertification. The director shall:

(1) Approve training programs for nurse aides and ensure that the training programs comply with all applicable federal and state requirements;

(2) Approve and arrange for the recertification process for nurse aides who work in medicare or medicaid certified nursing facilities;

(3) Approve and arrange for the recertification process for nurse aides who work in state-licensed or state-certified health care settings; and

(4) Require recertification not less than every two years. The number of continuing education hours required for recertification shall not exceed twenty-four hours, except as specified by federal law[.]; provided that the competency evaluation required pursuant to section 457A-7 and 457A-8 shall be included as continuing education hours and maintenance requirements."

SECTION 5. Section 457A-2, Hawaii Revised Statutes, is amended by amending subsection (c) to read as follows:

"(c) The director of human services shall implement this chapter in accordance with 42 United States Code Sections 1395i-3 and 1396r, that relate to:

(1) Training programs for nurse aides and recertification; provided that recertification shall be required not less than every two years and the number of continuing education hours required for recertification shall not exceed twenty-four hours, except as specified by federal law; provided further that the competency evaluation required pursuant to section 457A-8 shall be included as continuing education hours; and

(2) Disciplining of certified nurse aides employed in health care settings licensed or certified by the department of human services."

SECTION 6. Section 457A-7, Hawaii Revised Statutes, is amended by amending subsection (e) to read as follows:

"(e) Maintenance requirements for the recertification process shall be on a biennial basis, and shall include a competency evaluation equivalent to that required under section 457A-8, an annual performance review, and in-service training and employment in a medicare or medicaid facility as required by federal and state law."

SECTION 7. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 8. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

SECTION 9. New statutory material is underscored.
SECTION 10. This Act shall take effect on January 1, 2050.

THE SENATE	S.B. NO.	2650
TWENTY-FIFTH LEGISLATURE, 2010		S.D. 2
STATE OF HAWAII		H.D. 1
		Proposed