THE SENATE	S.B. NO.	7
TWENTY-NINTH LEGISLATURE, 2017
STATE OF HAWAII

A BILL FOR AN ACT

relating to medicaid.

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

     SECTION 1.  The legislature finds that homelessness continues to be one of the State's most significant and challenging social problems.  According to the 2016 Hawaii statewide homeless point-in-time conducted in January 2016, there are 7,921 homeless individuals in the State, an overall increase of four per cent from 2015.  Homeless persons face a myriad of issues, including general health care, mental illness, substance abuse, loss of employment and income, and a lack of affordable housing.

     The legislature further finds that many people who experience homelessness have high health care needs and costs.  In fiscal years 2014 and 2015, The Queen's Medical Center reported treating 3,441 patients who were homeless, including an unsheltered patient who reportedly received treatment 12,271 times over two years, which cost The Queen's Medical Center more than $5,000,000 per year.  For many of these individuals with complex health conditions, housing instability can be a significant barrier to regular health care access, which results in excessive use of expensive emergency department, inpatient treatment, and crisis services.  By recognizing the importance of housing stability within the practice of health care for homeless individuals and exploring creative and innovative solutions to address homeless individuals' health care needs through housing stability from traditional and non-traditional resources, the State may be able to recover the costs that homeless individuals incur over their lifetime.

     The purpose of this Act is to require the department of human services, in collaboration with the department of health, to create a medicaid supportive housing services benefit plan to enable medicaid to pay for supportive housing services for medicaid-eligible individuals, including applying to the Centers for Medicare and Medicaid Services through an 1115 waiver to amend the state medicaid plan to include supportive housing services for chronically homeless individuals.

     SECTION 2.  (a)  The department of human services, in collaboration with the department of health, shall develop and establish a medicaid supportive housing services benefit plan to allow medicaid funds to be used to provide supportive housing services for individuals who are eligible for medicaid.

     (b)  In developing the medicaid supportive housing services benefit plan, the department of human services shall consider the following:

     (1)  Benefit eligibility, including criteria related to:

         (A)  Health conditions;

         (B)  Housing status; and

         (C)  Current or potential system costs;

     (2)  Supportive housing services, including but not limited to:

         (A)  Outreach and engagement;

         (B)  Housing search assistance;

         (C)  Tenancy rights and responsibilities education;

         (D)  Eviction prevention;

         (E)  Service plan development;

         (F)  Coordination with primary care and health homes;

         (G)  Coordination with substance use treatment providers;

         (H)  Coordination with mental health providers;

         (I)  Coordination of vision and dental providers;

         (J)  Coordination with hospitals and emergency departments;

         (K)  Crisis interventions and critical time intervention;

         (L)  Independent living skills coaching; and

         (M)  Linkages to education, job skills training, and employment;

     (3)  State medicaid plan changes, including applying to the Centers for Medicare and Medicaid Services through an 1115 waiver to amend the state medicaid plan to include supportive housing services for medicaid eligible individuals, especially individuals experiencing homelessness;

     (4)  Financing and reinvestment strategies, including:

         (A)  Health care costs and housing status of current medicaid beneficiaries;

         (B)  The degree to which accurate and up-to-date information on housing status is available for current medicaid beneficiaries;

         (C)  Health care costs of current residents of supportive housing;

         (D)  Health care costs of the medicaid-expansion population;

         (E)  Potential impact on costs to other systems, such as jails, long-term care, and treatment facilities;

         (F)  Affordable housing investments that can be leveraged to create new units of supportive housing; and

         (G)  Amount of flexible service dollars available to cover what medicaid cannot; and

     (5)  Administration of the benefit, including:

         (A)  The role of managed care;

         (B)  The role of supportive housing service providers; and

         (C)  Coordination with existing and emerging systems.

     (c)  The department of human services shall submit the medicaid supportive housing services benefit plan, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular session of 2018; provided that the department of human services shall submit an 1115 waiver to the Centers for Medicare and Medicaid Services pursuant to this Act by          ,     .

     SECTION 3.  This Act shall take effect on July 1, 2017.

INTRODUCED BY:

_____________________________

Report Title:

Medicaid Supportive Housing Services Benefit; Homelessness; Department of Human Services; Department of Health

Description:

Requires the department of human services, in collaboration with the department of health, to develop a medicaid supportive housing services benefit plan through which medicaid can pay for supportive housing services for individuals who are eligible for medicaid, including applying to the Centers for Medicare and Medicaid Services through an 1115 waiver to amend the state medicaid plan to include supportive housing services for chronically homeless individuals.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.