House committee advances package of human services bills on Medicaid, SNAP, child welfare and early learning

The House Committee on Health & Homelessness on Feb. 4, 2025 voted to pass with amendments a package of bills that would increase state funding for in‑home Medicaid services, authorize emergency spending to improve the state SNAP eligibility system, and advance multiple child‑welfare and early‑learning reforms.

The package includes appropriations and program changes the committee described as complementary steps to reduce barriers to care, streamline eligibility, and strengthen supports for families and state workers. Chair Lisa Martin opened the hearing and led several hours of testimony from agency officials, providers, advocacy groups and members of working groups formed after the Malama Ohana report.

Why it matters: The bills would change how the Department of Human Services (DHS) administers benefits and supports for people with disabilities, SNAP recipients and families involved with child welfare. Committee members framed the measures as interlocking reforms—rate studies, automatic enrollments, training and pilot programs—that aim to improve access to services and reduce costly placements or federal penalties.

Most urgent items and committee action

Emergency SNAP appropriation (HB 1099)

The committee adopted an emergency appropriation to DHS to cover software and staffing fixes after the USDA Food and Nutrition Service assessed penalties tied to SNAP eligibility timelines. Scott Morishige, administrator of the Benefit, Employment and Support Services Division at DHS, testified that the department "strongly supports this administration measure" and that the funding should be made available in the current fiscal year to avoid or reduce federal penalties. Testimony from Catholic Charities Hawaii and public‑health advocates said investing in systems and staff could improve access for roughly 100,000 SNAP enrollees and avoid further federal penalties.

Medicaid in‑home services and monthly allowance fix (HB 702; HB 1477)

The committee advanced HB 702, which would appropriate additional a‑funds to increase compensation for Medicaid in‑home services contingent on obtaining federal matching funds. The chair noted an estimated state cost of $16,530,000 to reach the higher compensation level; the committee passed the measure with amendments and noted the amount in the committee report.

Separately, HB 1477 clarifies that a monthly needs allowance for certain long‑term care residents is supplemental to any state supplemental payment for domiciliary care and raises the ceiling; DHS testified with suggested technical amendments and the committee accepted department language and passed the bill with amendments.

Home health rate study (HB 713)

The Healthcare Association of Hawaii supported HB 713, urging a rate study for medical home health services because agencies report losses on Medicaid patients and rising labor costs. The committee adopted amendments and placed a study cost in the committee report: a total study cost of $500,000, with an expected $250,000 state appropriation (50% federal match).

Automatic Medicaid enrollment for SSI recipients (HB 646)

HB 646 would authorize DHS to automatically enroll or to arrange Social Security Administration enrollment of Supplemental Security Income (SSI) recipients into Medicaid and require a report to the Legislature. The Hawaii State Council on Developmental Disabilities testified in strong support. DHS officials noted they are researching legal and eligibility standards (including 209(b) state options) and flagged that if enrollment expands coverage, the state would need to estimate additional costs; the committee passed the bill with technical amendments.

Child welfare and related supports

Child abuse/neglect definition amendment (HB 239)

HB 239 amends the statutory definition of child abuse or neglect to clarify when failure to provide certain needs constitutes neglect if the lack of provision is not due solely to lack of financial means. The Attorney General submitted a suggested amendment to preserve mandatory reporting where safety concerns are present; the committee adopted the AG's language replacing the bill's subsection with: "when the child is not provided in a timely manner with adequate food, clothing, shelter, psychological care, physical care, medical care, or supervision, and the reason ... is not due solely to the lack of the person's financial means." DHS raised concerns about the statutory term "timely manner" and the availability of a service safety net when a case is unconfirmed; the committee moved the measure forward with the AG's amendment.

Trauma‑informed organizational assessment and training (HB 1079)

HB 1079 directs the Office of Wellness and Resilience to collaborate with DHS to design and implement trauma‑informed organizational assessments and training for Child Welfare Services staff, and to include train‑the‑trainer elements. Tia Hartsock, Director of the Office of Wellness and Resilience, described the office's role and said the proposal advances recommendations from the Malama Ohana Working Group; the committee adopted technical amendments and passed the bill with amendments.

Domestic violence specialists housed in child‑welfare offices (HB 1382)

HB 1382 would fund a contract with a nonprofit to place domestic‑violence specialists on site in DHS child welfare offices to support screening and response. Domestic‑violence advocates and Malama Ohana co‑chair Laurie Tochiki called for broader multidisciplinary approaches; DHS said it is exploring contract and training approaches and noted funding questions. The committee passed the bill with the recommended date deferral.

Family Resilience Pilot (HB 1383)

HB 1383 establishes a five‑year Family Resilience Pilot within the Office of Wellness and Resilience, with peer navigators, financial assistance and trauma‑informed parenting supports, and calls for evaluation. The committee added language requiring an implementation and evaluation plan with measurable goals by the end of 2025 and passed the bill with amendments.

Preschool Open Doors expansion and accreditation change (HB 692)

HB 692 would expand the Preschool Open Doors subsidy to additional age ranges and remove the statutory accreditation requirement for participating group childcare centers and group childcare homes, while allowing DHS to require a co‑payment on a sliding fee scale. Lieutenant Governor Toby Luke and early‑learning advocates supported the change, saying accreditation requirements had limited provider participation. DHS proposed terminology edits to use defined statutory terms ("group childcare center" and "group childcare home") and recommended keeping Preschool Open Doors focused on center‑based care for the purposes of the program; the committee adopted DHS language and passed the bill with amendments.

Protections for protective services workers (HB 1098)

HB 1098 makes assaulting or injuring protective services workers a class C felony and clarifies protected‑services workers are public servants for certain terroristic threatening provisions. DHS Director Ryan Yamane and the Honolulu Prosecutor's Office supported the bill; the committee passed the measure with the technical amendment to the effective date.

Office of Wellness and Resilience transfer (HB 1081)

HB 1081 would move the Office of Wellness and Resilience into the Department of Human Resources Development and create an advisory board; Tia Hartsock said the office hopes to strengthen workforce supports and collaborate with DHRD on state‑employee recruitment and retention. The committee passed the bill with technical amendments and noted an effective date in the committee report.

Votes at a glance (committee action)

- HB 702 (increase Medicaid in‑home funding): Passed with amendments; committee report notes state appropriation needed to reach target compensation: $16,530,000 (chair estimated). Recorded yes votes on the record for this measure included Chair Lisa Martin, Vice Chair (recorded as Oates/Olds), Representatives Amano, Chun, Keohokapu Leiloy, Takayama, Takayana Ouchi, and Alcos; Representative Garcia was excused.

- HB 1477 (monthly needs allowance fix): Passed with DHS‑requested amendments.

- HB 713 (home health rate study): Passed with amendments; committee report records study cost $500,000 with $250,000 state share.

- HB 646 (automatic Medicaid enrollment for SSI): Passed with amendments (DHS directed to continue legal review and cost estimates).

- HB 1099 (emergency SNAP appropriation): Passed with amendments; committee added emergency‑fund language so funds can be available in FY2024‑25 to meet federal timelines.

- HB 1079 (trauma‑informed assessments and training): Passed with amendments.

- HB 239 (amend child abuse/neglect definition): Passed with AG‑recommended amendment to avoid narrowing mandatory reporting where safety concerns exist.

- HB 1382 (domestic violence specialists in CWS offices): Passed with date technical amendments; committee asked DHS to return with budget details.

- HB 1383 (Family Resilience Pilot): Passed with amendments requiring an implementation and evaluation plan with SMART goals by end of 2025.

- HB 692 (Preschool Open Doors expansion / accreditation): Passed with DHS language clarifying program applies to group childcare centers and group childcare homes and allowing DHS discretion on co‑payments via rules.

- HB 1098 (crimes against protective services workers): Passed with amendments (effective date technical change).

- HB 1081 (transfer Office of Wellness and Resilience to DHRD): Passed with technical amendments; committee noted effective date in the report.

What committee members and witnesses emphasized

- System access and costs: Providers and advocates said Medicaid and home‑health reimbursement rates have not kept pace with labor costs. The Healthcare Association reported agencies "are losing over $1,000 on each Medicaid patient," a point the committee cited when approving a rate study.

- Avoiding unnecessary foster care: Child‑welfare advocates and the National Center for Youth Law pushed for reforms that treat poverty as a reason to connect families to concrete supports—not to trigger system involvement; the AG's amendment to HB 239 was accepted to preserve reporting when immediate safety concerns exist.

- SNAP penalties and automation: Advocates urged investing in DHS systems and staff to bring more eligible people into SNAP and to avoid multimillion‑dollar federal penalties; the committee adopted emergency funding language so DHS can act this fiscal year.

Next steps

Committee members voted to adopt the chair's recommendations and pass each measure with amendments; the bills will be reported out of committee with the committee report language and appropriations noted where the chair instructed. Several agencies (DHS, Office of Wellness and Resilience) were asked to return with cost estimates or implementation details in subsequent committee sessions.