SB 1443: DOH; Hawaii State Hospital; Psychiatric Facility; Long-Term Care Facility; Payment; Medicaid; Procurement Exemption

A BILL FOR AN ACT

RELATING TO THE DEPARTMENT OF HEALTH.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  Chapter 334, Hawaii Revised Statutes, is amended by adding a new section to part IV to be appropriately designated and to read as follows:

     "§334-     Psychiatric facility; procurement of and payment of expenses for medical care and long-term care.  (a)  Rates of payments for medical care for patients of the Hawaii state hospital and for patients under the custody of the director at a psychiatric facility other than the Hawaii state hospital shall be limited to the Hawaii medicaid fee schedule or the provider's billed amount, whichever is less.

     (b)  The department may establish rates of payment for long-term care services provided for patients who are discharged to a long-term care facility from the Hawaii state hospital or from a psychiatric facility other than the Hawaii state hospital where they were under the custody of the director.

     (c)  The department shall be exempt from chapter 103F for the procurement of medical care for patients of the Hawaii state hospital and for patients of a psychiatric facility other than the Hawaii state hospital who are under the custody of the director, and for the procurement of long-term care for patients discharged to a long-term care facility from the Hawaii state hospital or from a psychiatric facility other than the Hawaii state hospital where they were under the custody of the director.

     (d)  For the purposes of this section:

     "Long-term care" means care provided by a long-term care facility.

     "Long-term care facility" has the same meaning as defined in section 349-21.

     "Medical care" means examination, diagnosis, or treatment for medical and dental conditions, including outpatient and hospital-based services as well as appliances and supplies deemed clinically necessary by the department.  "Medical care" does not include long-term care."

     SECTION 2.  This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

     SECTION 3.  New statutory material is underscored.

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

Report Title:

DOH; Hawaii State Hospital; Psychiatric Facility; Long-Term Care Facility; Payment; Medicaid; Procurement Exemption

Description:

Establishes maximum rates of payment for medical care for patients of the Hawaii State Hospital or of another psychiatric facility who are under the custody of the Director of Health.  Authorizes the Department of Health to establish long-term care payment rates for certain patients discharged to a long-term care facility from the Hawaii State Hospital or another psychiatric facility.  Exempts the Department of Health from the Hawaii Public Procurement Code for the procurement of medical care and long-term care for certain patients.  (HD1)

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

A BILL FOR AN ACT

RELATING TO THE DEPARTMENT OF HEALTH.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  Chapter 334, Hawaii Revised Statutes, is amended by adding a new section to part IV to be appropriately designated and to read as follows:

     "§334-    Psychiatric facility; procurement of and payment of expenses for medical care and long-term care.  (a)  Rates of payments for medical care for patients of the Hawaii state hospital and for patients under the custody of the director at a psychiatric facility other than the Hawaii state hospital shall be limited to the Hawaii medicaid fee schedule or the provider's billed amount, whichever is less.

     (b)  The department may establish rates of payment for long-term care services provided for patients who are discharged to a long-term care facility from the Hawaii state hospital or from a psychiatric facility other than the Hawaii state hospital where they were under the custody of the director.

     (c)  The department shall be exempt from chapter 103F for the procurement of medical care for patients of the Hawaii state hospital and for patients of a psychiatric facility other than the Hawaii state hospital who are under the custody of the director, and for the procurement of long-term care for patients discharged to a long-term care facility from the Hawaii state hospital or from a psychiatric facility other than the Hawaii state hospital where they were under the custody of the director.

     (d)  For the purposes of this section:

     "Long-term care" means care provided by a long-term care facility.

     "Long-term care facility" has the same meaning as defined in section 349-21.

     "Medical care" means examination, diagnosis, or treatment for medical and dental conditions to include outpatient and hospital-based services as well as appliances and supplies deemed clinically necessary by the department.  "Medical care" does not include long-term care."

     SECTION 2.  This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

     SECTION 3.  New statutory material is underscored.

     SECTION 4.  This Act shall take effect on December 31, 2050.

Report Title:

DOH; Hawaii State Hospital; Psychiatric Facility; Long-Term Care Facility; Payment; Medicaid; Procurement Exemption

Description:

Establishes maximum rates of payment for medical care for patients of the Hawaii State Hospital or of another psychiatric facility who are under the custody of the Director of Health.  Authorizes the Department of Health to establish long-term care payment rates for patients discharged to a long-term care facility from the Hawaii State Hospital or another psychiatric facility where they were under the custody of the Director of Health.  Exempts the Department of Health from chapter 103F, HRS, for the procurement of medical care and long-term care for patients who are or were under the custody of the Director of Health at the Hawaii State Hospital or a psychiatric facility.  Effective 12/31/2050.  (SD1)

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

A BILL FOR AN ACT

RELATING TO THE DEPARTMENT OF HEALTH.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  Chapter 334, Hawaii Revised Statutes, is amended by adding to part IV a new section to be appropriately designated and to read as follows:

     "§334-     Psychiatric facility; procurement of and payment of expenses for medical care and long-term care.  (a)  Rates of payments for medical care for patients of the Hawaii state hospital and for patients under the custody of the director at a psychiatric facility other than the Hawaii state hospital shall be limited to the Hawaii medicaid fee schedule or the provider's billed amount, whichever is less.

     (b)  The department may establish rates of payment for long-term care services provided for patients who are discharged to a long-term care facility from the Hawaii state hospital or from a psychiatric facility other than the Hawaii state hospital where they were under the custody of the director.

     (c)  The department shall be exempt from chapter 103F for the procurement of medical care for patients of the Hawaii state hospital and for patients of a psychiatric facility other than the Hawaii state hospital who are under the custody of the director, and for the procurement of long-term care for patients discharged to a long-term care facility from the Hawaii state hospital or from a psychiatric facility other than the Hawaii state hospital where they were under the custody of the director.

     (d)  For the purposes of this section:

     "Long-term care" means care provided by a long-term care facility.

     "Long-term care facility" shall have the same meaning as in section 349-21.

     "Medical care" means examination, diagnosis, or treatment for medical and dental conditions to include outpatient and hospital-based services as well as appliances and supplies deemed clinically necessary by the department, and does not include long-term care."

     SECTION 2.  This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

     SECTION 3.  New statutory material is underscored.

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

Report Title:

DOH; Hawaii State Hospital; Psychiatric Facility; Long-term Care Facility; Payment; Medicaid; Procurement Exemption

Description:

Establishes maximum rates of payment for medical care for patients of the Hawaii State Hospital or of another psychiatric facility who are under the custody of the Director of Health.    Authorizes the Department of Health to establish long-term care payment rates for patients discharged to a long-term care facility from the Hawaii State Hospital or another psychiatric facility where they were under the custody of the Director of Health.  Exempts the Department of Health from chapter 103F, HRS, for the procurement of medical care and long-term care for patients who are or were under the custody of the Director of Health at the Hawaii State Hospital or a psychiatric facility.

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

STAND. COM. REP. NO.  1933

Honolulu, Hawaii

                , 2025

RE:   S.B. No. 1443

      S.D. 1

      H.D. 1

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2025

State of Hawaii

Madame:

     Your Committee on Finance, to which was referred S.B. No. 1443, S.D. 1, H.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO THE DEPARTMENT OF HEALTH,"

begs leave to report as follows:

     The purpose of this measure is to:

     (1)  Establish maximum payment rates for medical care for patients of the Hawaii State Hospital or in the custody of the Director of Health at another psychiatric facility;

     (2)  Authorize the Department of Health to establish payment rates for long-term care services for certain types of patients; and

     (3)  Exempt the Department of Health's procurement of medical care for certain types of patients from laws regarding contracts to provide health and human services to residents.

     Your Committee received testimony in support of this measure from the Department of Health and State Council on Mental Health.

     As affirmed by the record of votes of the members of your Committee on Finance that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 1443, S.D. 1, H.D. 1, and recommends that it pass Third Reading.

Respectfully submitted on behalf of the members of the Committee on Finance,

STAND. COM. REP. NO.  1306

Honolulu, Hawaii

                , 2025

RE:   S.B. No. 1443

      S.D. 1

      H.D. 1

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2025

State of Hawaii

Madame:

     Your Committee on Health, to which was referred S.B. No. 1443, S.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO THE DEPARTMENT OF HEALTH,"

begs leave to report as follows:

     The purpose of this measure is to:

     (1)  Establish maximum payment rates for medical care for patients of the Hawaii State Hospital or in the custody of the Director of Health at another psychiatric facility;

     (2)  Authorize the Department of Health to establish payment rates for long-term care services for certain types of patients; and

     (3)  Exempt the Department of Health from the Hawaii Public Procurement Code for the procurement of medical care for certain types of patients.

     Your Committee received testimony in support of this measure from the Department of Health and State Council on Mental Health.  

     Your Committee finds that although some aging patients at the Hawaii State Hospital (State Hospital) are psychiatrically stable, legally cleared for hospital discharge, and have long-term care needs that are more appropriate for community-based residential care than in-patient psychiatric hospitalization, no long-term care provider has agreed to take these patients at Medicaid rates.  As a result, the State Hospital has become the default long-term care facility.

     Your Committee further finds that when a patient at the State Hospital requires medical care outside of the State Hospital, hospital staff must perform all of the administrative work to obtain a procurement exemption, negotiate payment rates, and enter into a contract with the health care provider.  When providers submit bills to the State Hospital, hospital staff must manually review the billing and codes, resulting in significant delays in payments to providers.  Your Committee believes that streamlining this process by allowing the Department of Health a limited exemption from the Hawaii Public Procurement Code and establishing payment rates for certain types of medical care will ensure timely payments to health care providers and significantly reduce administrative burden on hospital staff.

     Your Committee has amended this measure by:

     (1)  Changing its effective date to upon approval; and

     (2)  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 Health that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 1443, S.D. 1, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 1443, S.D. 1, H.D. 1, and be referred to your Committee on Finance.

Respectfully submitted on behalf of the members of the Committee on Health,

STAND. COM. REP. NO. 978

Honolulu, Hawaii

RE:    S.B. No. 1443

       S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Thirty-Third State Legislature

Regular Session of 2025

State of Hawaii

Sir:

     Your Committee on Ways and Means, to which was referred S.B. No. 1443, S.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO THE DEPARTMENT OF HEALTH,"

begs leave to report as follows:

     The purpose and intent of this measure is to address operational issues at the Hawaii State Hospital.

     More specifically, this measure:

     (1)  Establishes maximum rates of payment for medical care for patients of the Hawaii State Hospital or of another psychiatric facility who are under the custody of the Director of Health;

     (2)  Authorizes the Department of Health to establish long‑term care payment rates for patients discharged to a long-term care facility from the Hawaii State Hospital or another psychiatric facility where they were under the custody of the Director of Health; and

     (3)  Exempts the Department of Health from chapter 103F, Hawaii Revised Statutes, for the procurement of medical care and long-term care for patients who are or were under the custody of the Director of Health at the Hawaii State Hospital or a psychiatric facility.

     Your Committee received written comments in support of this measure from the Department of Health.

     Your Committee finds that there is currently no standard rate of reimbursement for healthcare providers who provide medical care to patients under the custody of the Director of Health, as each rate is individually negotiated.  Your Committee further finds that limiting reimbursement rates to the Medicaid fee schedule, which is a consistent and transparent standard, will save the State money and improve the timeliness of payments to providers.

     As affirmed by the record of votes of the members of your Committee on Ways and Means that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 1443, S.D. 1, and recommends that it pass Third Reading.

Respectfully submitted on behalf of the members of the Committee on Ways and Means,

STAND. COM. REP. NO. 331

Honolulu, Hawaii

RE:    S.B. No. 1443

       S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Thirty-Third State Legislature

Regular Session of 2025

State of Hawaii

Sir:

     Your Committee on Health and Human Services, to which was referred S.B. No. 1443 entitled:

"A BILL FOR AN ACT RELATING TO THE DEPARTMENT OF HEALTH,"

begs leave to report as follows:

     The purpose and intent of this measure is to:

     (1)  Establish maximum rates of payment for medical care for patients of the Hawaii State Hospital or of another psychiatric facility who are under the custody of the Director of Health;

     (2)  Authorize the Department of Health to establish long-term care payment rates for patients discharged to a long-term care facility from the Hawaii State Hospital or another psychiatric facility where they were under the custody of the Director of Health; and

     (3)  Exempt the Department of Health from chapter 103F, Hawaii Revised Statutes, that governs the procurement of health and human services, for the procurement of medical care and long-term care for patients who are or were under the custody of the Director of Health at the Hawaii State Hospital or a psychiatric facility.

     Your Committee received testimony in support of this measure from the Department of Health.

     Your Committee finds that the Hawaii State Hospital has a number of patients that are psychiatrically stable, legally cleared for hospital discharge, and have long-term care needs that are more appropriate for community-based residential care than in-patient psychiatric hospitalization.  Your Committee further finds that no long-term care provider has agreed to accept these patients at Medicaid rates, resulting in the Hawaii State Hospital becoming the State's default long-term care facility.  This measure addresses the financial obstacles relating to payment rates for patients of or discharged from the Hawaii State Hospital to help patients at the Hawaii State Hospital be cared for in the most appropriate setting.

     Your Committee has amended this measure by:

     (1)  Inserting an effective date of December 31, 2050, to encourage further discussion; and

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

     As affirmed by the record of votes of the members of your Committee on Health and Human Services that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 1443, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 1443, S.D. 1, and be referred to your Committee on Ways and Means.

Respectfully submitted on behalf of the members of the Committee on Health and Human Services,