House Standing Committee on Health

Good morning, everyone. Welcome to this 10:00 AM hearing of the House Committee on Health. I'd like to welcome all of you who are here to testify in person or on zoom. First, some housekeeping rules. In order to allow as many people as possible to testify, we do have a two-minute suggested time limit per testifier.

For those on Zoom, please keep yourselves muted and your video off while waiting to testify. And if you are disconnected unexpectedly, you may attempt to rejoin the meeting. In the event of a total network failure, which has happened, but not very often, we may need to reschedule the hearing because we are required to be on Zoom.

Finally, please avoid, on Zoom, using any trademarked or copyrighted images. And finally, please refrain from, refrain from profanity or uncivil behavior. In other words, please act with the law, for everyone. Thank you so much. First up, we have House Bill 1233, relating to stormwater management, and we have the Attorney General's Office.

Morning chair, vice chair, and members of the committee. My name is Joanna Ye. I'm from the Department of the Attorney General. We submitted testimony noting that the state may be required to share in the costs of the administration of this new regulatory program with the counties. Thank you for your time and I'm available for questions.

Thank you very much. Kirsten Hem- Hermstead, Hawaiian Lifeguard Association.

Yes, good morning. Thank you, chair and committee members, for having us this morning. I'm Kirsten Hermstead. I'm the Executive Director of the Hawaiian Lifeguard Association. We're strongly in support of this bill. We don't just focus on the ocean. We do focus on other bodies of water that are risks for our community.

So I stand on my written testimony that I submitted earlier, and I'm here for questions if necessary. Thank you so much for your consideration of this bill.

Thank you very much. Allison Schaefers.

Thank you.

May I approach? I have some handouts.

Welcome.

Of course.

We have our committee clerk, and you can hand it to her and she'll distribute it.

A lot of people don't know what retention and detention ponds look like. I am Charlotte "Sharkey" Schaefer's mother.

She died in a detention pond in 2004 that was poorly maintained and flooded. Detention ponds are made to be dry, but this one was 89% clogged and they knew it. The pictures I wanted to show you, the flooded area is the pond was taken several days after she died.

And they put a temporary fence up prior to that. That pond, it's- it was between the houses and the playground in our neighborhood. And nobody knew that it was designed to hold water at all. And detention ponds should hold just a few inches of water and slowly recede, but because of that clog.

So the other pictures behind it were taken 20 years later on the anniversary of her death. And I wanted to show you those because that's why we need inspections. They fenced the pond finally, but the grass is so overgrown that it's actually blocking the drain again 20 years later.

And so, you know, not all developers will do the right thing. And I think some will. But this is a common sense bill and it, it's really just mandating that they do what they should be doing in the first place. It's not terribly onerous. A couple comments I wanted to make in relation to this bill.

I do support the Attorney General's suggestion that if you're going to have the counties that there should be a state cost share so that they have adequate resources.

I do feel very strongly that this- this should be a statewide comprehensive solution because otherwise we're choosing which kids that we're protecting on which islands, and they should all be protected so that no other family has to go through the hell that my family has been through.

The other thing that alternately, you could consider the Senate Bill, that they combine the two Senate Bill versions, and in that bill they actually designate the Department of Land and Natural Resources who already has Kuleana for dams. So they do have some expertise in this area. So that might be another alternate solution.

Also, House Bill 1232 did not get a hearing, but it's a very similar bill. And I would like you to perhaps consider taking the inspection language in that bill. This Bill does a much better job of spelling out the safety requirements.

I believe House Bill 1232 does a better job of spelling out what an inspection should look for. I think combining them would make a more robust bill and that's what the senate did. Thank you very much. I appreciate it.

Thank you for your suggestions and thank you for being here this morning. On Zoom, I believe we have Gregory Misakian. Please proceed.

Aloha chair and members of the committee, thank you. I fully support this bill and I hope- I hope you pass it today. I- I also serve as a- a member of the Waikiki Neighborhood Board, but today I'm here speaking as an individual on behalf of myself. We did see last night a presentation by Ms. Schaefer's regarding this concern.

So I was able to see the actual slides that she's got, you know, she's probably holding in her hand. And I fully support this bill again, and I really truly hope that this bill and others like it move forward through the legislature year.

Thank you for your testimony. Is there anyone else wishing to testify on this measure either in person or on Zoom? Seeing none. Members, any questions?

Vice chair?

Thank you, chair. Attorney General's Office. Thanks for coming.

Yes.

Hi. Good morning.

Hi. Good morning.

You know the cost sharing, I understand the cost sharing oftentimes when these retention bases are developed, especially in subdivisions, that's being done through a land use process at the county level.

And that's part of their conditions of approval for that subdivision action. And I'm reading a lot of testimony from the counties of the overburdening from the counties.

I just wanted you to walk me through this cost sharing portion because at some point the land use development is a home rule process by those counties and those conditions of approval to develop that subdivision is then generates real property tax for the counties to help maintain these improvements. Help walk me through that cost sharing.

Okay. So in our testimony we pointed out that it's a in the state constitution, the article, Article 8, Section 5.

So basically if the state is requiring the counties to, you know, increase the level of service in an existing program or if they're mandating the counties to provide something new, then the state has to consider cost sharing with the counties. And that's, you know, the basis of our testimony.

So I think this bill does require inspection program or some kind of new inspection regulatory program.

And it would be on the state side with county support or county inspections with state support?

I'm not, sorry, vice chair, I'm not sure the mechanisms of how the--

Got it.

cost sharing works. It's just that there needs the state does, I guess pursuant to the constitution, the state constitution, the state does need to put some kind of appropriations to share in the cost of this program with the counties.

Yeah. And I would leave it up to the legislature to determine how to do that.

Great.

Great. Thank you.

Thank you chair.

Yeah. Thank you.

Thank you. Any other questions, Members? If not, thank you very much. Let's move on to the next bill, which is House Bill 245 relating to student health, student heat exposure safety. And first up, we have Department of Education.

Aloha Chair Takayama, Vice Chair Keho Kapuliloy and Members of the Committee, Kinau Gardner, Assistant Superintendent of the Office of Student Support Services, testifying on behalf of the Department of Education. The Department stands on his written testimony in support of this measure. Thank you for the opportunity to testify.

Thank you. Hawaii State Council on Developmental Disabilities.

Good morning, Chair. Vice Chair, my name is Saman Gorham I'm representing the Hawaii State Council on Developmental Disabilities as an intern. We stand on our written testimony in support of this bill. Thank you.

In support. Thank you. Department of Health.

Good morning, Chair. Vice Chair. My name is Sarah Hipp with the State Department of Health. We send out our written testimony. We look forward to coordinating and collaborating with Department of Education and state public charter school Commission on a study. I'm available for questions. Thank you.

Thank you. Thank you very much. Climate Change and Health working group. James McCallan.

Hello. Hi, Chair. My colleague is next door. I'm a Member of the Committee. I can testify on behalf of the working group.

Please do so. Step up to the mic.

Good morning, Chair, Vice Chair and Health Committee representatives. My name is Dr. Elizabeth Keefer. I'm an internist on faculty at JABSOM and the mom of two teenage boys. I'm here testifying on behalf of the Climate Change and Health Working Group, but also submitted testimony as an individual in support of HB 245, the working group.

And I helped to author the bill with Rhett Martin. So we can answer any questions that you may have. Kids are especially vulnerable to heat. They are physically closer to heat sources. They acclimatize slower in hot weather, and they may even take ADHD medication that impairs their ability to regulate heat.

They have no say on the timing of recess or practice, and they often don't want to let adults down, so they might be afraid to speak up. Kids are under the sun in helmets and padding or marching with an instrument. And my own younger son had heat illness after a game in full gear.

He was irritable, nauseated, and actually it took me a minute to recognize the early signs. And school kids have died because of heat. Georgia used to lead the country in school deaths until the High School Association changed their vague guidelines to a data driven approach.

California State actually mandated the development and implementation of heat guidelines for all school districts in 2024 in response to the death of a 12 year old middle school boy after recess. Sorry, gym class. So let's not wait here. In Hawaii, the Hawaii High School Athletics Association has heat guidelines in place using wet bulb globe temperature thermometers.

This is a great start. This is one of them. But we need to go further, so. So let's put standardized guidelines in place for all kids to protect them from heat when they're outdoors. This is the gold standard indicator of heat stress on the body. It's used by the military and athletic associations to guide exercise in heat.

So if this reaches a Certain temperature or threshold, then outdoor activity is suspended or modified. We'd like to prepare and not wait until children get sick. Thank you for the opportunity to test that.

Thank you, Doctor. Let's see. Hawaii Association of Health Plan. Rachel Wilkinson in offering comments. Elizabeth Keefer. Oh, okay. I see you. Let's see. That's all people I have listed as testifying. Have I missed anyone who wishes to testify in this measure, if not members, questions?

Representative Marten, for Department of Education. Please. So I appreciate your folks being so open to this initiative. Do you have a budget or a proposed budget appropriation for you folks to be able to do this?

Not for the study itself, which the bill covers. I think through the process of the planning, I think we may have then surfaced some budget needs, but at this time, we don't have any budget requirements.

Meaning that you can do this study without. Without any additional appropriation at this time?

Yes.

Okay. Fantastic. And. And this. Okay. This bill includes also equipment. Would. That would. Do you not have a budget for that, or is that something you'd like to postpone until after the study?

I think after the study, then we'll see what the recommendation is for how many and. And who gets them. We do currently have some in the. Used by, you know, our athletic association, but we did want to wait until after the study.

Okay.

Thank you very much. Thank you. Chair, can I ask a question of the. Of course. Yes, please. Yeah. So are you folks okay with having it sequential do the study first and see what the needs are?

We've been working with DOE and are okay with doing the feasibility study first.

Thank you very much. Thank you.

Okay.

There being no other questions, let's move on to the next Bill, HB903, authorizing schools to maintain a supply of Bronco dilators. Department of Health.

Good morning, Chair, Vice Chair and Committee Members. Gloria Fernandez with the Communicable Disease and Public Health Nursing Division providing testimony on behalf of Sorry, I'm with testimony from the Department of Health. We submitted written testimony and we are standing on that written testimony. At this time, I am available for questions.

Thank you. Department of Education.

Aloha again, Chair, Vice Chair and Committee Members again. Kina Gardner from the Department of Education, Assistant Superintendent of os. The Department does stand on its written testimony in support of this measure. Aloha and mahalo.

Thank you, Attorney General.

Good morning, Chair Takayama, Vice Chair Keohu Kapuli, Members, my name is Randall Watt, Deputy Attorney General with the Department of the Attorney General. As outlining, I've written testimony The Department offers comments on this bill. First, the definition of school in the proposed section 302A.

is the definition of school in Section 302A, 901 HRS, which includes any day care center, child care facility, head start program, preschool, kindergarten, elementary or secondary school, public or private, including any special school for children in the state. The Department of Education does not have jurisdiction over all the entities included.

As a result, it's likely unable to develop and implement a protocol as required under section 302-AB. To address this, the Department suggests that the word protocol be replaced by the term guidelines. Second, if the Committee chooses to retain this responsibility within doe, we suggest that you include the public charter School Commission to develop the guidelines.

And we recommend, as outlined in the testimony, written testimony, to revise page one, lines 10 through 17 to include the Commission. Thank you for the opportunity to testify. I am available for questions.

Thank you very much. Hawaii Association of Professional Nurses on zoom. Jeremy Creekmore not present. Not present. Hawaii Association for Justice Evan Oi offering comments. Hawaii Association. I'm sorry. Hawaii State Center for Nursing Laura Reichardt. Thank you. In support American Lung Association Pedro Haro.

Aloha Chair, Vice Chair, Members of the Committee. Pedro Haro, Executive Director of the American Lung Association. The American Lung Association has been working and has been assisted in passing and implementing these policies in 21 states.

We started this process because we have been receiving emails and contact from parents and teachers talking about needing help to be able to administer bronchodilators in schools. Hawaii has one of the highest rates of asthma in the nation, particularly in Hawaii county on the west side of Oahu in an Maui County.

So it's an incredibly important and needed ability for schools to be able to do this. I'm available for questions. Thank you so much.

Thank you. That's all the testifiers I have. Anyone I missed? Yeah. Please step forward.

Good morning. Chair Takayama, Vice Chair Keohu Kapuli Loi and Members of the Committee. My name is Clementina Serjea Ulep, Dean of the University of Hawaii at Manoa School of Nursing and Dental Hygiene and the School of Nursing and Dental Hygiene and the School of the Jan Abrams School of Medicine support this measure and available for any questions.

Thank you.

Thank you, Dean for being here. I'm sorry I missed you. I didn't see you on the list of in person. Thank you. Anyone else I missed? Members, Any questions? Seeing none. Thank you all. Let's move on to the next bill, which is House Bill 1314 relating to youth mental health and we have Department of Education.

Aloha. Again, Chair Takayama, Vice Chair Keauhu Kapuliloy and Members of the Committee. The Department stands on its written testimony offering comments and appreciate the opportunity to testify on this matter, Department of Ed.

Thank you. On zoom, I believe we have Don Poyani not present. Noela Van Wiegand not present. Travis Brashers not present. Okay. Anyway, they were all in opposition. Anyone else I missed? Who wishes to testify on this bill? Seeing none. Members, questions? Seeing none. Let's move on.

House Bill 1334 relating to meat donation, exempting the donation of wild game meat, including access deer, to charitable organizations. DLNR.

Morning. Chair, vice chair, members of the committee. Nick Vargas with DLNR.

Yep. Can you. I'm sorry, you need to step forward. Otherwise people won't be able to hear or see you.

Good morning, chair, vice chair, members of the committee. Nick Vargas with the Division of For- DLNR, Division of Forestry and Wildlife. We stand on our written testimony in support and with written comments. And I'm here for any questions. Thank you.

Okay. Thank you. Department of Agriculture? Seeing none. Okay. Hawaii Food Industry Association, Lauren Zirbo on Zoom. Not present.

Not present. Hawaii Farm Bureau. Brian Miyamoto in support. No. Okay. Anyone I missed? HB 1334. Seeing none. Members, any questions? Okay, we'll move on to next bill, which is House Bill 799 relating to health care. And we have Hawaii Association of Health Plans, Rachel Wilkinson.

Good morning, Chair, Vice Chair, members of the committee. Rachel Wilkinson, on behalf of the Hawaii Association of Health Plans. And we are standing on our written testimony offering comments. Thank you.

Okay. HMSA.

Good morning, Chair Takayama, Vice Chair Keohokapu-Lee Loy, members of the committee. Dawn Kurisu, on behalf of HMSA. First of all, we just want to thank the committee for hearing this important measure. HMSA stands on our written testimony in support of HB 799. And I just want to highlight a few key points.

The changes proposed would align state rules around ambulatory surgical centers with those updated by CMS in 2019, and removes the barriers that sometimes could disincentivize providers from traveling to the neighbor islands to fill critical gaps in care, particularly around specialty care.

And so we strongly support efforts to increase access and support our healthcare workforce, particularly on the neighbor islands and in our state's rural communities. And thank you so much for hearing this measure and for the opportunity to testify in support.

Thank you very much. Let's see, that's all the testifiers I have on this measure. Oh, please step forward. Department of Health.

Good Morning, Chair. Vice Chair. Lorrin Kim, Planning and Policy Officer for the Department of Health. I'm sorry the department did not submit testimony. We intended to, but it. It's taking some time to unpack some of the regulatory impacts this has. But we are submitting comments supporting the intent. We hope that this measure moves through.

And we are actively working on proposed amendments that limits this to Maui, proposes a sunset date of several years, a study to impact the quality, a study to look at the impacts of this to quality and access, and a specific exemption from Hawaii administrative rules that directly conflict with this or prohibit this.

So again, we are submitting comments supporting the intent, but there is more work to be done. But we think this is a valuable conversation and would like to see this measure moved. But it does need amendments and we are actively working on them.

Okay, thank you. Thank you very much. Now, should the bill move, it does move on to the Committee on Consumer Protection, so I'm sure they would anxiously await your comments. Anyone else I missed on this measure? If not, members any questions? Seeing none. Let's move on to House Bill 952 relating to Parkinson's disease research. Department of Health.

Good morning again. Lorrin Kim, DoH. The department will stand on its testimony offering comments identifying the need for for additional appropriations, FTE and research, as well as a suggestion that I do think, the department thinks that state assistance in Parkinson's research would be valuable. I have been touched by Parkinson's.

My mom passed away from complications due to Parkinson's, so I realize the devastation that it brings. However, looking at our private sector partners, I think they're in a better position to manage this kind of registry.

And if the state is interested in support, one potential mechanism is to funnel funding through the Department of Health rather than stand up additional civil servants and a new program at DoH. So just tossing that out there as a potential alternative to our comments requesting additional appropriations. This would be a heavy lift. Absolutely necessary, absolutely helpful.

But this would be a new and heavy lift for the Department of Health. Thank you.

Okay, thank you. Let's see. Glen Higa, Hawaii Parkinson Association.

Aloha. Good morning. Chair Takayama, Vice Chair Keohokapu-Lee Loy, members of the House Committee on Health. My name is Glen Higa. I'm the President of the Hawaii Parkinson Association and I've been living with young onset Parkinson's disease since 2018. I stand on my written testimony in support of this bill which establishes the Parkinson's Disease research collection database.

If I could just point out a couple things of reason why- why we need a database. One is in the language and the bill itself. It cites 4,000 patients estimated and- and- and by the Michael J. Fox Foundation and Parkinson's Foundation.

It also cites an estimated 7,000 patients, which is- which was provided by former President and Chairman of the board, Jerry Boster. And furthermore, the Queen's Medical Center's Parkinson's and Movement Disorders- Disorder Center has estimated 8,000 people diagnosed. So you can see with all these different numbers that- that there's a need for a database.

If I could also just share a couple of- of- of goals that I have as- a couple of the goals that I have as President of HPA. One is to inspire those diagnosed with Parkinson's here in Hawaii to live their best life.

I've been fortunate enough to be able to keep my condition under control through good fortune, assistance of family and friends, and hard work. Still able to play softball competitively, travel, watch UH sports, go bulls, work as a personal trainer for people with Parkinson's, and be an inspiration to the Parkinson community.

The second goal is to ensure that no one living with Parkinson's feels they are alone or living in isolation due to- due to this condition. It's a tall order given the uncertainty of the number of people diagnosed with Parkinson's. And that's where the Parkinson's database will greatly benefit our community. So there.

So- So I want to just say thank you for the opportunity to- to stand in support of this- of this measure. And- And I- And I thank you on behalf of the Hawaii Parkinson's Association. Thank you.

Thank you, Glen. Nice to see you again. See, we have Queen's Health System.

Aloha. Good morning, chair and vice chair, members of the committee, JC Miki, like on behalf of Queens. Will largely stand on our written testimony. But instead of hearing from me today and seeing my face, I thought it'd be great if one of our clinicians from Queens, Dr. Michiko Bruno, who's a

director, medical director and heads up our Parkinson's and Movement Disorder Center, could speak to you a little bit this morning.

Good morning. Good morning, chair and vice chair and members of the committee, thank you so much for having me. My name is Michiko Bruno and I'm a neurologist, movement specialized neurologist at Queen's. Medical Center, as well as Professor at John A. Burns Medical School. Parkinson disease is a very complex disease.

Affects many, touches- touch many, as exemplified already we heard. But this type of registry will tremendously help patients as well as communities. We did identify that there is a lot of disparities and access issues still on this state. So we- this type of registry will also help improve that. So it is, in addition, it will also help be

a pilot and example for other devastating neurological disease such as Alzheimer's, multiple sclerosis, epilepsy. So I think we would love to work- work in and try to support this in any way we can. Thank you so much.

Thank you very much. Anyone I missed who wishes to testify on this measure? If not, members, any questions?

Chair? Chair, if I could?

From Zoom.

Oh yes.

Mr. Misakian, please proceed.

Thank you. Aloha again, chair, vice chair, members of the committee. And I apologize. I had written testimony that I did not get in in a timely manner. So I didn't submit it late last night. I- For those who know me, I currently- I currently serve as first Vice President of the Kakua Council. I was president last year.

And the Kakua Council advocates for our kupuna. We've been around since 1972. Today, I'm speaking as an individual. I'm not speaking on behalf of Kakua Council, but because of what I do and what I advocate for and because I lost my mother due to Parkinson's, complications from Parkinson's, where she fell and broke her hip in 2023.

She died a short time later. And because of that and because of others that I know who suffer from Parkinson's, I fully support this bill.

I would ask that whatever registry or databases created that that information, in addition to the information that's collected and available, that there's a comprehensive amount of information regarding falling, things- things that can be supportive to those who care for Parkinson's patients or par- people with Parkinson's.

So we just ask that it be clearly looked at to provide a wealth of information. So thank you for the opportunity to speak today.

Thank you very much. Let's see, have I missed anyone else wishing to testify on this bill? If not- Oh, I'm sorry. Members, any questions? I do have a question for Dr. Bruno, if you would. Dr.

Bruno, in your testi- in your testimony you mentioned that a handful of other states have created a registry like what is being proposed in this measure.

Exactly. Correct.

Do you know where such registries are maintained? Are they with their respective departments of health or universities or where are they?

That's a great question. I- I had opportunity to talk to Dr. Carolyn Tanner from UCSF who worked with the California Legislatures. So I might have the technicality. Quite. Not exactly. But they started with the Department of Health with some- some additional potential funding and university input. So it's a partnership.

I believe it's a partnership because I completely agree that might be difficult to. The funding is a very important point that I- we recognize so we can- we can try to get more information on that.

Okay, thank you very much. Appreciate the information. There being no other questions, Members, let's move on to... We have a 10:15 agenda, and it is on House Bill 1431, establishing an Oral Health Task Force. And we have Hawaii State Health Planning and Development Agency, SHPDA. Dr. Lewin.

Good morning, Chair, Vice Chair, and Members. Jack Lewin from State Health Planning and Development Agency. Really the state is really lacking in the kind of dental oversight that the Department of Health needs, so we strongly support this bill. It's been a long time coming. We have many keiki out there that really still need services, but also kupuna that need dental services, particularly in our Medicaid program. So we strongly support this and think this is a great investment in health. Mahalo.

Thank you very much. Let's see, we have written comments from the Office of Information Practices. UH System, Dean.

Good morning, Chair Takayama, Vice Chair Keohokapu-Lee Loy, and Members of the Committee. My name is Clementina Ceria-Ulep, UH at Manoa School of Nursing and Dental Hygiene. And thank you for the opportunity to testify in support of this bill. And further, we recommend that Dr. Deborah Mattheus, who is a faculty from the School of Nursing and Dental Hygiene.

And also endowed professor in school health and professor is the Senior Practice Director for the Dental Sealant Program and the Director for the Hawaii Keiki Healthy and Ready to Learn Program for the State of Hawaii. And for the School of Medicine, we recommend Dr. Jill Omori, Director of the Office of Medical Education, and Dr. Matthew Oishi, part time faculty in charge of the oral health curriculum for the medical students. Thank you.

Thank you very much. Department of Human Services offering comments. Department of Health.

Good morning, Chair. My name is Matt Shim. I'm Chief of the Family Health Services Division. The Department supports this bill. I provided an amendment for the Sunshine Law that would allow specialized discussions between professionals while not in the in the conduction of their regular work or associations, which they would not be able to do without this exemption.

I did work with OIT to come up with the correct language. Also, we appreciate the funds to convene the task force, but we do have a Governor's executive budget request to re-establish the Department's oral health program, and that request includes two permanent FTE positions. So the establishment of the one FTE in this measure may not be necessary. I'm available for any questions. Thank you.

Okay, thank you. Let's see. Hawaii Dental Association, Kim Nguyen.

Richmond Luzar, Hawaii Dental Association. Hi, Chair, Vice Chair. We stand on our written testimony in support. Thanks.

Thank you. We have AlohaCare offering support, and Arlene Kiyohara in support. Have I missed anyone else wishing to testify on this bill? If not, Members, any... Members, any questions? Okay. Sorry. Okay. If seeing none, let's move on to decision making on the 10:00am as well as the 10:15 agenda.

First up, we have House Bill 1233 relating to stormwater management systems. I took note of the Attorney General's suggestion that changing the measure, as the prior committee did, to require counties to be responsible for this issue does require us to provide an appropriation of some kind.

So I suggest we move this bill forward with a draft that first of all defects the date to ensure continued discussion and also put in an appropriation that is blank for further discussion in the House Finance Committee to consider. I have discussed the changes with the prior committee chair and he concurs with the changes.

Members, any questions or comments or concerns? First of all, thank you very much, by the way, to Mrs. Schaefers for being here. Appreciate your testimony. Any questions, comments, concerns? If not Vice Chair, please take the vote.

Thank you, Chair. Members, voting on House Bill 1233, house draft 1. Chair's recommendation is to pass with amendments. Chair votes I. Vice Chair votes. I.

[roll call]

Chair, your recommendation is adopted.

Thank you. House Bill 245 relating to student health, student heat exposure safety. I'd like to suggest we move this bill as is. Questions, comments, concerns? If not, Vice Chair.

Thank you, Chair. Members voting on House Bill 245. Chair's recommendation is to pass with amendments. Noting all members. I'm sorry. Pass as is. Noting all members present. Any members voting no? Any with reservation? Chair, your recommendation is adopted.

Thank you. Next bill is House Bill 903 relating to schools supplying themselves with bronchodilators. I know that there needs to be further discussion as to its cost implications that I think can be considered by the House Finance Committee. So at this point, I'd like to suggest we pass this bill on as is. Questions? Comments?

If not Vice Chair.

Thank you, Chair. Members voting on House Bill 903. Chair's recommendation is to pass as is. Noting all members present. Any members voting with reservations? Any members voting no? Chair, your recommendation is adopted.

Thank you. The next bill is House Bill 1314 relating to youth mental health. I've consulted with the author of this measure and he's asked that we defer this bill to enable schools who are currently working on such a plan to continue their work and he will monitor them.

And thank you, Representative Olds, for your work on this measure. So we'll defer this measure. House Bill 1334 relating to meat donation. I'd like to suggest a small amendment which changes the reference in the bill which is currently section 145 relating to. I'm sorry, suggesting a change from 145 to Chapter 145D, which directly relates to food donations.

I believe this better conforms to bill with to federal regulations in terms of food donations, which is the intent of the bill to do so in a safe manner. So I'd like to make that small change consulted with the chair of agriculture and she concurs with the change. So any questions, comments? Members, if not Vice Chair.

Thank you, chair. Members voting on House Bill 1334. Chair's recommendation is to pass with amendments. Noting all members present. Any members voting no? With reservation? Chair, your recommendation is adopted.

Thank you. House Bill 952 relating to Parkinson's disease research. I'd like to suggest we move this bill on. I know that there needs to be further discussion as to exactly where such a database would be located. I think by moving this bill on, we will enable further discussion to occur in subsequent committees.

So I'd like to move this on with a simple defective date. Members, questions, comments? If not, Vice Chair for the vote.

Thank you, chair. Members voting a House Bill 952. Chair's recommendation is to pass with amendments. Noting all members present. Any members voting no? With reservations? Chair, your recommendation is adopted.

Oh, thank you. My oversight. I missed a bill. House Bill 799 authorizing physicians to practice at organized ambulatory care facilities. Like to move this on with house draft, simply defecting the effective date. Members, any questions or comments? If not, Vice Chair.

Thank you, Chair. Members voting on House Bill 799. Chair's recommendation is to pass with amendments. Any? Noting all members present. Any members voting no? Any members with reservation? Chair, your recommendation is adopted.

Finally, on House Bill 1431 relating to establishing an oral health task force, I'd like to move this bill on with house draft as a house draft, defecting the effective date, blanking out the suggested appropriations and putting them in the report language to the effect of suggesting that the finance committee consider $200,000 for a consultant as well as one FTE at the Department of Health at a cost of $79,872.

Those are my suggestions. Oh, yeah, I'm sorry. And also note that the committee should consider the Department of Health's comments that such a FTE may not be necessary, but allow them to consider it. Members, thank you. Members. Any questions or comments? If not, Vice Chair.

Thank you, Chair. Members, voting on House Bill 1431. Chair's recommendation is to pass with amendments. Noting all members present. Any Members voting no? Any members with reservations? Chair, your recommendation is adopted.

Okay, thank you very much. Before we adjourn, I'd like to apologize to the committee. I. I do know that we have an 11:30 hearing posted and I apologize for the add on because we received a late request from the author of the bill and it relates to Maui health situation that he considered urgent.

So with that, we'll see you at 11:30 and we're adjourned.

Good morning. Convening the 11:30am meeting of this hearing on this Committee on Health here in Conference Room 329, Hawaii State Capitol. One Bill on the agenda. House Bill 905. Appropriating funds to purchase an advanced life support ambulance to be based in Central Maui. Department of Health.

Aloha Chair, Vice Chair and Members of the Committee. My name is Kristy Luke and I am from the Department of Health's EMS and Injury Prevention System branch.

The department supports the intent of the measure which is to improve access to primary health care in Central Maui and suggest considering community paramedicine or mobile integrated health integrated-a mobile integrated health program as an alternative solution. With rising emergency call volumes, a new ambulance does help to increase the availability of 911 service.

We also need to understand that there's a change in medical needs in the community and not all 911 calls are true emergencies. So a Community Paramedicine Mobile Integrated Health Program or CPMIH Program would focus on more community based care addressing a variety of healthcare needs rather than strictly 911 response.

So a program like this addresses the entire community system rather than just 911 response.

Thank you.

You can stay up there for a minute. Just to note for the record that we have written testimony in support from the Office of Hawaiian Affairs, Victor Ramos and Chair Alice Lee from Maui? Maui County Council. Members, questions? I have a question for Department of Health. Ms. Luke.

Thank you.

We considered a similar Bill establishing an ambulance service on the Big Island in Kona, I think, and the estimated cost was 1.75 million. Would that be a similar cost in this situation?

Yes. Yes.

Okay.

That's for ambulance equipment, supplies and for staffing.

Okay, thank you.

There being no other questions, we have enough for decision making, right? Yes. Okay, we'll go on right into decision making on House Bill 905. My suggestion is that we move forward House draft deleting-I mean defecting the effective date.

And in report language asking the Committee on Finance if it so chooses to consider this measure that the estimated cost would be 1.75 million. And furthermore in the report, note the Department of Health's suggestion that alternative and less costly service models should also be considered. Members, any questions or comments? If not Vice Chair for the vote.

Thank you, Chair. Members voting on House Bill 905. Chair's recommendation is to pass with amendment. Chair votes aye. Vice Chair votes Aye. Member Amato? Member Chun? Member Martens? Excused. Member Olds? Member Takenouchi? Excused. Member Alcos? Excused. Member Garcia? Excused. Chair, your recommendation is adopted.

Thank you and thanks Members.