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HOUSE OF REPRESENTATIVES             H.C.R. NO.            H.D. 1
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
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                     HOUSE  CONCURRENT
                        RESOLUTION

REQUESTING THE AUDITOR TO CONDUCT A STUDY OF MANDATORY HEALTH
   INSURANCE COVERAGE FOR MENTAL HEALTH AND SUBSTANCE ABUSE.



 1        WHEREAS, mental illness and substance abuse are diseases
 2   that are often misunderstood, and those with these diseases,
 3   are often stigmatized by others; and
 4   
 5        WHEREAS, research is finding that an increasing number of
 6   mental illnesses and substance abuse problems have a biological
 7   or genetic basis, and in many cases cannot be controlled by the
 8   individual, alone; and
 9   
10        WHEREAS, the effect of mental illness and substance abuse
11   on an individual can be as debilitating and serious as any
12   other illness or injury, and may even result in death; and
13   
14        WHEREAS, mental illness and substance abuse problems often
15   go hand-in-hand, and today, mental illness and substance abuse
16   problems may be as precisely and effectively identified and
17   treated as any other illness or injury; and
18   
19        WHEREAS, in response to unequal treatment of mental
20   illness and substance abuse problems in health insurance
21   coverage, in 1997, Congress passed the Mental Health Parity Act
22   to encourage health plans to provide the same mental health
23   benefits as provided for other health care benefits, and 19
24   states have passed laws with various approaches to mandating
25   parity for mental health, substance abuse, or both mental
26   health and substance abuse coverage; and
27   
28        WHEREAS, in the 1997 regular session of the Nineteenth
29   State Legislature, H.B. No. 427 was introduced to mandate
30   parity of mental health and alcohol and drug abuse treatment
31   coverage with coverage for other medical illness, and in 1998,
32   the Legislature, in Act 78, Session Laws of Hawaii (SLH),
33   doubled the number of mental health outpatient benefits; and

 
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                                  H.C.R. NO.            H.D. 1
                                                        
                                                        

 
 1        WHEREAS, in 1997, the Legislative Auditor (Auditor) was
 2   requested to study the social and financial impact of House
 3   Bill No. 427, and in Report No. 97-19, found that the
 4   definition of parity needed clarification; and
 5   
 6        WHEREAS, lack of parity may mean that the treatment needs
 7   of certain individuals with mental health illness or substance
 8   abuse problems are not being adequately met; and
 9   
10        WHEREAS, in Report No. 97-19, the Auditor found that for
11   individuals with severe mental disorders, lack of parity may
12   result in hardship under existing health coverage; and
13   
14        WHEREAS, in 1999, the Department of Health testified
15   before the House Committee on Commerce and Consumer Protection
16   that of the five per cent of the population that use mental
17   health or substance abuse services in any year, only a small
18   portion who are likely to suffer from severe disability will
19   require additional mental health and substance abuse services;
20   and
21   
22        WHEREAS, there was testimony in 1999, before the House
23   Committee on Commerce and Consumer Protection by those
24   suffering from mental illnesses that existing levels of mental
25   health coverage are inadequate; and
26   
27        WHEREAS, there is a need to better identify the needs as
28   well as define the size and composition of the group of
29   individuals, if any, who are adversely affected by existing
30   levels of mental health and substance abuse treatment coverage,
31   including that mandated by Act 78, SLH 1998, to determine the
32   need for such coverage, the form that such coverage may take,
33   as well as the potential costs of mandating additional
34   coverage; now, therefore,
35   
36        BE IT RESOLVED by the House of Representatives of the
37   Twentieth Legislature of the State of Hawaii, Regular Session
38   of 1999, the Senate concurring, that the Auditor is requested
39   to identify to the extent feasible, the population of persons
40   in this state needing additional mental health and substance
41   abuse services coverage, and to the extent possible, identify
42   the cost of providing additional coverage to this group; and
43   
44        BE IT FURTHER RESOLVED that, to the extent relevant and
45   instructive, the Auditor is requested to describe, examine, and
46   evaluate the methods used by other states to provide coverage
47   for this group, as well as the costs of these methods; and

 
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                                  H.C.R. NO.            H.D. 1
                                                        
                                                        

 
 1        BE IT FURTHER RESOLVED that the Auditor is requested to
 2   consult with representatives of relevant legislative
 3   committees, as well as the parties affected by any additional
 4   mandated mental health and substance abuse coverage under
 5   chapter 431M, Hawaii Revised Statutes, including the
 6   Departments of Health and Human Services, Insurance
 7   Commissioner, Hawaii Psychological Association, Hawaii Nurses
 8   Association, Equal Insurance Coalition, insurance carriers,
 9   nonprofit mutual benefit associations, health maintenance
10   organizations, private health insurance providers, employers,
11   and consumers; and
12   
13        BE IT FURTHER RESOLVED that certified copies of this
14   Concurrent Resolution be transmitted to the Auditor, the
15   Directors of Health, Commerce and Consumer Affairs, and Human
16   Services, and the Insurance Commissioner.