| 47 | | - | SECTION 1. The legislature finds that oral disease is a significant health problem for many Hawaii residents, affecting their overall health and well-being. Native Hawaiians and Pacific Islanders were disproportionately represented in emergency room visits for dental-related diagnoses. In 2009, the State terminated all preventive and restorative dental care services for adult medicaid recipients and reduced coverage to emergency-only care, which is limited to pain relief, injuries, trauma, and tooth removal and extraction. The lack of preventive and restorative dentistry services for adult medicaid beneficiaries increases potential health care complications for persons with co-existing chronic diseases, such as diabetes and heart disease. Poor oral health, combined with co-existing conditions like these, have been shown to lead to increased disability and death. Since 2010, Hawaii has received a failing grade of "F" in three oral health report cards published by the Pew Center on the States due to multiple policy and systems issues in the State that have left the oral health of Hawaii's families and children worse than the rest of the nation. The legislature further finds that in Hawaii, a disproportionate number of adult medicaid enrollees ages twenty‑one to forty-four years use the emergency room for emergency dental services. While adult medicaid beneficiaries represent about twenty-five per cent of Hawaii's population, they represent forty-seven per cent of all dental services provided by emergency rooms. Between 2016 and 2020, medicaid enrollees made an average of two thousand seven hundred emergency room visits per year for acute oral health conditions, totaling $21,700,000 in charges for outpatient emergency room services only. Recent analysis suggests that investing in preventive dental benefits for medicaid-enrolled adults will, in the long term, lead to reductions in medical costs paid by medicaid. A February 2020 research brief authored by the American Dental Association's Health Policy Institute and the Hawaii department of human services' med-QUEST division estimates the cost of reinstating coverage in Hawaii and identifies three possible options: (1) Option 1 ($7,800,000 per year or $3.32 per enrollee) covers a basic dental benefit package of diagnostic, preventive, and restorative services; (2) Option 2 ($19,900,000 per year or $8.45 per enrollee) includes the basic dental benefit package, plus core prosthodontic services; and (3) Option 3 ($36,200,000 per year or $15.37 per enrollee) further expands prosthodontic services. All three options cover periodontal services. The research brief estimates potential medical care cost savings of $1,900,000 to $5,300,000 per year, which is attributable to a reduction in emergency department visits for dental conditions and reduced medical care costs among medicaid beneficiaries with diabetes and coronary artery disease, as well as pregnant women. It has been twelve years since the State removed all but emergency medicaid adult dental benefits. The legislature additionally finds that it is in the best interest of the State and its residents to expand access to care by restoring dental benefits to adult medicaid enrollees. The purpose of this Act is to appropriate funds to restore diagnostic, preventive, and restorative dental benefits to adult medicaid enrollees. This appropriation will make Hawaii eligible for federal matching funds via medicaid's Federal Medical Assistance Percentage for these purposes. SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2022-2023 to restore diagnostic, preventive, and restorative dental benefits to adult medicaid enrollees under Option 2 referenced in section 1 of this Act, which includes basic dental benefits, core prosthodontic services, and periodontal services; provided that the department of human services shall obtain the maximum federal matching funds available for this expenditure; provided further that the department of human services shall pursue all funding sources known to the State, including private grants, prior to expending any general revenues appropriated pursuant to this Act. The sum appropriated shall be expended by the department of human services for the purposes of this Act. SECTION 3. This Act shall take effect upon its approval. |
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| 47 | + | SECTION 1. The purpose of this Act is to appropriate funds to restore diagnostic, preventive, and restorative dental benefits to adult medicaid enrollees. This appropriation will make Hawaii eligible for federal matching funds via medicaid's Federal Medical Assistance Percentage for these purposes. SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2022-2023 to restore diagnostic, preventive, and restorative dental benefits to adult medicaid enrollees; provided that the department of human services shall obtain the maximum federal matching funds available for this expenditure; provided further that the department of human services shall pursue all funding sources known to the State, including private grants, prior to expending any general revenues appropriated pursuant to this Act. The sum appropriated shall be expended by the department of human services for the purposes of this Act. SECTION 3. This Act shall take effect on July 1, 2060. |
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