SB1443 amends Hawaii law to create a specific framework for paying for medical care and long-term care for patients of the Hawaii State Hospital and certain other psychiatric-facility patients who are under the custody of the Director of Health. For medical care, the bill caps payment rates at the Hawaii Medicaid fee schedule or the provider’s billed amount, whichever is lower. For long-term care, it authorizes the Department of Health to set payment rates for patients discharged from a state hospital or other psychiatric facility into a long-term care facility.
The bill also exempts the Department of Health from the Hawaii Public Procurement Code, chapter 103F, when procuring medical care and long-term care for these patients. It defines the covered services and clarifies that “medical care” includes medical and dental treatment, outpatient and hospital-based services, and clinically necessary appliances and supplies, but not long-term care. The measure takes effect upon approval and does not disturb prior rights, duties, penalties, or proceedings.
Impact
The bill would add a new section to chapter 334, Hawaii Revised Statutes, affecting how the Department of Health pays for and procures care for individuals in state psychiatric custody. It would limit medical payment rates to Medicaid-based benchmarks, give DOH discretion to set long-term care rates for certain discharged patients, and remove these procurements from the normal competitive procurement requirements of chapter 103F. The practical effect is to streamline contracting and potentially control costs for psychiatric and post-discharge care.
Sentiment
The available voting history suggests broad support for the measure. It passed the Senate Health and Human Services Committee 4-0 with amendments and later passed the Senate Ways and Means Committee 10-0 without further amendment. No committee transcripts were provided, but the unanimous votes indicate the bill was viewed favorably and without recorded opposition in committee.
Contention
The main policy issues appear to be the Department of Health’s authority to bypass the Hawaii Public Procurement Code and the use of Medicaid fee schedule limits for medical care. Those provisions may raise concerns about procurement transparency, provider reimbursement adequacy, and administrative discretion, although no specific objections are documented in the available materials. The bill’s supporters appear to have favored the flexibility and cost control it gives DOH for psychiatric and long-term care services.
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