STAND. COM. REP. NO. 374-26

Honolulu, Hawaii

, 2026

RE: H.B. No. 2009

H.D. 1

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2026

State of Hawaii

Madame:

Your Committee on Human Services & Homelessness, to which was referred H.B. No. 2009 entitled:

"A BILL FOR AN ACT RELATING TO FAMILY CAREGIVER SUPPORT,"

begs leave to report as follows:

The purpose of this measure is to:

(1) Extend child care subsidies to children of disabled parents regardless of their employment status;

(2) Require the Department of Human Services to evaluate caregiver capacity and dependent-care responsibilities when determining eligibility for Medicaid Home and Community-Based Services; and

(3) Require the Department of Human Services to update its Form 1147 and health and functional assessment protocols to ensure that families with disabled caregivers received appropriate and timely support.

Your Committee received testimony in support of this measure from the Hawaiʻi State Council on Developmental Disabilities; Indivisible Hawaiʻi; Hawaiʻi Children's Action Network Speaks!; and numerous individuals. Your Committee received comments on this measure from the Department of Human Services.

Your Committee finds that federal Medicaid rules do not provide clear guidance on evaluating caregiver capacity and state level child care subsidies do not adequately account for situations where caregivers themselves face significant health or functional limitations. Addressing this gap is intended to correct structural inequities that have placed families with disabilities at risk of service loss, instability, and unnecessary institutionalization.

However, your Committee has heard the concerns raised in testimony by the Department of Human Services (Department) that federal programs and funding sources cannot be used to provide the subsidies or payments proposed by this measure. Rather, such support would require state general fund appropriations.

Your Committee has also heard the concerns of the Department regarding form DHS 1147. This form is focused exclusively on evaluating the extent and severity of a Medicaid recipient's disability, for purposes of evaluating whether the Medicaid recipient will meet a level of care to qualify for long-term services and supports (LTSS). The Department noted that form DHS 1147 is not intended to be a detailed assessment of a recipient's needs. Rather, once a member has qualified for LTSS, a health and functional assessment will serve as a more comprehensive evaluation of service needs.

Your Committee has amended this measure by:

(1) Removing the requirement for the Department of Human Services to seek and utilize federal funds;

(2) Removing the requirement for the Department of Human Services to revise its form DHS 1147 and deleting associated references to the form; and

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

As affirmed by the record of votes of the members of your Committee on Human Services & Homelessness that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 2009, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 2009, H.D. 1, and be referred to your Committee on Finance.

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

____________________________

LISA MARTEN, Chair