Bill Text: HI HCR23 | 2018 | Regular Session | Amended

Hawaii House Concurrent Resolution 23 (Prior Session Legislation)

Bill Title: Urging The Governor And The Director Of Human Services To Reinstate Restorative And Preventative Dental Medicaid Coverage For Adult Beneficiaries In The State Of Hawaii.

Spectrum: Partisan Bill (Democrat 5-0)

Status: (Introduced - Dead) 2018-03-28 - Report adopted. referred to the committee(s) on FIN as amended in HD 1 with none voting aye with reservations; none voting no (0) and Representative(s) Souki excused (1). [HCR23 Detail]

Download: Hawaii-2018-HCR23-Amended.html

HOUSE OF REPRESENTATIVES	H.C.R. NO.	23
TWENTY-NINTH LEGISLATURE, 2018		H.D. 1
STATE OF HAWAII

HOUSE CONCURRENT

RESOLUTION

URGING THE GOVERNOR AND THE DIRECTOR OF HUMAN SERVICES TO REINSTATE RESTORATIVE AND PREVENTATIVE DENTAL MEDICAID COVERAGE FOR ADULT BENEFICIARIES IN THE STATE OF HAWAII.

WHEREAS, the Legislature believes that a more concerted effort needs to be made to address oral health in Hawaii, especially in underserved communities in response to the State's receipt of a failing grade of "F" in a series of recent oral health report cards released by The Pew Center on the States; and

WHEREAS, according to the Department of Health in its "Hawaii Oral Health: Key Findings" report of September 25, 2015:

(1) Eighty-two percent of high-income adults in Hawaii see a dentist each year, as compared to only fifty-two percent of low-income adults;

(2) Fifty-one percent of low-income adults lost teeth due to dental disease, compared to only thirty-two percent of high-income adults;

(3) Only forty-one percent of pregnant women in Hawaii reported seeing a dentist during their pregnancy from 2009 to 2011, with low-income women and women in the medicaid program among the lowest estimated groups of receiving care;

(4) In 2012, there were more than three thousand emergency room visits due to preventable dental problems, representing a sixty-seven percent increase from 2006, significantly higher than the national average, and these visits accounted for $8,500,000 in total expenditures by the State, more than double the $4,000,000 spent in 2006; and

(5) Only eleven percent of Hawaii's residents receive fluoridated drinking water, as compared to seventy-five percent for the United States as a whole; and

WHEREAS, the Legislature asserts that these figures represent that oral health in the State is a pervasive and expensive public health crisis that needs to be addressed, especially in low-income and underserved populations; and

WHEREAS, in response to these glaring disparities and inadequacies, the Department of Health posited eight key strategies for rebuilding the State's dental public health infrastructure, including:

(1) Continuing to support and expand affordable and accessible preventive dental care services to Hawaii's low-income populations;

(2) Expanding medicaid dental services for adults beyond the current coverage for "emergencies only" to include preventive and treatment services;

(3) Considering increasing reimbursements to dental providers for key preventive or restorative procedures to increase participation in medicaid; and

(4) Developing strategies to reduce barriers to finding and receiving preventive dental care services for children enrolled in the medicaid program; and

WHEREAS, the Legislature believes that it is in the best interest of the State to expand access to coverage by restoring basic adult dental benefits to medicaid enrollees; and

WHEREAS, the Legislature further finds that the State's Federally matched medicaid program forms an essential support for underserved individuals by offering insurance options for low-income citizens, in addition to other social service programs; and

WHEREAS, restoring basic adult dental benefits would be in line with the intent of the Department of Health, allowing for individuals to eat properly, work productively, improve mental health well-being, and increase attendance and participation in school; and

WHEREAS, funding for Hawaii's medicaid program is under the auspices of the Department of Human Services, not the Department of Health; and

WHEREAS, the entire medicaid program is funded in a single line item in the Executive Budget, General Appropriations Act of 2017, Session Laws of Hawaii (SLH) 2017; and

WHEREAS, the objective of this line item is to "ensure that qualified low-income and disabled individuals and families are provided health care services, including medical, dental, hospital, nursing home, home and community-based, and other professional services, either through a fee-for-service or QUEST-managed care program."; and

WHEREAS, in addition to general funds, special funds, federal funds, other federal funds, and interdepartmental transfers were appropriated into the General Appropriations Act of 2017; and

WHEREAS, in 2018, the Department of Human Services requested $4,704,480 in general funds, and $7,066,720 in federal funds for fiscal year 2019, to restore adult dental medicaid benefits, including preventative and restorative oral health services; and

WHEREAS, $4,704,480 in general funds requested is less than one-half of one percent of the $944,108,598 in general funds that had already been appropriated into General Appropriations Act of 2017; and

WHEREAS, accordingly, the Legislature asserts that adult dental medicaid benefits can be restored without the appropriation of additional funds if the Department of Human Services can achieve cost savings of less than one-half of one percent of the current appropriation for the General Appropriations Act of 2017; and

WHEREAS, the Legislature also acknowledges that the governor has significant discretionary authority to shift funds for budgeting purposes; and

WHEREAS, among other things, the governor could transfer surplus general funds to the General Appropriations Act of 2017 to supplement the operational funds for medicaid; and

WHEREAS, according to the governor's six-year financial plan, it is estimated that the State will experience a general fund surplus of between $654,900,000 and $829,100,000 for fiscal year 2019; and

WHEREAS, the total funding requested to reinstate adult dental medicaid benefits of $11,771,200 amounts to between 1.4 and 1.7 percent of the estimated general fund carry-over balance; now, therefore,

BE IT RESOLVED by the House of Representatives of the Twenty-ninth Legislature of the State of Hawaii, Regular Session of 2018, the Senate concurring, that the Governor and the Director of Human Services are urged to reinstate restorative and preventative dental coverage for adult medicaid beneficiaries within its current budget appropriation found in the General Appropriations Act of 2017; and

BE IT FURTHER RESOLVED that the Director of Human Services is requested to submit a report to the Legislature at least twenty days prior to the convening of the regular session of 2019 that includes, but is not limited to:

(1) The number of adult medicaid recipients receiving restorative and preventative dental benefits; and

(2) A projection of the number of eligible adult medicaid beneficiaries who would be eligible to receive restorative and preventative dental benefits during fiscal biennium 2019-2020; and

BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Governor, the Directors of Human Services, Health, and Finance, and the Chief Executive Officer of the Hawaii Primary Care Association.

Report Title:

URGING THE GOVERNOR AND THE DIRECTOR OF HUMAN SERVICES TO REINSTATE RESTORATIVE AND PREVENTATIVE DENTAL MEDICAID COVERAGE FOR ADULT BENEFICIARIES IN THE STATE OF HAWAII.