HB2744

SECTION 1. The legislature finds that Hawaii's oral health program is not meeting the needs of residents. Unlike forty-two other states, this State's department of health does not retain dedicated oral health staff to assess and monitor the population's oral health status, community needs, and assets; inform and educate people about oral health; mobilize community partners to leverage resources; develop, champion, and implement policies, laws, and plans that support oral health efforts; reduce barriers to care; assure a competent and skilled public and private oral health workforce; and improve public oral health functions through ongoing evaluation and continuous quality improvement.

The legislature further finds that the adult medicaid population has limited access to dental care. While there are more than 288,000 adults with medicaid dental benefits, there is a lack of dental providers for this population. Additionally, while federally qualified health centers in each county are a critical medical and oral health safety net, approximately forty-two thousand people of all ages and covered by all types of health insurance were served by the health centers in 2021.

The legislature additionally finds that while the department of health operates five small dental clinics and also serves individuals who are elderly, blind, intellectually disabled, developmentally disabled, and mentally ill, all clinics are located in the city and county of Honolulu. The State does not operate dental clinics to serve similar populations in other counties. The legislature notes that three hundred thirty-nine dentists in the State currently accept and treat adults covered by medicaid.

While the legislature allocated more than $25,000,000 in 2022 to reinstate adult medicaid dental benefits, the legislature is concerned that the current oral health infrastructure is insufficient to deliver oral health services to those most in need.

The purpose of this Act is to:

(1) Establish an oral health task force to review information and data on the status of oral health in the State and make recommendations to improve the State's oral health infrastructure; and

(2) Appropriate funds to help facilitate the work of the oral health task force.

SECTION 2. (a) There is established an oral health task force to be placed within the department of health for administrative purposes.

(b) The oral health task force shall:

(1) Review all information and data relating to oral health status in Hawaii, including the Hawaii Oral Health Coalition 2022-2023 environmental scan, for evidence of key oral health issues and evident areas for action;

(2) Review all information and data relating to the department of health oral health program functions and processes and make recommendations regarding organizational structure, personnel needs, contracted service needs, required resources, and potential additional funding and support;

(3) Review and analyze systemic issues in oral health services and processes statewide and make recommendations for systemic changes and improvements to improve equity in oral health;

(4) Develop an oral health strategic blueprint that includes goals, objectives, specific actions, and resources needed;

(5) Act as a systemic facilitator for key oral health stakeholders so that complex and problematic issues can be discussed and addressed in a timely and effective manner;

(6) Ensure that there are agreed-upon community metrics for analyzing the development and implementation of medicaid funding for oral health; and

(7) Make recommendations to state and county policymakers regarding systemic actions recommended to improve oral health in Hawaii.

(1) One representative of the family health services division of the department of health, to be appointed by the director of health;

(2) One representative of the developmental disabilities division of the department of health, to be appointed by the director of health;

(3) One representative of the med-QUEST division of the department of human services, to be appointed by the director of human services;

(4) One representative of the student services branch of the department of education, to be appointed by the superintendent of education;

(5) One representative of the state council on developmental disabilities, to be appointed by the speaker of the house of representatives;

(6) A faculty member of the university of Hawaii at Manoa Nancy Atmospera-Walch school of nursing dental hygiene program, to be appointed by the speaker of the house of representatives;

(7) One representative of the university of Hawaii John A. Burns school of medicine, to be appointed by the president of the senate;

(8) One representative of the county of Hawaii who is a department of health employee or community oral health representative, to be appointed by the president of the senate;

(9) One representative of the county of Maui, to be appointed by the speaker of the house of representatives;

(10) One representative of the county of Kauai, to be appointed by the president of the senate;

(11) One representative of the Hawaii Oral Health Coalition, to be invited by the president of the senate;

(12) One representative of the Hawaii Dental Association, to be invited by the speaker of the house of representatives;

(13) One representative of the Hawaii Dental Service, to be invited by the president of the senate;

(14) One representative of the Hawaii Dental Service Foundation, to be invited by the speaker of the house of representatives;

(15) One representative of a Hawaii dental medicaid insurer, to be invited by the president of the senate;

(16) Two community advocates for medicaid and oral health, one each to be invited by the speaker of the house of representatives and president of the senate, respectively;

(17) One representative of the Hawaii Primary Care Association, to be invited by the president of the senate;

(18) One representative of the Native Hawaiian Health Care Systems, to be invited by the speaker of the house of representatives;

(19) One representative of Papa Ola Lokahi, to be invited by the president of the senate;

(20) One representative of the Hawaii Dental Hygienists' Association, to be invited by the speaker of the house of representatives; and

(21) One representative advocate from the private practice dental community who is working with the adult medicaid population and other medicaid-associated dentists, to be invited by the director of health.

(d) The representative of the family health services division of the department of health shall serve as the chairperson of the task force. If the representative of the family health services division of the department of health is unable to serve as the chairperson of the task force, the members of the task force shall select a chairperson from among the remaining members.

(e) The oral health task force shall submit an interim report of its findings and recommendations to the legislature no later than twenty days prior to the convening of the Regular Session of 2025. The department of health shall submit a final report of the oral health task force's findings and recommendations, pursuant to section 321-63, Hawaii Revised Statutes, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the Regular Session of 2027.

(f) The task force shall cease to exist on June 30, 2027.

(g) No member of the task force shall be made subject to section 84-17, Hawaii Revised Statutes, solely because of that member's participation on the task force. The task force shall be exempt from part I of chapter 92, Hawaii Revised Statutes.

SECTION 3. In accordance with section 9 of article VII, of the Constitution of the State of Hawaii and sections 37-91 and 37-93, Hawaii Revised Statutes, the legislature has determined that the appropriations contained in this Act will cause the state general fund expenditure ceiling for fiscal year 2024-2025 to be exceeded by $ , or per cent. The reasons for exceeding the general fund expenditure ceiling are that the appropriations made in this Act are necessary to serve the public interest and to meet the needs provided for by this Act.

SECTION 4. There is appropriated out of the general revenues of the State of Hawaii the sum of $200,000 or so much thereof as may be necessary for fiscal year 2024-2025 for the family health services division of the department of health to contract with a consultant to facilitate the work of the oral health task force, including completing the interim and final reports required by subsection (e) of section 2 of this Act.

The sum appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 5. There is appropriated out of the general revenues of the State of Hawaii the sum of $79,872 or so much thereof as may be necessary for fiscal year 2024-2025 for the establishment of one permanent full-time equivalent (1.0 FTE) program specialist V position within the family health services division of the department of health.

This position shall:

(1) Collect, analyze, and evaluate information relevant to specific oral health policy issues and related material to enable oral health task force members to develop informed policy recommendations affecting oral health care;

(2) Serve as the representative of the department of health oral health program to the Hawaii Oral Health Coalition;

(3) Develop, administer, monitor, and provide oversight of the contract for a consultant to facilitate the work of the oral health task force; and

(4) Serve as a liaison between the department of health and other state agencies on the oral health task force.

The sum appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 6. This Act shall take effect upon its approval; provided that sections 4 and 5 shall take effect on July 1, 2024.

INTRODUCED BY:	_____________________________

HOUSE OF REPRESENTATIVES	H.B. NO.	2744
THIRTY-SECOND LEGISLATURE, 2024
STATE OF HAWAII