STAND. COM. REP. NO. 511

Honolulu, Hawaii

, 2025

RE: H.B. No. 700

H.D. 1

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2025

State of Hawaii

Madame:

Your Committees on Health and Human Services & Homelessness, to which was referred H.B. No. 700 entitled:

"A BILL FOR AN ACT RELATING TO COGNITIVE ASSESSMENTS,"

beg leave to report as follows:

The purpose of this measure is to:

(1) Require all health care providers who accept Medicare to provide a cognitive assessment as part of the Medicare Part B annual wellness visit for Medicare beneficiaries sixty-five years of age or older, with certain exceptions;

(2) Require all health care providers to submit certain information to the Executive Office on Aging relating to cognitive assessments; and

(3) Require the Executive Office on Aging to report de-identified aggregated data to the Legislature on annual basis and appropriate funds for this purpose.

Your Committees received testimony in support of this measure from the State Health Planning and Development Agency; State Council on Developmental Disabilities; Policy Advisory Board for Elder Affairs; Hawai‘i Primary Care Association; Hawaii Disability Rights Center; Alzheimer's Association - Hawaii; AARP Hawai‘i; Hawai‘i Public Health Association; Hawaii Parkinson Association; and numerous individuals. Your Committees received testimony in opposition to this measure from one individual. Your Committees received comments on this measure from the Department of Health; Executive Office on Aging; and Healthcare Association of Hawaii.

Your Committees find that Alzheimer's disease is one of the top ten leading causes of death in the United States, with ninety percent of cases occurring in individuals aged sixty-five or older. Your Committees further find that early detection and diagnosis of Alzheimer's disease and other dementias enables timely intervention, better care planning, and access to treatments that can slow the disease's progression. Your Committees note that Medicare beneficiaries who have opted to take Part B coverage already receive an annual cognitive assessment as part of their supplemental coverage. Your Committees believe that offering cognitive assessment tests as a standard part of the health care plan for an individual sixty-five years or older is a crucial part of the State's strategic plan to address Alzheimer's disease and related dementias. However, your Committees recognize that, due to the potential magnitude of this bill, it is more prudent at this time to establish a pilot program rather than require immediate implementation of these requirements, which will allow the Executive Office on Aging to best determine what would be needed for a statewide rollout.

Your Committees have amended this measure by:

(1) Establishing a Cognitive Assessments for Medicare Beneficiaries Pilot Program within the Executive Office on Aging, rather than statutorily requiring all health care providers to provide cognitive assessments for Medicare Part B beneficiaries;

(2) Requiring the Executive Office on Aging to collaborate with a health care system for purposes of the pilot program, including identifying health care providers to participate in the program and offer and conduct cognitive assessments to Medicare Part B beneficiaries;

(3) Permitting, rather than requiring, participating health care providers to report certain data to the Executive Office on Aging;

(4) Requiring the Executive Office on Aging to secure the transmission and storage of information reported as part of the pilot program rather than requiring the Office to adopt rules for this purpose;

(5) Changing the effective date to January 1, 3000, to encourage further discussion; and

(6) Making technical, nonsubstantive amendments for the purposes of clarity, consistency, and style.

Your Committees respectfully request your Committee on Finance, should it deliberate on this measure, to consider an appropriation amount of $150,000.

As affirmed by the records of votes of the members of your Committees on Health and Human Services & Homelessness that are attached to this report, your Committees are in accord with the intent and purpose of H.B. No. 700, as amended herein, and recommend that it pass Second Reading in the form attached hereto as H.B. No. 700, H.D. 1, and be referred to your Committee on Finance.

Respectfully submitted on behalf of the members of the Committees on Health and Human Services & Homelessness,

____________________________ LISA MARTEN, Chair

____________________________ GREGG TAKAYAMA, Chair