HB617

SECTION 1. The legislature finds that Hawaii's dental public health program is not meeting the needs of residents. Unlike forty-two other states, the State's department of health currently does not have dedicated public dental 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 dental 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 over 288,000 adults with medicaid dental benefits, there is a lack of dental providers of needed services for the population. Additionally, while federally qualified health centers in each county are a critical medical and oral health safety net, in 2021, about 42,000 people of all ages and all types of health insurance were served by the health centers.

The legislature additionally finds that while the department of health operates five small dental clinics and serves individuals who are elderly, blind, intellectually disabled, developmentally disabled, and mentally ill at the Hawaii state hospital, all clinics are located in the city and county of Honolulu. The State does not operate dental clinics to serve similar populations on the neighbor islands. The legislature notes that 339 dentists currently accept and treat adults on medicaid.

While the legislature allocated over $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 establish an oral health task force to review information on the status of oral health in the State and make recommendations to improve oral health infrastructure in Hawaii.

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 existing 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 existing information and data relating to the department of health public dental health functions and program 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 on 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 medquest 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 Hawaii Oral Health Coalition, to be appointed by the president of the senate;

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

(7) One representative of the Hawaii Dental Services, to be appointed by the president of the senate;

(8) One representative of the Hawaii Dental Services Foundation, to be appointed by the speaker of the house of representatives;

(9) One representative of the Hawaii Dental Medicaid Insurer, to be appointed by the president of the senate;

(10) A community advocate for medicaid and oral health, to be appointed by the speaker of the house of representatives;

(11) A community advocate for medicaid and oral health, to be appointed by the president of the senate;

(12) One representative of the Hawaii State Council on Developmental Disabilities, to be appointed by the speaker of the house of representatives;

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

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

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

(16) One representative of the Hawaii Dental Hygienists' Association, to be appointed by the speaker of the house of representatives;

(17) 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;

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

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

(20) 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; and

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

(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 December 1, 2023. The oral health task force shall submit a final report of its findings and recommendations, including any proposed legislation, no later than December 1, 2024.

(f) The task force shall cease to exist on June 30, 2025.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2023-2024 and the same sum 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 administer a contract to hire a consultant to facilitate the work of the oral health task force, including completing the task force's interim and final reports.

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

SECTION 4. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2023-2024 and the same sum 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 hire one full-time equivalent (1.0 FTE) program specialist IV and one full-time equivalent (1.0 FTE) program specialist V to oversee the contract to hire a consultant to facilitate the work of the oral health task force and to lay the foundation for a robust public dental health program in the State.

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

SECTION 5. This Act shall take effect upon its approval; provided that sections 3 and 4 shall take effect on July 1, 2023.

INTRODUCED BY:	_____________________________

HOUSE OF REPRESENTATIVES	H.B. NO.	617
THIRTY-SECOND LEGISLATURE, 2023
STATE OF HAWAII