STAND. COM. REP. NO. 252-20

Honolulu, Hawaii

, 2020

RE: H.B. No. 1865

H.D. 1

Honorable Scott K. Saiki

Speaker, House of Representatives

Thirtieth State Legislature

Regular Session of 2020

State of Hawaii

Sir:

Your Committees on Health and Human Services & Homelessness, to which was referred H.B. No. 1865 entitled:

"A BILL FOR AN ACT RELATING TO ALZHEIMER'S DISEASE AND RELATED DEMENTIA,"

beg leave to report as follows:

The purpose of this measure is to ensure that staff in care facilities are adequately trained to work with individuals with Alzheimer's disease and related dementias by:

(1) Requiring the Department of Health to develop and coordinate an Alzheimer's disease and related dementia training program for care workers whose work involves extensive contact with participants or residents; and

(2) Authorizing the Department of Human Services to negotiate an increased reimbursement rate to facilities for individuals with Alzheimer's disease and related dementias.

Your Committees received testimony in support of this measure from Manoa Cottage and two individuals. Your Committees received testimony in opposition to this measure from the Department of Health. Your Committees received comments on this measure from the Department of Human Services, Executive Office on Aging, Alzheimer's Association – Aloha Chapter, and Healthcare Association of Hawaii.

Your Committees find that an estimated 29,000 individuals in Hawaii suffer from Alzheimer's disease, a progressive brain disease that is the sixth leading cause of death in the nation. Your Committees further find that due to the nature of Alzheimer's disease, there is a high and growing demand for in-home care, adult daycare, assisted living facilities, and care homes. Assistance for most of the daily life activities at these facilities is performed by nurse aides or nursing assistants. As a result, staff at these facilities need to be properly trained to interact with individuals suffering from Alzheimer's disease.

Your Committees note that the federal Centers for Medicare and Medicaid Services may not approve a general increase in reimbursement for services provided to individuals with Alzheimer's disease and related dementias in facilities. If the Centers for Medicare and Medicaid Services does not approve a rate change, then the reimbursement increase would need to be solely funded by the State.

Accordingly, your Committees have amended this measure by:

(1) Deleting its substance and requiring the Executive Office on Aging to convene a working group to:

(A) Review the best practices of other states as they relate to dementia training requirements in care facilities;

(B) Make recommendations on standards of training regarding the number of hours, learning objectives, to which staff the standards should apply, and other relevant criteria determined by the working group; and

(C) Make recommendations on strategies to implement these standards.

(2) Changing its effective date to July 1, 2050, to encourage further discussion; and

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

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. 1865, as amended herein, and recommend that it pass Second Reading in the form attached hereto as H.B. No. 1865, H.D. 1, and be referred to your Committee on Consumer Protection & Commerce.

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

____________________________ JOY A. SAN BUENAVENTURA, Chair

____________________________ JOHN M. MIZUNO, Chair