Hawaii-2021-HB541-Introduced

SECTION 1. The legislature finds that the department of health's behavioral health administration is responsible for planning, coordinating, and promoting statewide access to integrated behavioral health services to reduce the biological, social, psychological, and economic consequences of substance use disorder, mental health disorders, and other behavioral health conditions.

The legislature finds that fragmentation in the financing and payment ecosystem of behavioral health and homelessness care payers of state funding perpetuates disparity in monitoring outcomes and results of services purchased by the State. Further, the siloed manner in which state-funded services are purchased in this area leads to: increased administrative burdens on both providers and funders; disparity and inequity in reimbursement rates paid for similar services with state funds; difficulty in standardizing contracting, payment, evaluation processes, and quality assurance metrics; and duplication of effort at best, and waste of resources at worst.

As a result, patients receive uncoordinated care across a variety of services by public providers, contracted providers, and other private providers. The legislature further finds that consumers and patients of behavioral health services should have improved quality of behavioral health care through greater integration, lower fragmentation of payment models, and standard performance metrics.

The legislature also finds that Act 90, Session Laws of Hawaii 2019, established the involuntary hospitalization task force, and Act 263, Session Laws of Hawaii 2019, established a working group to evaluate current behavioral health care and related systems, including existing resources, systems gaps, and identification of action steps that could be taken to improve the overall system of care. The findings of these efforts highlighted various gaps and identified action steps that could be taken by the State to improve the coordination of the overall system of care. Since then, the behavioral health administration has made strides in implementing the recommendations and closing service gaps, which is evident in the expansion of the coordinated access resource entry system (CARES) and the recent implementation of stabilization beds for sub-acute care. However, there is still much work to be done if the State is to realize the goal of a comprehensive coordinated system of care for behavioral health and homelessness for services purchased by the State, as State resources should be used for services with optimal value and impact.

The legislature additionally finds that the legislature has the ability to promote greater coordination and enhance recent accomplishments through enacting legislation that requires more formalized coordination of purchasing services with state resources. Further, mandating such activities can facilitate multi-sectoral coordination of state resources, and given the current economic situation facing the State, it is in the State's best interests to do so. Accordingly, the purpose of this Act is to:

(1) Require executive programs that purchase social services related to mental health, substance abuse, and homelessness, to establish uniform baseline performance metrics, evaluation standards, and reimbursement rates;

(2) Require all community or private organizations that purchase services for behavioral health, substance abuse, or homelessness, at the request of any state funding agency, to disclose the source of other federal, state, or county-level funding it receives for the purposes of performing such services; and

(3) Establish the state payor committee, to be led by the department of health, to oversee and coordinate the purchase of services and recommend approval or rejection of the purchase of service contracts covered by this Act.

SECTION 2. Chapter 103D Hawaii Revised Statutes, is amended by adding two new sections to part III to be appropriately designated and to read as follows:

"§103D-A Mental health, substance abuse, and homelessness services. (a) All executive state agencies or programs that purchase social services related to mental health, substance abuse, and homelessness, shall establish uniform baseline performance metrics and evaluation standards across all contracts entered into for the purposes of purchasing such services with state resources.

(b) All executive state agencies or programs shall establish uniform reimbursement rates across all contracts entered into for the purpose of purchasing behavioral health, substance abuse, or homelessness services with state resources.

(c) All community or private organizations that purchase services for behavioral health, substance abuse, or homelessness services, at the request of any state funding agency, shall disclose the source of any other federal, state, or county level funding it receives for purposes of performing such services.

(d) Beginning July 1, 2021, no purchase of service contracts for behavioral health, substance abuse, or homelessness services using state resources shall be initiated, renewed, or continued unless reviewed and approved by the state payor committee, established pursuant to section 103D-B.

§103D-B State payor committee. (a) There is established the state payor committee, which shall be composed of members from any executive department or agency that purchases contracts for the delivery of services related to substance abuse, mental health, and homelessness with state resources.

(b) The director of health or the director's designated representative shall serve as the administrative head of the state payor committee.

(c) The committee shall have oversight of the coordination of the purchase of services and shall be responsible for recommending approval or rejection of service contracts pursuant to section 103D-A."

SECTION 3. New statutory material is underscored.

SECTION 4. This Act shall take effect upon its approval.

INTRODUCED BY:	_____________________________

Report Title:

Procurement; Service Contracts; Mental Health Services; Substance Abuse Services; Homelessness Services; Department of Health; State Payor Committee

Description:

Requires executive programs that purchase social services related to mental health, substance abuse, and homelessness to establish uniform baseline performance metrics, evaluation standards, and reimbursement rates. Requires all community or private organizations that purchase services for behavioral health, substance abuse, or homelessness, at the request of any state funding agency, to disclose the source of other federal, state, or county-level funding it receives for the purposes of performing such services. Establishes the state payor committee, to be administered by the director of the department of health, to oversee and coordinate the purchase of services and recommend approval or rejection of the purchase of contracts relating to mental health, substance abuse, or homelessness services.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

HOUSE OF REPRESENTATIVES	H.B. NO.	541
THIRTY-FIRST LEGISLATURE, 2021
STATE OF HAWAII