REPORT TITLE:
Approp. Medically Underserved


DESCRIPTION:
Makes appropriations for DHS and DOH to support primary care for
medically underserved populations.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        
HOUSE OF REPRESENTATIVES                H.B. NO.1641       
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
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                   A  BILL  FOR  AN  ACT

RELATING TO THE MEDICALLY UNDERSERVED.



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

 1      SECTION 1.  The legislature finds that it is in the best
 
 2 interests of the State to ensure access to primary and preventive
 
 3 health care to all its residents.  This care not only results in
 
 4 a healthier and more productive population but also reduces
 
 5 publicly-supported costs for hospital and emergency room use for
 
 6 preventable conditions.
 
 7      The legislature further finds that certain individuals
 
 8 covered by QUEST are not receiving sufficient medical treatment
 
 9 and require additional clinical and other services to improve
 
10 their health.
 
11      The legislature further finds that access to primary and
 
12 preventive health care is in jeopardy as the number of medically
 
13 uninsured persons has increased by a rate of fifty per cent
 
14 between 1992 and 1997 from seventy thousand to one hundred five
 
15 thousand six hundred individuals.
 
16      The legislature further finds that Hawaii has a unique
 
17 system of nonprofit community-based providers of care who have an
 
18 expertise in caring for those with cultural and socioeconomic
 
19 barriers to care.  These nonprofit community-based providers
 

 
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 1 contribute greatly to the economies of the depressed areas they
 
 2 serve by directly or indirectly adding $73,000,000 and nine
 
 3 hundred jobs to the local economy annually.
 
 4      The legislature further finds that adequate financial
 
 5 support to ensure the sustainability of this nonprofit
 
 6 community-based system of care has been diminished by inadequate
 
 7 payments for services to patients covered by Medicaid managed
 
 8 care (QUEST) and by insufficient state funding for purchase of
 
 9 service contacts for health care services for the uninsured.
 
10      The legislature further finds that the State receives twice
 
11 as much for each dollar spent for supporting Medicaid costs for
 
12 services rendered by eligible, nonprofit community-based
 
13 providers because half of those costs are reimbursed by the
 
14 federal government.
 
15      The purpose of this Act is to maximize the availability of
 
16 combined state and federal resources to ensure the viability and
 
17 sustainability of the nonprofit community-based system of care
 
18 for the uninsured and persons covered by QUEST.
 
19      SECTION 2.  Whenever the department of human services
 
20 contracts with a health plan for the provision of QUEST services
 
21 to enrollees, that contract shall provide that in the case of
 
22 services furnished under contract to the health plan's enrollees
 
23 by a federally qualified health center or rural health center,
 

 
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                                     H.B. NO.1641       
                                                        
                                                        

 
 1 payment to the federally qualified health center or rural health
 
 2 center by the plan shall be comparable to, but no less than, the
 
 3 amount that plan pays to its other providers in the same
 
 4 geographic area for comparable services.
 
 5      At least quarterly, the department of human services shall
 
 6 pay the federally qualified health centers or rural health
 
 7 centers the difference between the payment received by the
 
 8 federally qualified health center or rural health center from the
 
 9 health plans and the reasonable cost of the federally qualified
 
10 health center or rural health center in providing those services
 
11 to the plan's QUEST enrollees.  Reasonable cost shall be
 
12 determined pursuant to section 1902(a)(13)(C)(i) of the federal
 
13 Social Security Act, and any applicable regulations promulgated
 
14 thereunder.
 
15      SECTION 3.  The department of health shall provide resources
 
16 to nonprofit community-based providers for caring for the
 
17 uninsured.  Distribution of those funds may be on a "per visit"
 
18 basis and shall take into consideration needs of uninsured
 
19 persons on all islands.  Nonprofit community-based providers that
 
20 are appropriate recipients of those funds and resources include
 
21 without limitation, community health centers, school-based
 
22 clinics, and the care-a-van program for the homeless.
 
23      SECTION 4.  There is appropriated out of the general
 

 
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 1 revenues of the State of Hawaii the sum of $500,000, or so much
 
 2 thereof as may be necessary for fiscal year 1999-2000, to support
 
 3 health care for primary care for medically underserved
 
 4 populations.
 
 5      The sum appropriated shall be expended by the department of
 
 6 human services for the purposes of this Act.
 
 7      SECTION 5.  There is appropriated out of the general
 
 8 revenues of the State of Hawaii the sum of $500,000, or so much
 
 9 thereof as may be necessary for fiscal year 1999-2000, to support
 
10 health care for medically underserved populations for primary
 
11 care.
 
12      The sum appropriated shall be expended by the department of
 
13 health for the purposes of this Act.
 
14      SECTION 6.  This Act shall take effect on July 1, 1999.
 
15 
 
16                           INTRODUCED BY:  _______________________