HOUSE OF REPRESENTATIVES

H.B. NO.

2098

THIRTIETH LEGISLATURE, 2020

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

relating to health.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 

     SECTION 1.  The legislature finds that there are medicaid beneficiaries in the State with autism, intellectual disabilities, or developmental disabilities who are unable to access home- and community-based services.  These individuals are at higher risk for future institutionalization, because they may lack independent daily living skills and may be unable to manage their own care.

     Accordingly, the purpose of this Act is to:

     (1)  Require the department of human services to establish and implement a program to offer home- and community-based services to individuals with autism, intellectual disabilities, or developmental disabilities who are found, through a functional assessment, to be at risk of institutionalization;

     (2)  Require the department of human services to apply by December 31, 2020, for an amendment to the QUEST integration section 1115 demonstration project to provide coverage for home- and community-based services for individuals with autism, intellectual disabilities, and developmental disabilities; and

     (3)  Appropriate moneys for the department's program for at-risk individuals who do not meet medicaid's criteria for treatment at an intermediate care facility.

     SECTION 2.  Chapter 346, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:

"Part   .  HOME- AND COMMUNITY-BASED SERVICES FOR

INDIVIDUALS WITH AUTISM, INTELLECTUAL DISABILITIES,

OR DEVELOPMENTAL DISABILITIES

     §346-A  Definitions.  As used in this part, unless the context requires otherwise:

     "Autism" has the same meaning as defined in section 431:10A-133.

     "Developmental disability" has the same meaning as defined in section 321-502.

     "Intellectual disability" has the same meaning as defined in section 333F-1.

     "Therapeutic care" means services provided by licensed speech pathologists, psychiatrists, psychologists, social workers, clinical social workers, and physical therapists and registered occupational therapists.

     §346-B  Individuals with autism, intellectual disabilities, or developmental disabilities; eligibility for home- and community-based services.  (a)  Beginning January 1, 2021, and notwithstanding any law to the contrary, the State's medicaid managed care and fee-for-service programs shall not deny coverage for home- and community-based services to individuals who have been diagnosed with autism, intellectual disabilities, or developmental disabilities.

     (b)  Services covered under this section shall include, but not be limited to:

     (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 specialists, community support programs, and systematic skill building services;

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

    (12)  Temporary supplemental services;

    (13)  Therapeutic care;

    (14)  Transitional work services;

    (15)  Vehicle modifications;

    (16)  Supportive housing; and

    (17)  Access to medicaid's early and periodic screening, diagnosis, and treatment program for eligible individuals under the age of twenty-one.

     (c)  Services covered pursuant to this section shall be consistent with all federal and state privacy, security, and confidentiality laws.

     (d)  Notwithstanding any other law to the contrary, the provisions of this section shall comply with the applicable federal requirements related to utilization, coverage, and reimbursement for services provided to individuals who have been diagnosed with autism, intellectual disabilities, or developmental disabilities.

     §346-C  Program for at-risk individuals with autism, intellectual disabilities, or developmental disabilities.  (a)  The department shall establish and implement a program for providing additional home- and community-based services, including long-term services and supports, to at-risk individuals with autism, intellectual disabilities, or developmental disabilities who do not meet medicaid's criteria for treatment at an intermediate care facility.  Individuals eligible for services under this program shall:

     (1)  Have been diagnosed with autism, an intellectual disability, or a developmental disability;

     (2)  Have been found through a functional assessment to be at risk of deteriorating to the institutional level of care if certain long-term services and supports are not provided;

     (3)  Have been found ineligible under medicaid for treatment at an intermediate care facility; and

     (4)  Reside in his or her own home; provided that individuals who reside in a community shelter may receive at-risk services that are appropriate for their living environment as determined by            ; provided further that services under this section shall not be provided to individuals already residing in a care facility, including but not limited to a care home, foster home, hospital, nursing facility, or hospice facility.

     (b)  Services covered under this section shall be provided for a maximum of one year, based on the needs of the eligible individual, but may be renewed in yearly increments if a functional assessment of the individual indicates that ongoing at-risk services are medically necessary."

     SECTION 3.  No later than December 31, 2020, the department of human services shall seek a waiver pursuant to section 1115 of the Social Security Act and other approvals from the centers for medicare and medicaid services that may be necessary to amend the state medicaid plan to provide coverage for home- and community-based services for medicaid eligible individuals who have been diagnosed with autism, intellectual disabilities, or developmental disabilities.

     SECTION 4.  The provision of home- and community-based services for individuals diagnosed with autism, intellectual disabilities, or developmental disabilities shall apply to all plans issued under medicaid managed care and fee-for-service programs in the State.

     SECTION 5.  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 2020-2021 for the department of human services to establish and implement a program for providing home- and community-based services to at-risk individuals with autism, intellectual disabilities, or developmental disabilities; provided that the sum appropriated shall be in addition to the base budget of the department of human services.

     The sum appropriated shall be expended by the department of human services for the purposes of this Act.

     SECTION 6.  This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

     SECTION 7.  If any provision of this Act, or the application thereof to any person or circumstance, is held invalid, 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 8.  New statutory material is underscored.

     SECTION 9.  This Act shall take effect on July 1, 2020.

 

INTRODUCED BY:

_____________________________

 

 

 

 

Report Title:

DHS; Autism; Intellectual Disabilities; Developmental Disabilities; Home- and Community-Based Services; Medicaid; Appropriation

 

Description:

Requires the Department of Human Services to establish and implement a program for providing additional home- and community-based services to at-risk individuals with autism, intellectual disabilities, or developmental disabilities who meet certain criteria and who do not meet Medicaid's criteria for treatment at an intermediate care facility.  Requires the department to seek a section 1115 waiver to amend the state Medicaid plan to cover home- and community-based services for individuals with autism, intellectual disabilities, or developmental disabilities.  Appropriates funds.

 

 

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