HOUSE OF REPRESENTATIVES	H.R. NO.	60
TWENTY-EIGHTH LEGISLATURE, 2015
STATE OF HAWAII

HOUSE RESOLUTION

 

 

requesting the department of human services to consider an alternate methodology for establishing the basic prospective payment system rates for intermediate care facilities for individuals with intellectual disabilities, to rebase the rates at least every two fiscal years, and to increase bed reservation days to twenty-four DAYS per calendar year for hospitalization and other absences of residents from intermediate care facilities for individuals with intellectual disabilities.

 

 

     WHEREAS, seventeen intermediate care facilities for individuals with intellectual disabilities operated by private, nonprofit agencies provide a home and needed twenty-four hour care, active treatment, and community living for up to eighty-two individuals and serve as important components of the State's long-term care of individuals with intellectual disabilities; and

 

     WHEREAS, providers of services in intermediate care facilities for individuals with intellectual disabilities are compensated by per diem payments under the Medicaid long-term care prospective payment system, as provided in chapter 17‑1739.2, Hawaii Administrative Rules; and

 

     WHEREAS, chapter 17-1739.2, Hawaii Administrative Rules, provides for the Department of Human Services to establish a per diem basic prospective payment system (PPS) rate based on actual cost reports submitted by providers for a prior designated fiscal year; and

 

     WHEREAS, the Department of Human Services has made it a practice in recent decades to perform a rebasing of the basic PPS rate so that an intermediate care facility for individuals with intellectual disabilities provider does not have its basic PPS rate calculated by reference to the same base year for more than eight fiscal years, based on cost reports submitted for one or two fiscal years before the rebased rates go into effect; and

 

     WHEREAS, basing payment for services on the same basic PPS rate for eight years ignores costs incurred by providers resulting from changes in the level of care needed by residents and the number of employees required to provide essential services, higher wage and benefit standards, and changes in regulatory requirements and best practices; and

 

     WHEREAS, as a result of the foregoing factors, the basic PPS rates in effect for eight years are increasingly insufficient to cover the costs of providing services to the residents of intermediate care facilities for individuals with intellectual disabilities and to compensate the caretakers and others who assist residents at a competitive fair wage; and

 

     WHEREAS, rebasing the basic PPS rate on a more frequent basis and ensuring a fair annual inflation adjustment would more fairly and accurately represent the cost of services provided in intermediate care facilities for individuals with intellectual disabilities; and

 

     WHEREAS, the basic PPS rate is paid on a per diem basis for each occupied bed in an intermediate care facility for individuals with intellectual disabilities, but not if the resident is absent at midnight, even if the facility provided services to the resident for a large portion of the day; and

 

     WHEREAS, chapter 17-1739.2, Hawaii Administrative Rules, allows a provider to be paid the per diem rate for up to twelve days of bed hold absence by a resident per year, except in the case of an absence or hospitalization, in which case no per diem bed hold payment is made; and

 

     WHEREAS, the payment for only twelve non-hospitalization bed hold days is among the lowest number of days in the nation for similar facilities, and the ongoing expenses of operating an intermediate care facility for individuals with intellectual disabilities are not materially decreased by a resident's absence for any reason, including hospitalization, resulting in a severe financial challenge to operators of intermediate care facilities for individuals with intellectual disabilities; now, therefore,

 

     BE IT RESOLVED by the House of Representatives of the Twenty-eighth Legislature of the State of Hawaii, Regular Session of 2015, that the Department of Human Services is requested to evaluate and consider an alternate methodology for establishing the basic PPS rates for intermediate care facilities for individuals with intellectual disabilities to address the inadequacy of the existing process and to adopt rules pursuant to chapter 91, Hawaii Revised Statutes, to require rebasing of the basic PPS rates using updated cost report data at least every two fiscal years; and

 

     BE IT FURTHER RESOLVED that the Department of Human Services is urged to adopt rules pursuant to chapter 91, Hawaii Revised Statutes, to establish that intermediate care facilities for individuals with intellectual disabilities may reserve a bed for a resident receiving Medicaid who is absent from the facility on any day for no more than twenty-four days in a calendar year, regardless of whether the absence is due to hospitalization or other reasons; and

 

     BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Director of Human Services, Director of Health, and Executive Administrator of the Hawaii State Council on Developmental Disabilities.

 

 

 

	OFFERED BY:	_____________________________

Report Title: 

DHS; Intermediate Care Facilities For Individuals With Intellectual Disabilities