SB 1450: RELATING TO AN INTENSIVE MOBILE TEAM PILOT PROGRAM FOR HOUSELESS INDIVIDUALS SUFFERING FROM SERIOUS BRAIN DISORDERS.

A BILL FOR AN ACT

RELATING TO AN INTENSIVE MOBILE TEAM PILOT PROGRAM FOR HOUSELESS INDIVIDUALS SUFFERING FROM SERIOUS BRAIN DISORDERS.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  (a)  There is established an intensive mobile team pilot program within the adult mental health division of the department of health to provide intensive mobile team services, including "street psychiatry", to chronically houseless individuals suffering from serious brain disorders, including but not limited to schizophrenia and schizoaffective disorder.

     (b)  The pilot program shall establish one intensive mobile team in the community mental health center system.

     (c)  The intensive mobile team shall:

     (1)  Establish criteria for pilot program participation, which shall include being houseless and suffering from a serious brain disorder, prioritizing individuals with schizophrenia or schizoaffective disorder;

     (2)  Manage not more than forty participants who shall be vetted and enrolled by the intensive mobile team;

     (3)  Offer after-hour services to existing participants, including:

          (A)  Responding to crisis;

          (B)  Visiting emergency rooms; and

          (C)  If and when they are arrested, meeting with law enforcement and participants at the receiving desk or similar place where the participant is being held in custody to share information on their participation in the pilot program;

     (4)  Determine, in collaboration with area hospitals and the behavioral health crisis center, appropriate hospitalizations and behavioral health crisis center admissions;

     (5)  Prioritize housing placements for participants;

     (6)  Begin participant treatment on psychiatric medications when appropriate;

     (7)  Actively pursue assisted community treatment orders when appropriate;

     (8)  Continue services if a participant is admitted to the Hawaii state hospital;

     (9)  Engage social work interns and advanced practice registered nurse students to expand service capacity for the target population;

    (10)  Bill third-party payors, medicare, or medicaid, as appropriate for services; and

    (11)  Be staffed as follows:

          (A)  One full-time equivalent (1.0 FTE) human services professional V who shall serve as the clinical supervisor;

          (B)  One-half full-time equivalent (0.5 FTE) psychiatrist;

          (C)  Five full-time equivalent (5.0 FTE) human services professionals or social workers;

          (D)  One-half full-time equivalent (0.5 FTE) registered nurse;

          (E)  One-tenth full-time equivalent (0.1 FTE) epidemiologist, epidemiology specialist, or research statistician; and

          (F)  One full-time equivalent (1.0 FTE) program specialist.

     (d)  The department of health shall collaborate with law enforcement agencies, courts, hospitals, providers who serve houseless individuals, mental health providers, and community stakeholders for the implementation of the pilot program.

     (e)  The adult mental health division of the department of health shall submit a report on the intensive mobile team pilot program to the legislature no later than twenty days prior to the convening of the regular sessions of 2026 and 2027.  Each report shall include any proposed legislation and progress updates on the aggregate numbers of:

     (1)  Participant arrests;

     (2)  Participants requiring an emergency examination and hospitalization;

     (3)  Participants placed into housing;

     (4)  Participants started on medications;

     (5)  Participants hospitalized at the Hawaii state hospital;

     (6)  Participants reconnected with family; and

     (7)  Assisted community treatment orders pursued and granted.

     (f)  The intensive mobile team pilot program shall be dissolved on June 30, 2028.

     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 2025-2026 and the same sum or so much thereof as may be necessary for fiscal year 2026-2027 for the implementation of the intensive mobile team pilot program, including the establishment of eight and one-tenth full-time equivalent (8.1 FTE) positions, that shall be exempt from chapter 76, Hawaii Revised Statutes, operating costs, and equipment, pursuant to this Act.

     The sums appropriated shall be expended by the department of health for the purposes of this Act.

     SECTION 3.  This Act shall take effect on December 31, 2050.

Report Title:

DOH; AMHD; Intensive Mobile Team Pilot Program; Reports; Positions; Appropriations

Description:

Establishes a three-year Intensive Mobile Team Pilot Program in the Department of Health to provide intensive mobile treatment-type services, including "street psychiatry", to chronically houseless individuals suffering from serious brain disorders, including schizophrenia and schizoaffective disorder.  Requires the Adult Mental Health Division of the Department of Health to submit reports to the Legislature.  Establishes positions.  Appropriates funds.  Effective 12/31/2050.  (SD1)

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

A BILL FOR AN ACT

RELATING TO AN INTENSIVE MOBILE TEAM PILOT PROGRAM FOR HOUSELESS INDIVIDUALS SUFFERING FROM SERIOUS BRAIN DISORDERS.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  (a)  There is established an intensive mobile team pilot program within the adult mental health division of the department of health to provide intensive mobile team services, e.g., "street psychiatry," to chronically houseless people suffering from serious brain disorders, including but not limited to schizophrenia and schizoaffective disorder.

     (b)  The pilot program shall establish one intensive mobile team in the community mental health center system.

     (c)  The intensive mobile team established for the purposes of the pilot program shall:

     (1)  Establish criteria for pilot program participation, which shall include being houseless and suffering from a serious brain disorder, prioritizing individuals with schizophrenia or schizoaffective disorder;

     (2)  Manage no more than forty participants who shall be vetted and enrolled by the intensive mobile team;

     (3)  Offer after-hours availability for existing participants to:

          (A)  Respond to crisis;

          (B)  Visit emergency rooms; and

          (C)  If and when they are arrested, meet with law enforcement and participants at the receiving desk or similar place where the participant is being held in custody to share information on their participation in the pilot program;

     (4)  Determine, in collaboration with area hospitals and the behavioral health crisis center, appropriate hospitalizations and behavioral health crisis center admissions;

     (5)  Prioritize housing placements for participants;

     (6)  Begin participant treatment on psychiatric medications when appropriate;

     (7)  Actively pursue assisted community treatment orders when appropriate;

     (8)  Continue services if a participant is admitted to the Hawaii state hospital;

     (9)  Engage social work interns and advanced practice registered nurse students to expand service capacity for the target population;

    (10)  Bill third-party payors, medicare, or medicaid, as appropriate for services; and

    (11)  Be staffed as follows:

          (A)  1.0 FTE human services professional V who shall serve as the clinical supervisor;

          (B)  0.5 FTE psychiatrist;

          (C)  5.0 FTE human services professionals or social workers;

          (D)  0.5 FTE registered nurse;

          (E)  0.1 FTE epidemiologist, epidemiology specialist, or research statistician; and

          (F)  1.0 FTE program specialist.

     (d)  The department of health shall collaborate with law enforcement agencies, courts, hospitals, providers who serve houseless individuals, mental health providers, and community stakeholders for the implementation of the pilot program.

     (e)  The adult mental health division of the department of health shall submit a report on the intensive mobile team pilot program to the legislature no later than twenty days prior to the convening of the regular sessions of 2026 and 2027.  Each report shall include any proposed legislation and progress updates on the aggregate:

     (1)  Number of participant arrests;

     (2)  Number of participants requiring an emergency examination and hospitalization;

     (3)  Number of participants placed into housing;

     (4)  Number of participants started on medications;

     (5)  Number of participants hospitalized at the Hawaii state hospital;

     (6)  Number of participants reconnected with family; and

     (7)  Number of assisted community treatment orders pursued and granted.

     (f)  The intensive mobile team pilot program shall be dissolved on June 30, 2028.

     SECTION 2.  There is appropriated out of the general revenues of the State of Hawaii the sum of $1,300,000 or so much thereof as may be necessary for fiscal year 2025-2026 and the sum of $1,300,000 or so much thereof as may be necessary for fiscal year 2026-2027 for eight and one-tenth full-time equivalent (8.1 FTE) positions, who shall be exempt from chapter 76, Hawaii Revised Statutes, operating costs, and equipment, pursuant to this Act.

     The sums appropriated shall be expended by the department of health for the purposes of this Act.

     SECTION 3. This Act, upon its approval, shall take effect on July 1, 2025.

Report Title:

DOH; Intensive Mobile Team Pilot Program; Appropriation

Description:

Establish a pilot program in the Department of Health to provide intensive mobile treatment-type services, e.g., "street psychiatry," to chronically houseless people suffering from serious brain disorders like schizophrenia and schizoaffective disorder.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

STAND. COM. REP. NO. 503

Honolulu, Hawaii

RE:    S.B. No. 1450

       S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Thirty-Third State Legislature

Regular Session of 2025

State of Hawaii

Sir:

     Your Committee on Health and Human Services, to which was referred S.B. No. 1450 entitled:

"A BILL FOR AN ACT RELATING TO AN INTENSIVE MOBILE TEAM PILOT PROGRAM FOR HOUSELESS INDIVIDUALS SUFFERING FROM SERIOUS BRAIN DISORDERS,"

begs leave to report as follows:

     The purpose and intent of this measure is to establish a three-year Intensive Mobile Team Pilot Program in the Department of Health to provide intensive mobile treatment-type services, including "street psychiatry", to chronically houseless individuals suffering from serious brain disorders, including schizophrenia and schizoaffective disorder.

     Your Committee received testimony in support of this measure from the Office of the Governor, Department of Health, Department of Human Services, Hawaiʻi Primary Care Association, Hawaii Medical Association, Hawaii Substance Abuse Coalition, Hawaii Health & Harm Reduction Center, and two individuals.

     Your Committee received testimony in opposition to this measure from one individual.

     Your Committee received comments on this measure from Reimagining Public Safety in Hawaiʻi Coalition.

     Your Committee finds that there is a clear and pressing need to develop upstream services that impact key social determinants of health including housing instability and access to health care services, particularly substance use disorders and untreated serious mental health conditions which are root causes of chronic unsheltered homelessness.  Your Committee further finds that mobile crisis teams that deliver on-site care to individuals experiencing behavioral health crises reduces escalation to and reliance on law enforcement.  This measure's proposed Intensive Mobile Team Pilot Program provides expanded services to respond to crises, provide care coordination, and collaborate with health care systems, law enforcement agencies, and homeless services providers to address the needs of houseless individuals experiencing mental health crises.

     Your Committee has amended this measure by:

     (1)  Changing the appropriation to an unspecified amount;

     (2)  Inserting an effective date of December 31, 2050, to encourage further discussion; and

     (3)  Making technical, nonsubstantive amendments for the purposes of clarity and consistency.

     Your Committee notes that this measure, as amended, contains an unspecified appropriation amount.  Should your Committee on Ways and Means choose to deliberate on this measure, your Committee respectfully requests that it consider inserting an appropriation amount of $1,300,000 for the implementation of the Intensive Mobile Team Pilot Program, including the establishment of eight and one-tenth full-time equivalent (8.1 FTE) positions.

     As affirmed by the record of votes of the members of your Committee on Health and Human Services that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 1450, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 1450, S.D. 1, and be referred to your Committee on Ways and Means.

Respectfully submitted on behalf of the members of the Committee on Health and Human Services,