Hawaii Senate Bill SB648

Hawaii 2026 Regular Session

• Introduced: 1/17/25
• Refer: 1/23/25

Caption

RELATING TO THE DEPARTMENT OF HEALTH.

Summary

SB 648 would direct the Department of Health’s Developmental Disabilities Division to amend its administrative rules for the home and community-based services Medicaid waiver for individuals with intellectual or developmental disabilities. The bill’s core change is to expand eligibility so that people with an intellectual or developmental disability who also have a comorbid mental illness are not excluded under current rules. The findings section states that existing criteria can unfairly bar individuals who otherwise have qualifying conditions, and it specifically references conditions such as cerebral palsy, epilepsy, autism spectrum disorder, and certain neurological or chromosomal disorders. The bill also requires the division to report back to the Legislature on the status of rulemaking before the 2026 regular session. In addition, it includes an appropriation from general revenues for fiscal years 2025-2026 and 2026-2027 to carry out the measure, including funding for unspecified full-time equivalent positions needed to amend and implement the eligibility criteria. The act would take effect on July 1, 2025.

Impact

SB 648 would affect the Department of Health’s administrative rules governing eligibility for the Medicaid home and community-based services waiver for people with intellectual and developmental disabilities. It would not directly rewrite the waiver program in statute, but it would require the Developmental Disabilities Division to use rulemaking under chapter 91, Hawaii Revised Statutes, to broaden eligibility and to report implementation progress to the Legislature. The bill would also authorize state funding for implementation, potentially increasing administrative capacity and, depending on final rule changes, expanding access to waiver services for additional individuals and families.

Sentiment

The overall sentiment reflected in the bill text is supportive of expanding access and correcting what the Legislature views as an overly restrictive eligibility policy. The findings emphasize fairness, co-occurring mental health conditions, and the need to align eligibility criteria with the realities faced by people with developmental disabilities. No committee testimony or vote record is provided, so there is no recorded opposition or support from hearings in the materials supplied.

Contention

The main point of contention identified in the bill itself is the current exclusionary eligibility framework used by the Developmental Disabilities Division, which the Legislature says can deny services to people who have qualifying intellectual or developmental disabilities but also have certain comorbid conditions. The bill suggests disagreement over whether conditions such as mental illness, emotional disorders, substance abuse, sensory impairment, learning disabilities, ADHD, spinal cord injuries, and neuromuscular disorders should disqualify applicants when they also have an eligible disability. Because the bill includes an appropriation with blank funding and FTE amounts, fiscal impact and staffing needs may also be a practical issue, but no committee debate is available to show specific objections or amendments.