| 41 | | - | WHEREAS, neurodevelopmental disorders are disabilities associated primarily with the functioning of the neurological system and brain; and WHEREAS, one neurodevelopmental disorder is autism spectrum disorder, a developmental disability that can cause significant social, communication, and behavioral challenges; and WHEREAS, treatments for individuals with developmental disabilities, such as Applied Behavior Analysis, can improve physical and mental development; and WHEREAS, Medicaid is a jointly-funded, federal-state health insurance program for individuals with limited income and resources who meet eligibility requirements; and WHEREAS, the Medicaid Home and Community-Based Services Waiver for individuals with intellectual and developmental disabilities is authorized under section 1915(c) of the federal Social Security Act (section 1915(c) waiver); and WHEREAS, these services are designed to implement creative, person-centered alternatives to long-term institutionalized care; and WHEREAS, Hawaii's state Medicaid program, Med-QUEST, is administered through the Department of Human Services in partnership with the Department of Health's Developmental Disabilities Division; and WHEREAS, there are reports of individuals with autism spectrum disorder and other neurodevelopmental disorders who are aged twenty-one and older being denied Med-QUEST coverage for medically-needed autism services, including Applied Behavior Analysis services; and WHEREAS, Applied Behavior Analysis services and similar services should be covered by Med-QUEST for eligible individuals with neurodevelopmental disorders; and WHEREAS, according to the Centers for Medicare and Medicaid Services' Informational Bulletin dated July 7, 2014, individuals aged twenty-one and older may continue to receive services to address autism spectrum disorder through the section 1915(c) waiver if a state does not elect to provide these services to adults under its Medicaid state plan; and WHEREAS, this guidance also provides that states need to ensure that these individuals are receiving a waiver service not coverable under section 1905(a) of the federal Social Security Act to ensure that they do not lose access to all Medicaid services by losing waiver eligibility; now, therefore, BE IT RESOLVED by the Senate of the Thirty-first Legislature of the State of Hawaii, Regular Session of 2022, that the Department of Health and Department of Human Services are requested to jointly review any research regarding Applied Behavior Analysis for adults; and to develop and adopt all rules, policies, and plan amendments necessary to ensure that the State Medicaid program covers medically-needed services, including Applied Behavior Analysis services, for individuals aged twenty-one and older with neurodevelopmental disorders, including autism spectrum disorder; and BE IT FURTHER RESOLVED that the Department of Health and Department of Human Services are requested to ensure that any rules, policies, and plan amendments adopted pursuant to this request do not impair or limit any existing coverages; and BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Director of Health and Director of Human Services. Report Title: Medicate; Med-QUEST; Neurodevelopmental Disorder; Autism Spectrum Disorder |
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| 41 | + | WHEREAS, neurodevelopmental disorders are disabilities associated primarily with the functioning of the neurological system and brain; and WHEREAS, one neurodevelopmental disorder is autism spectrum disorder, a developmental disability that can cause significant social, communication, and behavioral challenges; and WHEREAS, treatments for individuals with developmental disabilities, such as Applied Behavior Analysis, can improve physical and mental development; and WHEREAS, Medicaid is a jointly-funded, federal-state health insurance program for individuals with limited income and resources who meet eligibility requirements; and WHEREAS, the Medicaid Home and Community-Based Services Waiver for individuals with intellectual and developmental disabilities is authorized under section 1915(c) of the federal Social Security Act (section 1915(c) waiver); and WHEREAS, these services are designed to implement creative, person-centered alternatives to long-term institutionalized care; and WHEREAS, Hawaii's state Medicaid program, Med-QUEST, is administered through the Department of Human Services in partnership with the Department of Health's Developmental Disabilities Division; and WHEREAS, there are reports of individuals with autism spectrum disorder and other neurodevelopmental disorders who are aged twenty-one and older being denied Med-QUEST coverage for medically-needed autism services, including Applied Behavior Analysis services; and WHEREAS, Applied Behavior Analysis services and similar services should be covered by Med-QUEST for eligible individuals with neurodevelopmental disorders; and WHEREAS, according to the Centers for Medicare and Medicaid Services' Informational Bulletin dated July 7, 2014, individuals aged twenty-one and older may continue to receive services to address autism spectrum disorder through the section 1915(c) waiver if a state does not elect to provide these services to adults under its Medicaid state plan; and WHEREAS, this guidance also provides that states need to ensure that these individuals are receiving a waiver service not coverable under section 1905(a) of the federal Social Security Act to ensure that they do not lose access to all Medicaid services by losing waiver eligibility; now, therefore, BE IT RESOLVED by the Senate of the Thirty-first Legislature of the State of Hawaii, Regular Session of 2022, that the Department of Health and Department of Human Services are requested to jointly develop and adopt all rules, policies, and plan amendments necessary to ensure that the State Medicaid program covers medically-needed services, including Applied Behavior Analysis services, for individuals aged twenty-one and older with neurodevelopmental disorders, including autism spectrum disorder; and BE IT FURTHER RESOLVED that the Department of Health and Department of Human Services are requested to ensure that any rules, policies, and plan amendments adopted pursuant to this request do not impair or limit any existing coverages; and BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Director of Health and Director of Human Services. OFFERED BY: _____________________________ Report Title: Medicate; Med-QUEST; Neurodevelopmental Disorder; Autism Spectrum Disorder |
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