HB668 HD1

SECTION 1. The legislature finds that it must act to stop the inequity of and discrimination by the department of human services' decision to limit the number of QUEST health plans available on the neighbor islands to only two while allowing Oahu the choice of four QUEST health plans.

The legislature further finds that the department of human services issued a request for proposals on or about August 26, 2019 (RFP-MQD-2019-002) "with the intent of securing contracts with four (4) Health Plans for the provision of covered services to eligible Medicaid and Children's Health Insurance Program (CHIP) members for medically necessary medical, behavioral health and long-term services and supports in a fully risk-based managed care environment." In this request for proposals, the State sought to "improve the health care and to enhance and expand coverage for persons eligible for Medicaid and Children's Health Insurance Program by the most cost effective and efficient means through the QUEST Integration program with an emphasis on prevention and quality health care." However, by limiting the number of contracts on the neighbor islands to two, compared to four for Oahu residents, the request for proposals may result in a reduction of coverage and threaten the quality of health care options for medicaid beneficiaries. Furthermore, reducing health plan options will also increase administrative costs for the department of human services due to the need for outreach and reassignment of nearly fifty thousand medicaid members to a new health plan.

As a result of limiting the number of contracted health plans on neighbor islands, some current medicaid members will be forced to find new providers, which will be nearly impossible given the shortage of physicians and will result in adverse health outcomes for these individuals.

The legislature moreover finds that it should review the possibility of adding two health plans for medicaid members who reside on the neighbor islands so that they will have access to the same number of health plans that medicaid members who reside on Oahu do.

The legislature further finds that the department of human services should focus on fair access to health care for medicaid members statewide and that limiting health plans for medicaid members on the neighbor islands to only two but providing a choice of four health plans to medicaid members on Oahu is both explicitly and inherently unfair to neighbor island residents.

The legislature also finds that a significant collaborative effort by all stakeholders is needed to resolve the issue of inequity and to allow for equal access, equal protection, and parity for all medicaid members, regardless of whether they reside on Oahu or the neighbor islands.

Pursuant to section 5-7.5, Hawaii Revised Statutes, the legislature recognizes that the "Aloha Spirit" is the coordination of mind and heart within each person. It brings each person to the self. Each person must think and emote good feelings to others. In the contemplation and presence of the life force, "Aloha", the following unuhi laula loa may be used:

(1) "Akahai", meaning kindness to be expressed with tenderness;

(2) "Lokahi", meaning unity, to be expressed with harmony;

(3) "Oluolu", meaning agreeable, to be expressed with pleasantness;

(4) "Haahaa", meaning humility, to be expressed with modesty; and

(5) "Ahonui", meaning patience, to be expressed with perseverance.

The legislature further recognizes that these are traits of character that express the charm, warmth, and sincerity of Hawaii's people. It was the working philosophy of native Hawaiians and was presented as a gift to the people of Hawaii. "Aloha" is more than a word of greeting or farewell or a salutation. "Aloha" means mutual regard and affection and extends warmth in caring with no obligation in return. "Aloha" is the essence of relationships in which each person is important to every other person for collective existence. "Aloha" means to hear what is not said, to see what cannot be seen, and to know the unknowable.

In exercising their power on behalf of the people and in fulfillment of their responsibilities, obligations, and service to the people, the members of the legislature; governor; lieutenant governor; executive officers of each department; chief justice; associate justices; judges of the appellate, circuit, and district courts; chiefs of police of each county; and first responders may contemplate and reside with the life force and give consideration to the "Aloha Spirit" in all decisions affecting the people of Hawaii.

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

"§346- Medicaid plans; reductions; legislative approval. Prior to executing any contract that would reduce the number of medicaid plans available in any part of the State, the department of human services shall receive the approval of the legislature by concurrent resolution by a two-thirds vote of each house of the legislature."

SECTION 3. (a) The auditor shall conduct an audit of the department of human services' request for information and request for proposals processes regarding RFP-MQD-2019-002.

(b) No later than twenty days prior to the convening of the regular session of 2021, the auditor shall submit to the legislature a report of the auditor's findings and recommendations, including any proposed legislation.

SECTION 4. (a) There is established a task force to review the department of human services' request for information and request for proposals processes.

(b) The task force shall consist of:

(1) The chairperson of the senate standing committee on human services;

(2) The chairperson of the senate standing committee on commerce, consumer protection, and health;

(3) The chairperson of the house of representatives standing committee on human services and homelessness; and

(4) The chairperson of the house of representatives standing committee on health.

(d) No later than twenty days prior to the convening of the regular session of 2021, the task force shall submit to the legislature a report of its findings and recommendations, including any proposed legislation, regarding the department of human services' request for information and request for proposals processes.

SECTION 5. 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 6. New statutory material is underscored.

SECTION 7. This Act shall take effect on July 1, 2050.

HOUSE OF REPRESENTATIVES	H.B. NO.	668
THIRTIETH LEGISLATURE, 2019		H.D. 1
STATE OF HAWAII