HOUSE OF REPRESENTATIVES

H.B. NO.

2116

TWENTY-SIXTH LEGISLATURE, 2012

H.D. 1

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO HEALTH.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 

     SECTION 1.  The legislature finds that recent budgetary reductions to the medicaid QUEST health care program will result in fewer persons being eligible for benefits due to the change in applicable income limits, which have been reduced from the existing income limit of below two hundred per cent of the federal poverty level to the new income limit of below one hundred thirty-three per cent of the federal poverty level.  The change in program eligibility requirements will result in disenrollment of approximately four thousand five hundred adults from QUEST, making them uninsured.

     The legislature further finds that twenty-seven per cent of individuals at community health centers, or thirty-five thousand individuals, are currently uninsured.  In addition, eighty-five per cent of community health center patients have incomes below two hundred per cent of the federal poverty level, and approximately half of the total patients seen by community health centers are current medicaid enrollees.  The legislature finds that any changes to the medicaid program will disproportionately affect community health centers because of their patient demographics.  The vast majority of newly uninsured health care consumers who will be cut from the QUEST program will either turn to community health centers for their care or seek out hospital emergency department care, which reports show is seven times more costly to the State than providing basic coverage.

     Community health centers serve uninsured individuals, low-income patient populations with demographic complexities and co-morbidities, medicaid members, the homeless, and privately insured individuals and families.  Community health centers:

     (1)  Are nonprofit, community-based organizations whose purpose and expertise are to provide quality person centered health care to underserved populations and regions;

     (2)  Provide culturally and linguistically appropriate health care including a broad range of primary care and preventive services;

     (3)  Are located in medically-underserved areas where individuals have limited access to other health care providers because of geographic and socio-economic barriers;

     (4)  Contribute greatly to the economies and livability of the communities they serve; and

     (5)  Are cost-effective providers whose care results in healthier patients and decreased use of emergency, specialty, and in-patient services.

     By helping avoid unnecessary emergency room, in-patient, and specialty use, community health centers save the health care system $1,262 per year per patient.  In 2009, community health centers in Hawaii saved the State more than $160,000,000, an even greater savings than the $128,000,000 realized in 2008.  Community health centers are a smart investment that results in healthier communities while saving the state money.

     Although the Patient Protection and Affordable Care Act, P.L. 111-48, expands the population that will be eligible for medicaid coverage and private insurance, those provisions will not take effect until 2014, leaving uncertainty for many, including the increased numbers of uninsured individuals, as Hawaii's economy continues to struggle.  Furthermore, as seen in Massachusetts, following implementation of that state's landmark health reform law, community health centers may see an increase in the number and proportion of the state's uninsured that are treated at their facilities after the federal law becomes effective.

     The purpose of this Act is to provide funding for quality, cost-effective health care for Hawaii's uninsured.

     SECTION 2.  There is appropriated out of the general revenues of the State of Hawaii the sum of $5,500,000 or so much thereof as may be necessary for fiscal year 2012-2013 to carry out the purposes of this Act, including the provision of primary medical, dental, and behavioral health care for uninsured persons through nonprofit community health centers; provided that distribution of funds by the department of health may be on a per-visit basis, and may include a per-member per-month quality incentive payment, taking into consideration the need on all islands.

     The sum appropriated shall be expended by the department of health for the purposes of this Act.

     SECTION 3.  This Act shall take effect on July 1, 2012.

 

 

Report Title:

Department of Health; Community Health Centers; Appropriation

 

Description:

Appropriates funds for the provision of health care services to uninsured persons through nonprofit community health centers.  Effective July 1, 2012. (HB2116 HD1)

 

 

 

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