SB 3324

THE SENATE
S.B. NO.
3324
THIRTY-THIRD LEGISLATURE, 2026
S.D. 1
STATE OF HAWAII
H.D. 1
C.D. 1
A BILL FOR AN ACT
RELATING TO MEDICAID.
BE IT
ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
���� SECTION 1.� The
legislature finds that, in a 2021 quantitative research study, the AARP found
that, among Hawaii residents aged forty-five and older, seventy-five per cent
of the respondents reported that having affordable long-term care options in
their communities was an important independent living issue.� Respondents also reported that maintaining a
connection with family and friends and the ability to continue visiting
familiar health care providers are significantly easier when the State's kupuna
can be cared for closer to home.� The
legislature recognizes that, in 2026, a strong demand for community-based care
options for kupuna still exists.
���� The legislature further finds that the
latest review of the State's home and community-based medicaid reimbursement
rates for residential services was a third-party study conducted by the
actuarial firm Milliman, published on December 30, 2022.� The study developed benchmark comparison
rates for certain home and community-based services, including residential
services provided in community care foster family homes and expanded adult
residential care homes.� Notably, amongst
all provider types examined in the Milliman study, the current median direct
care wages paid to home and community-based services providers fell below the
twenty-fifth percentile for those occupation codes and titles as determined by
the United States Bureau of Labor Statistics.
���� The legislature also finds that, in 2024, a
recurring budget appropriation for residential settings rates was enacted.� The appropriation was passed as a budget
line-item reflecting an annual state share increase of $5,750,000 for select
home and community-based services.� This
increase was inclusive of residential services for community care foster family
homes and expanded adult residential care homes, effective in 2025 and beyond,
and reflected the "low" rate scenario for the residential services
included in Milliman's 2022 rate study.
���� The legislature acknowledges that, while
meaningful, the 2024 appropriation was inadequate.� Service providers remain unable to offer
benefits, including health insurance, to their employees and continue to rely
on substitute caregivers, sometimes unpaid, including family members and
friends of the providers.� Additionally,
high inflation has persisted, further increasing costs for operators providing
residential services in community care foster family homes and expanded adult
residential care homes.� The result of
these ongoing financial pressures is that few providers are able to operate
sustainably, leading to limited community-based care options for Hawaii's
kupuna.
���� Accordingly, the purpose of this Act is to:
���� (1)� Appropriate
funds to increase the funding of residential services offered in community care
foster family homes and expanded adult residential care homes to the
"medium" rate scenario published in Milliman's 2022 rate study; and
���� (2)� Require
the department of human services to obtain the maximum federal matching funds
available for the increased expenditure, which will result in a larger impact
on reimbursements paid to service providers.
���� SECTION 2.�
There is appropriated out of the general revenues of the State of Hawaii
the sum of $1,700,000 or so much thereof as may be necessary for fiscal year
2026-2027 to increase funding for certain medicaid home- and community-based
services, including residential services offered in community care foster
family homes and expanded adult residential care homes; provided that no sum
shall be expended unless the department of human services:
���� (1)� Obtains
the maximum federal matching funds available for this appropriation; and
���� (2)� Exhaustively
pursues all funding sources identified by the State, including private grants.
���� The sum appropriated shall be expended by
the department of human services for the purposes of this Act.
���� SECTION 3.�
This Act shall take effect on July 1, 2026.
Report Title:
DHS;
Medicaid; Med-QUEST; Home- and Community-Based Services; Residential Services;
Community Care Foster Family Homes; Expanded Adult Residential Care Homes;
Federal Matching Funds; Appropriation
Description:
Appropriates
funds to the Department of Human Services to increase funding for certain
Medicaid home- and community-based services, including residential services
offered in community care foster family homes and expanded adult residential
care homes.� Requires the Department to
obtain matching federal funds and pursue additional funding sources as a
condition for expending the appropriated funds.�
(CD1)
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.