THE SENATE	S.C.R. NO.	119
THIRTY-SECOND LEGISLATURE, 2023
STATE OF HAWAII

SENATE CONCURRENT

RESOLUTION

Requesting the Department of Health and Department of Human Services to: Jointly review any research applied behavior analysis for adults; Develop and adopt rules, policies, and plan amendments necessary to ensure that the State Medicaid program covers medically NECESSARY services, including Applied Behavior Analysis services, for individuals aged twenty-one and older with neurodevelopmental disorders, including autism spectrum disorder; and Apply for any necessary approvals from the federal Centers for Medicare and Medicaid Services to amend the state Medicaid plan to provide reimbursements for medically necessary services, including applied behavior analysis services, to Medicaid-eligible persons over the age of twenty-one diagnosed with autism spectrum disorder.

WHEREAS, neurodevelopmental disorders are disabilities associated primarily with the functioning of the neurological system and brain; and

WHEREAS, one neurodevelopmental disorder is autism spectrum disorder, a developmental disability that can cause significant social, communication, and behavioral challenges; and

WHEREAS, treatments for individuals with developmental disabilities, such as applied behavior analysis, can improve physical and mental development; and

WHEREAS, Medicaid is a jointly-funded, federal-state health insurance program for individuals with limited income and resources who meet eligibility requirements; and

WHEREAS, the Medicaid Home and Community-Based Services Waiver for individuals with intellectual and developmental disabilities is authorized under section 1915(c) of the federal Social Security Act (section 1915(c) waiver); and

WHEREAS, these services are designed to implement creative, person-centered alternatives to long-term institutionalized care; and

WHEREAS, Hawaii's state Medicaid program, Med-QUEST, is administered through the Department of Human Services in partnership with the Department of Health's Developmental Disabilities Division; and

WHEREAS, there are reports of individuals with autism spectrum disorder and other neurodevelopmental disorders who are aged twenty-one and older being denied Med-QUEST coverage for medically necessary autism services, including applied behavior analysis services; and

WHEREAS, applied behavior analysis services and similar services should be covered by Med-QUEST for eligible individuals with neurodevelopmental disorders; and

WHEREAS, according to the federal Centers for Medicare and Medicaid Services' Informational Bulletin dated July 7, 2014, individuals aged twenty-one and older may continue to receive services to address autism spectrum disorder through the section 1915(c) waiver if a state does not elect to provide these services to adults under its Medicaid state plan; and

WHEREAS, the Informational Bulletin also provides that states need to ensure that these individuals are receiving a waiver service not coverable under section 1905(a) of the federal Social Security Act to ensure that they do not lose access to all Medicaid services by losing waiver eligibility; now, therefore,

BE IT RESOLVED by the Senate of the Thirty-second Legislature of the State of Hawaii, Regular Session of 2023, the House of Representatives concurring, that the Department of Health and Department of Human Services are requested to:

(1) Jointly review any research regarding applied behavior analysis for adults;

(2) Develop and adopt rules, policies, and plan amendments necessary to ensure that the State Medicaid program covers medically necessary services, including applied behavior analysis services, for individuals aged twenty-one and older with neurodevelopmental disorders, including autism spectrum disorder; and

(3) Apply for any necessary approvals from the federal Centers for Medicare and Medicaid Services to amend the state Medicaid plan to provide reimbursements for medically necessary services, including applied behavior analysis services to Medicaid-eligible persons over the age of twenty-one diagnosed with autism spectrum disorder; and

BE IT FURTHER RESOLVED that the Department of Health and Department of Human Services are requested to ensure that any rules, policies, and plan amendments adopted pursuant to this request do not impair or limit any existing coverages; and

BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Director of Health and Director of Human Services.

OFFERED BY:

_____________________________

Report Title:

Medicaid; Med-QUEST; Coverage; Neurodevelopmental Disorder; Autism Spectrum Disorder; Applied Behavior Analysis; Department of Health; Department of Human Services