HB897

SECTION 1. The purpose of this Act is to assist persons who have been diagnosed with autism or fetal alcohol spectrum disorder to participate in their communities by making medicaid home and community-based services and other medicaid services more accessible.

SECTION 2. This Act shall be known and may be cited as "Ann and Kelii's Law".

SECTION 3. The legislature finds that persons who have been diagnosed with autism or fetal alcohol spectrum disorder in Hawaii face difficult and profound challenges and a present system of care that can be complicated to navigate. Other states, such as Minnesota and Virginia, have made dedicated efforts to make the coverage of medicaid services accessible to persons with autism or fetal alcohol spectrum disorder. The legislature finds that Hawaii needs to make a similar effort to minimize the burdens that persons with autism or fetal alcohol spectrum disorder experience in the navigation, access, and coverage of medicaid services.

SECTION 4. (a) There is established jointly within the department of health's behavioral health services administration and the department of human services' med-QUEST division a task force to review policy issues and opportunities relating to the navigation, access, and coverage of medicaid services by persons with autism or fetal alcohol spectrum disorder. The members of the task force shall consist of:

(1) A representative from the department of health's behavioral health services administration;

(2) A representative from the department of health's developmental disabilities division;

(3) A representative from the department of human services;

(4) A representative from the department of human services' med-QUEST division;

(5) A representative from the department of health's state council on developmental disabilities;

(6) At least one representative from a med-QUEST health plan;

(7) A member to be selected by the chair of the house standing committee with the primary purview over human services;

(8) A member to be selected by the chair of the senate standing committee with the primary purview over human services;

(9) A member to be selected by the chair of the house standing committee with the primary purview over health and homelessness;

(10) A member to be selected by the chair of the senate standing committee with the primary purview over health and human services;

(11) At least one member of a developmental or intellectual disability advocacy group;

(12) Two parent-advocates to be selected by the speaker of the house of representatives;

(13) Two parent-advocates to be selected by the president of the senate; and

(14) Any additional representatives from state agencies, stakeholders, advocates, parent-advocates, or other individuals, as deemed necessary by the other members of the task force.

(b) The task force shall conduct a study and submit a report of its findings and recommendations to the legislature no later than twenty days prior to the convening of the regular session of 2024. The study shall include:

(1) Identification of all populations and sub-populations with autism or fetal alcohol spectrum disorder that currently, or may in the future, experience burdens in the navigation, access, and coverage of medicaid services;

(2) Recommendations for potential changes to medicaid policies and rules that may increase access to home and community-based services and other medicaid services by improving navigation, existing service delivery, coverage, and access;

(3) A screening tool for autism or fetal alcohol spectrum disorder, using the guidelines developed for the Canada Fetal Alcohol Spectrum Disorder Research Network titled, Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan (February 2016), as published in the Canadian Medical Association Journal;

(4) Recommendations for ways to improve support services as part of the medicaid state plan for persons who have been diagnosed with autism or fetal alcohol spectrum disorder; and

(5) Recommendations for potential legislation, if necessary.

(c) The task force shall also conduct an analysis and make a recommendation on whether a waiver, a waiver amendment, or any other necessary policy approval from the Centers for Medicare and Medicaid Services may be necessary to ensure the following services are accessible to persons with autism or fetal alcohol spectrum disorder:

(1) Assistive technology;

(2) Career planning, including vocational assessment and job placement services;

(3) Community transition services;

(4) Day habilitation;

(5) Family support;

(6) Home modifications;

(7) Nutritional consultation;

(8) Residential habilitation;

(9) Respite care;

(10) Specialized skill development, including behavioral specialist, community support, and systematic skill building services;

(11) Supported employment, including extended employment supports and intensive job coaching;

(12) Temporary supplemental services;

(13) Therapeutic care;

(14) Transitional work services;

(15) Vehicle modifications; and

(16) Supportive housing.

(d) Notwithstanding any other law to the contrary, any waiver, waiver amendment, or any other necessary policy approval from the Centers for Medicare and Medicaid Services recommended by the task force pursuant to this section shall comply with the applicable federal requirements related to utilization, coverage, and reimbursement for services provided to persons who have been diagnosed with autism or fetal alcohol spectrum disorder, including any federally mandated level of care or needs-based criteria requirements.

(e) The members of the task force shall serve without compensation, but shall be reimbursed for necessary expenses, including travel expenses, incurred for service on the task force.

(f) The task force shall convene no later than thirty days after the effective date of this Act.

(g) The task force shall serve until it has accomplished the objectives of this Act or twenty days prior to the convening of the regular session of 2024, whichever occurs first.

(h) As used in this section, unless the context clearly requires otherwise:

"Autism" means autism spectrum disorder, which is a neurodevelopmental disorder, as defined by the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders.

"Therapeutic care" means services provided by licensed speech pathologists, licensed occupational therapists, licensed social workers, licensed clinical social workers, or licensed physical therapists.

SECTION 5. (a) The department of human services shall seek a waiver, a waiver amendment, or any other necessary policy approval from the Centers for Medicare and Medicaid Services that may be necessary to provide home and community-based services or other medicaid services for medicaid-eligible individuals who have been diagnosed with autism or fetal alcohol spectrum disorder, if recommended by the task force pursuant to section 4(c).

(b) If the task force recommends a waiver, waiver amendment, or any other necessary policy approval that requires additional medicaid expenditures to implement, then an appropriation shall be sought from the legislature that is sufficient to cover the state portion of increased medicaid expenditures arising from the waiver, waiver amendment, or any other necessary policy approval. Any waiver, waiver amendment, or other necessary policy approval shall not be implemented without an appropriation.

SECTION 6. The provision of home and community-based services and other medicaid services for individuals diagnosed with autism or fetal alcohol spectrum disorder as required by this Act shall apply to all plans issued under medicaid managed care and fee-for-service programs in the State.

SECTION 7. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

SECTION 8. If any provision of this Act, or the application thereof to any person or circumstance, is held invalid by state or federal law, the invalidity does not affect other provisions or applications of the Act that can be given effect without the invalid provision or application, and to this end the provisions of this Act are severable.

SECTION 9. This Act shall take effect on July 1, 2023; provided that section 6 shall take effect upon approval by the Centers for Medicare and Medicaid Services of any waiver, waiver amendment, or necessary policy change submitted pursuant to section 5 of this Act; provided further that the legislature shall appropriate any necessary state dollars required to fund the waiver, waiver amendment, or policy change pursuant to section 5.

INTRODUCED BY:	_____________________________

HOUSE OF REPRESENTATIVES	H.B. NO.	897
THIRTY-SECOND LEGISLATURE, 2023
STATE OF HAWAII