STAND. COM. REP. NO. 162

Honolulu, Hawaii

RE:    S.B. No. 7

       S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Twenty-Ninth State Legislature

Regular Session of 2017

State of Hawaii

Sir:

     Your Committees on Commerce, Consumer Protection, and Health and Human Services, to which was referred S.B. No. 7 entitled:

"A BILL FOR AN ACT RELATING TO MEDICAID,"

beg leave to report as follows:

     The purpose and intent of this measure 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, including applying for a 1115 waiver or state Medicaid plan amendment to include supportive housing services for chronically homeless individuals.

     Your Committees received testimony in support of this measure from Hawai‘i Pacific Health; Ho‘omana Pono, LLC; and one individual.  Your Committees received comments on this measure from the Governor's Coordinator on Homelessness and Department of Human Services.

     Your Committees find that homelessness continues to be one of Hawaii's most important and challenging social problems, and that many people who experience homelessness have significant health care needs.  In fiscal years 2014 and 2015, The Queen's Medical Center reported treating 3,441 homeless patients.  For many individuals with complex health conditions, housing instability is a significant barrier to consistent health care access, which results in excessive use of expensive emergency department, inpatient treatment, and crisis services.

     Your Committees recognize that while there is an integral link between health and housing, it is difficult to identify and work with individuals who have health and housing needs.  Your Committees find that the healthcare system can be one valuable point of identification to not only collect data but also encourage clinicians to recognize the social impact of housing, employment, social networks, and economic status on health through improved communication between a doctor and patient.  Your Committees recognize the existing efforts by the Department of Human Services, in collaboration with the Governor's Coordinator on Homelessness and other community partners, to study and address the intersection between healthcare and homelessness, but want to ensure that progress continues toward expanding supportive housing services for Hawaii's homeless individuals.

Accordingly, your Committees have amended this measure by:

     (1)  Amending the purpose section to discuss the Hawaii Pathways Project pilot;

     (2)  Requiring the Department of Human Services, in collaboration with the Department of Health, to review the progress of the Hawaii Pathways Project pilot, rather than establish a Medicaid supportive housing services benefit plan, and continue to pursue efforts to utilize Medicaid to provide supportive housing services for chronically homeless individuals;

     (3)  Requiring the Department of Human Services to consider certain services, actions, and strategies in planning for the expansion of supportive housing services provided through Medicaid managed care plans, rather than in developing the Medicaid supportive housing services benefit plan;

     (4)  Removing the requirement that the Department of Human Services submit the Medicaid supportive housing services benefit plan to the Legislature and inserting language to require the Department of Human Services to submit a report to the Legislature that includes the status of the proposed amendment to expand the state 1115 Medicaid waiver, a description of supportive housing services to be provided to the chronically homeless population, and proposed eligibility criteria to qualify for supportive housing services; and

     (5)  Inserting an effective date of July 1, 2050, to encourage further discussion.

     As affirmed by the records of votes of the members of your Committees on Commerce, Consumer Protection, and Health and Human Services that are attached to this report, your Committees are in accord with the intent and purpose of S.B. No. 7, as amended herein, and recommend that it pass Second Reading in the form attached hereto as S.B. No. 7, S.D. 1, and be referred to your Committee on Ways and Means.

Respectfully submitted on behalf of the members of the Committees on Commerce, Consumer Protection, and Health and Human Services,

________________________________ JOSH GREEN, Chair

________________________________ ROSALYN H. BAKER, Chair