STAND. COM. REP. NO. 2036

Honolulu, Hawaii

RE: S.B. No. 1294

S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Thirty-First State Legislature

Regular Session of 2022

State of Hawaii

Sir:

Your Committee on Human Services, to which was referred S.B. No. 1294 entitled:

"A BILL FOR AN ACT RELATING TO MEDICAID BENEFITS,"

begs leave to report as follows:

The purpose and intent of this measure is to appropriate funds to restore diagnostic, preventive, and restorative dental benefits to adult Medicaid enrollees, provided that the Department of Human Services obtains maximum federal matching funds available and pursues all funding sources, including private grants, prior to expending any general fund appropriations.

Your Committee received testimony in support of this measure from the Department of Human Services; State Council on Developmental Disabilities; AlohaCare; Hawaii Dental Association; AARP Hawai‘i; Kaiser Permanente Hawai‘i; The Queen's Health Systems; Ho‘ōla Lāhui Hawai‘i; Hawaii Disability Rights Center; Arc of Maui County; Hawai‘i Health & Harm Reduction Center; ‘Ohana Health Plan; Hawai‘i Children's Action Network Speaks!; Bay Clinic, Inc.; American College of Obstetricians and Gynecologists, Hawai‘i Section; Hawaii Association of Health Plans; Hawaii Medical Service Association; Hawai‘i State Rural Health Association; Kōkua Kalihi Valley Comprehensive Family Services; Hawaii Primary Care Association; United Healthcare; Early Childhood Action Strategy; Hawaii Dental Hygienists' Association; Papa Ola Lōkahi; Waimānalo Health Center; Hawai‘i Oral Health Coalition; Full Life; Easterseals Hawaii; Hawaii Family Caregiver Coalition; and thirty-nine individuals. Your Committee received comments on this measure from the Department of Budget and Finance.

Your Committee finds that despite oral disease being a significant health problem that affects the overall health and well-being of many Hawaii residents, in 2009, the State terminated all preventive and restorative dental care services for adult Medicaid recipients and reduced coverage to emergency-only care that is limited to pain relief, injuries, trauma, and tooth removal and extraction. Your Committee further finds that recent research shows a disproportionate number of adult Medicaid enrollees ages twenty-one to forty-four years using the emergency room to receive emergency dental services. Your Committee is concerned that the lack of preventive and restorative dentistry services for adult Medicaid beneficiaries increases potential health care complications for Hawaii residents, especially those who have co-existing chronic diseases, such as diabetes and heart disease, which may lead to increased disability or death. Investing in preventive dental benefits for Medicaid-enrolled adults will, in the long term, lead to reductions in medical costs paid by Medicaid. Therefore, your Committee believes it is in the best interest of the State and its residents to reinstate coverage over diagnostic, preventive, and restorative dental benefits for adult Medicaid enrollees. This measure will appropriate funds to enable the State to do so.

Your Committee has reviewed the written testimony of the Department of Budget and Finance stating that the Executive Supplemental Budget for fiscal year 2022-2023 already includes $3,466,328 in general funds and $6,728,754 in federal funds for Department of Human Services (HMS 401) to reinstate certain adult dental benefits. As such, your Committee finds that this measure will become unnecessary if the funding in the Executive Supplemental Budget is approved. Your Committee further notes that Senate Bill No. 2401, Regular Session of 2022, is a substantially similar measure with updated information included.

Accordingly, your Committee has amended this measure by:

(1) Replacing the purpose section with the updated language for Senate Bill No. 2401, Regular Session of 2022;

(2) Clarifying that the funds appropriated by this measure are for the purpose of reinstating coverage of the basic package of diagnostic, preventive, and restorative dental benefits for adult Medicaid enrollees;

(3) Inserting an appropriation amount of $10,195,082;

(4) Inserting an effective date of December 31, 2050, to allow further discussion on whether the funding in the Executive Supplemental Budget for fiscal year 2022-2023 for the Department of Human Services (HMS 401) to reinstate certain adult dental benefits will be appropriated or authorized; and

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

As affirmed by the record of votes of the members of your Committee on Human Services that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 1294, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 1294, S.D. 1, and be referred to your Committee on Ways and Means.

Respectfully submitted on behalf of the members of the Committee on Human Services,

________________________________

JOY A. SAN BUENAVENTURA, Chair