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THE SENATE |
S.B. NO. |
450 |
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THIRTY-THIRD LEGISLATURE, 2025 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
relating to autism.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
The legislature further finds that med-QUEST reimbursement rates for applied behavioral analysis have not increased since 2015. Since then, the Hawaii labor market has experienced significant wage pressure and med-QUEST beneficiaries must compete for applied behavioral analysis services with the private sector and other government programs, such as the department of education and department of health, which offer significantly higher reimbursement rates.
At the request of the legislature, a report was submitted in December 2023 based on a study commissioned by the med-QUEST division and conducted by actuarial firm Milliman. Reimbursement rates and costs were researched for a broad range of applied behavioral analysis services. Three rate scenarios were modeled in the study, all of which exceeded existing rates. The lowest rate was based on the fiftieth percentile Bureau of Labor Statistics wage blend for direct care staff, while the highest rate was based on the seventy-fifth percentile of the same data. The medium rate was based on the median direct care staff wage from a survey of applied behavioral analysis service providers.
Furthermore, the legislature finds that modeled rates for individual one-to-one services increased significantly for all scenarios. However, modeled rates for group services decreased for the lowest and medium rate scenarios. Part of the decrease stemmed from the fact that indirect time has become separately billable since the med-QUEST division rates were set and was thus not included in the rate. Another reason was that group rates were decreased to reflect the number of members served simultaneously, rather than allowing the same rate to be charged concurrently for each client, which is the med-QUEST division's existing guideline.
The legislature also finds that the lowest-rate scenario requires a composite rate change of 33.9 per cent and will require $2,690,000 in state funds, which will be matched by a corresponding $3,810,000 increase in federal funds. Moreover, the legislature finds that the concomitant increase in federal matching funds will result in a greater impact on the reimbursement rates received by applied behavioral analysis service providers.
Therefore, the purpose of this Act is to make an appropriation to increase funding for the department of human services' med‑QUEST division reimbursement for applied behavioral analysis services.
SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2025-2026 and the same sum or so much thereof as may be necessary for fiscal year 2026-2027 to increase funding for applied behavioral analysis services; provided that the department of human services shall obtain the maximum federal matching funds available for this expenditure; provided further that the department of human services shall pursue all funding sources available to the State, including private grants, prior to expending any general revenues appropriated pursuant to this Act.
The sums appropriated shall be expended by the department of human services for the purposes of this Act.
SECTION 3. This Act shall take effect on July 1, 2025.
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INTRODUCED BY: |
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Report Title:
Autism; Applied Behavioral Analysis Services; Appropriation; General Fund Expenditure Ceiling Exceeded
Description:
Appropriates funds to increase the funding for applied behavioral analysis services for persons with autism. Requires the Department of Human Services to obtain maximum federal matching funds and pursue all other funding sources. Appropriates funds.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.