House Standing Committee on Judiciary & Hawaiian Affairs

Welcome, everyone, to the House Committee on Judiciary and Hawaiian Affairs. It is Tuesday, March 25th, 2025, at 2:00 PM, here in Conference Room 325. We're here for the purposes of considering numerous measures. Those who are testifying today, I would request that you limit your testimony to two minutes per testifier.

I'll ask you to wrap up at that point and summarize. If you're testifying on Zoom, please keep yourself muted and your video off until your testimony is called for and then, if you could mute yourself and turn your video off after your testimony is complete, that'd be great.

If you have technical issues, you can use the Zoom chat function to communicate with our excellent technical staff, and they'll help you out as best they can. If you are disconnected, don't panic, just rejoin as soon as you can, and I'll try to fit your testimony in when you return.

If the power goes off in the room here or network fails and we have to reschedule, we'll make sure to post appropriate notice, so everyone knows when we're meeting and what we're going to be doing. If you're testifying on Zoom, please avoid using any trademarked or copyrighted images.

That kicks us off of YouTube, and that's not good, because we want the public to watch what we're doing. Please conduct yourself with aloha and refrain from profanity or any uncivil behavior. It's okay to disagree, but let's not be disagreeable. First up, we have Senate Bill 1322, Senate Draft 2, House Draft 1, relating to mental health.

This measure clarifies the procedures for emergency transportation, examination and hospitalization for individuals who may be mentally ill or suffering from substance abuse who are imminently dangerous to self or others and establishes limitations on liability relating to emergency procedures.

Requires treatment providers to provide relevant information to the Attorney General for purposes of preparing an assisted community treatment petition and expands the notice requirements for an emergency hospitalization to include an individual's health care surrogate. And clarifies when an individual can waive notice to family Members. And it goes on, but that's the primary summary of the measure.

First up, we have the Attorney General testifying on Zoom in person. Welcome.

Okay. Good afternoon, Chair, Committee Members. Good afternoon. Ian Sudo with the Department of the Attorney General providing testimony and support. This is a comprehensive reexamination of Hawaii's mental health code. The goal of the bill is to clarify and enhance existing law, and this bill reflects the input and concerns of various stakeholders involved in the mental health system.

And as a product of collaborative work that had gone on since the end of the last session legislative session, we believe that this will provide Hawaii with a useful framework that providers can utilize as we continue to develop mechanisms to help care for people in our community facing mental health challenges. So we support this Bill.

We do have recommendations for revisions to the provision regarding emergency transportation for individuals under an order for assisted community treatment. We believe these revisions will better achieve the intent of the amendments made to this section by the Senate Committee on the Judiciary. And if this Committee has any questions, I'm available.

Thank you. Thank you very much. Next we have Department of Health come on up to the podium so everyone in TV land can see you and hear you. And if you could, instead of just standing on your testimony, if you could, give us the highlights of your testimony.

Chad Koinagi, Department of Health Generally standing on written testimony with one offered amendment regarding the procedure for provider generated emergency transport. And we'd just like to have a copy of the written documentation to come to our Department within five days for purposes of tracking data and planning resources in the future.

Excellent. Thank you very much. Next we have Department of Law Enforcement in support. Next we have Lou Erticek, Hawaii Disability Rights Center.

Thank you. Good afternoon, Chair, Committee Members. We're opposed to the bill basically because of some major concerns that we have. There's a lot in here that is when I say not a big deal, I mean basically because it repeals a lot of current law and places it into a new subpart.

And some of those changes are probably not that big a deal. But we do have two serious concerns. And I think the most important one that I want to address first is this issue of immunity from basic negligence that was in the original Bill. The Senate Judiciary Committee wisely took that out when it went to the House.

I was actually surprised to see the Attorney General asked to have it put in. And if you look at his testimony then and now, he says, well, this is modeled after 127A of the Hawaii Revised Statutes. So here's the overview of 127A. This is all about Gubernatorial powers in an emergency, things that the mayors can do.

This is natural disasters, public utilities. This has nothing to do with with what we're talking about here. These are delicate people. If anything, they should be treated more carefully, not less carefully.

And so the idea that this bill is going to say, well, as long as you're not like grossly negligent or totally reckless, you can transport them and do what you know and you're not going to be liable. I think there's an irresponsible position to take. I mean, you're going to hear the bill later on. Excited delirium.

We've already talked this session about the lack of proper training for police officers. So you're going to have potentially untrained people transporting delicate people and not necessarily held to a basic negligence standard. So I would urge this Committee to take that out of there entirely.

The other issue is the order to treat at the state hospital, which has always been a really odd proceeding. I mean, normally if somebody is supposed to be involuntarily medicated, you go to court and you get a court order. If the person meets the criteria.

For those at the state hospital under the current law, they go before a panel of three doctors or health care, this would reduce it to one. And I don't think that that makes any sense. I did note a lot of concerns from Hawaii Pacific Health in Queens.

The more I think about it, I kind of like the suggestion at the end of the ACLU testimony about potentially shelving this bill and setting up an interim work group. This is a complicated area or using this bill as a vehicle. So that would be an alternative consideration. Thank you.

Thank you very much. Mr. Next, Edward Chu, Hawaii Health Systems Corporation for his designee. Hello.

Good afternoon, Chair. My name is Malia Espinda for HHSC. I've been part of this MH1 law since 2009 when now Governor was the House Health Chair. And we've seen many revisions since then.

And I just want to start with, you know, Queens as the designee MHEW contract, who helps to do what I call air traffic control has been a very blessed, wonderful thing for HHSC. It's a good partnership. It has really helped to manage and coordinate our ERs better than before. So that's first.

But to our amendments that we are requesting on this Measure, on page 10, line 14, we are asking for the restoration of that 72 hour versus 48 hours. Why? Because the 72 hours will provide additional time to stabilize that patient.

It's not a mandate, it's not a requirement to hold the person for 48, but to allow it to go to 72 means that we can stabilize and while also at the same time decreasing because they have to apply. While they're trying to stabilize in that 48, they're applying for an MH6.

They stabilize, they're withdrawing, and that's creating a bureaucracy between us and ags that allowing that a little extra time will help to mediate under 334 if a patient is provided an emergency exam and at any point of care is determined to either not meet or or no longer meet the criteria for involuntary hospitalization the patient must be discharged expeditiously so you don't have to hold them contrary to some of the testimony I've read.

So that's why we are asking for that 72 to lower our administrative burden and then finally and I apologize for the small typo in my testimony we are also asking in 334B what we understand is it's very rare that an individual law enforcement or crisis officer is not able to reach an MHEW it's incredibly rare but if they don't in the occasion that they don't that they don't just bring them to our hospitals especially our EDS because we need that sort of air traffic control so therefore that's why the request that then the person be taken to a law enforcement facility.

Thank you.

Thank you very much. Next we have the Queen's Health Systems.

Aloha, Chair, Vice Chair, Members of the. Committee. JC Mikulanec, on behalf of the Queen's Health System. Sandra couldn't be here today, unfortunately, but I'm also joined by Ashley Shearer, Senior Director of Care Coordination and Patient Flow from Queen's, who can speak to some of the questions that you may have later on.

We'll largely stand on our written testimony and note that we are supportive of the amendments made by the previous Committee, related to how providers are able to initiate a transfer of somebody going through a mental health crisis. We believe those amendments really seek to bring the same qualifications that MHEWs are integrated into this process, as we see throughout the rest of the statute. We're available for any questions and thanks very much.

Sure. Thank you very much. Next, we have Hawaii Pacific Health.

Good afternoon, Chair. Mike Robinson, Hawaii Pacific Health. I've submitted my testimony in writing. We also agree with the changes that the prior Committee made. We had one—our comments were related to another section. It's in 334-E.

It might be disambiguous drafting, but we weren't sure whether under the requirements of this Bill that a second examination by qualified psychiatric examiner was required as written.

So, we're just asking that in 334-E, in that bracket, it be struck out to make it clear which we believe the intent is just to have a qualified one psychiatric exam per 334-B, C, and D. But the way it's written in E, we weren't sure whether we would have to do it again in the ED.

And the reason for that is we just don't have the physician resources to do that, right? We're not a behavioral health inpatient facility. And I'm sure that the concerns that we have are shared by other providers as well, in terms of accessibility.

We don't want to slow the system down by having another requirement if it's not needed. Thanks.

Okay, thank you very much. We received written testimony in support from the Hawaii Substance Abuse Coalition. Next, ACLU of Hawaii, Ms. Shirota, welcome. Please proceed.

Aloha, Chair Tarnas, Vice Chair Poepoe, Committee Members. Carrie Ann Shirota, Policy Director, on behalf of the ACLU Hawaii. We strongly oppose this measure. This measure lacks due process safeguards, violates civil rights and civil liberties, and opens the door to a legal challenge against the State of Hawaii. First and foremost, we want to highlight case law.

In Vitec v. Jones, the US Supreme Court held and recognized that for the ordinary citizen, commitment to a mental health hospital produces a massive curtailment of liberty and it requires due process protection.

In Suzuki v. Yuen, the Ninth Circuit Court of Appeals noted that the state interests must be equally significant to the liberty interest that is being deprived.

In drafting involuntary commitment statutes, states should be cognizant of the significant deprivation of liberty and significantly, our own Hawaii Supreme Court has held in Reid Do that the civil commitment of the mentally ill for any purpose constitutes a significant deprivation of liberty and I'm quoting from the court, "To be considered dangerous to self, under Hawaii's statutory scheme, it is not enough that an individual is unable to satisfy need for nourishment, essential medical care, shelter, or self-protection without supervision and assistance of others."

"There must also be a clear and convincing evidence that the individual's inability to satisfy their need for nourishment, essential medical care, shelter, self-protection, without supervision and assistance of others will probably result in death, substantial bodily injury, or serious physical debilitation or disease unless adequate treatment is afforded to the individual."

That is the standard and we're very concerned that there seems to be appearing of weakening of standards under this statute and a few other statutes that have been proposed this session. We want to note that there are a number of best practices that would also uphold constitutional rights of individuals with mental illness and/or co-occurring disorders.

It is not an either/or. Then, in order to provide compassionate care, we must strip people away from their constitutional rights. We want to highlight that under the assisted community treatment proceeding, we have raised this previously and we will continue to raise it at every hearing.

We believe that it is a blatant violation of due process not to allow an indigent person who is subject of an act petition in a family court closed proceeding that they are not guaranteed right to counsel in every proceeding.

Our act law is modeled after Kendra's Law in New York and that is also modeled after Laura's Law in California, and both require, specifically, the right to legal counsel at every stage of the proceeding. And that is not what is happening here.

I know you've got a long testimony which I made sure everyone has—if you could summarize.

I would like to point out the emergency transport, Chair, because I know we're using words like emergency transport, but when we have armed police officers who are not trained in behavioral health, we know the data that people who have mental illness and encounters with police that there is a 16% chance, 10 times as much, higher likelihood experience of use of force in interactions which could include death.

And we're using terms like transport, but it's actually a detainment and, and detainment requires, under the 8th Circuit Court of Appeals, there's a standard that for emergency mental health seizures in the 8th court, that there cannot be a detention unless there is probable cause. And we, again, are sending police officers.

And we just heard at a conference yesterday that less than 20% are trained in CIT, Crisis Intervention Training. But beyond that, again, 20 hours, 40 hours of training, is not the equivalent of someone who is trained to deal with behavioral health.

And just last, we want to just note that because of these numerous violations of constitutional rights, we ask that you hold this measure and that we create an interim working group and the ACL would be willingly to participate in that. Thank you, Chair.

Thank you very much. Next, we have written testimony with comments from Adventist Health. Nathan Lee with ACLU.

Apologies for submitting late.

Thank you, Chair, Vice Chair. Just briefly, we want to note that while we are in opposition, we request if the Bill moves forward, the following amendments. The first would be removing the immunity from liability, as previous Committee has done, has been discussed.

The second is just including reporting requirements that look something like the reporting requirements under Laura's Law in California. And in California, this requires reports to the Legislature through California's Department of Mental Health that basically explain how hospitalizations are occurring, what treatment is like for these individuals.

And we think that this is tremendously important, especially given the liberty interests involved. And we believe that if you are to move this measure forward, including a reporting requirement to the Legislature so that we can hold individuals accountable and understand how the most vulnerable in our society are being treated is essential. So, we set forth those amendments.

But we do urge you to oppose this Bill. Thank you.

Thank you very much. Next, Institute for Human Services on Zoom. Angie Knight, please proceed.

Hi, Angie Knight with the Institute for Human Services. Apologies for the late testimony. We just wanted to comment on the immunity of—liability for transport.

And we suggest that a solution for the questions of liability that have come up whenever we have asked different Emergency Department, or not Emergency Department, emergency services, and police to help with the transport for those under the ACT Petition to have more developed protocols so that the question of liability is no longer a question and that with the protocols in place, they will be able to provide the service that is provided under the ACT Petition.

Thank you very much. And finally, we have Brendan Joanou, individual in support, on Zoom. Please proceed.

Thank you.

Aloha Chair Members. Thank you for letting me testimony. My name is Brendan Joanou. I am a graduate student at the University of Manoa—University of Hawaii, Manoa. Although my viewpoints do not necessarily reflect that of the larger institution, are on my own. I wanted to say that I am in support of SB 1322.

It is a sweeping bill. There's a lot of parts in it and I hear the concerns about protecting the rights of people's autonomy, dignity, and personhood. I believe those are very important and should always be safeguarded.

However, I do believe that there are efforts in this Bill that can help to facilitate and improve Hawaii's mental health care delivery, which I believe is important in this time when we are facing provider shortages across the state. I believe that's just where I will end it and I am supportive of the Bill. Thank you.

Thank you very much. That's all the testimony we received on this measure. Is there anyone else here or on Zoom wishing to testify on Senate Bill 1322? Please come up and introduce yourself.

Yes. Thank you, Chair, Vice Chair. Heather Lusk with the Hawaii Health and Harm Reduction Center. Forgive me for not getting my testimony in. I actually wanted to provide comments about a part of this Bill that's not been talked about.

While there is significant evidence that people with schizophrenia benefit from this, there's been no talk about substance use and there is no evidence around people with substance use disorder being—having—involuntary treatment, having it be effective. And we know that from the Treatment Action Center.

So, I do—would recommend as well that if we are able to have a working group that we do a deeper dive into the substance use component of this that would tagged on. We recently have had some predatory substance use providers coming into our state trying to sell and send people to different places and get money.

It won't be the first time that someone's utilized a kind of loophole like this to force substance use treatment without any evidence. So, thank you for the opportunity to provide comment and have this dialogue go deeper about the substance use component of this Bill.

Thank you very much. So, I don't see any testimony from you, is that correct? There's no written—okay. If you could just provide your name and your organization to our staff over here, that'd be great. Okay. Anyone else wishing to testify on this measure? If not questions, Members? Representative Belatti, please proceed.

First up, Mr. Sudo. You stated that this is a product of collaborative work since last session, and I understand that there was a mental health working group. Can you explain what your process was and who were the stakeholders involved and if any reports were provided by your Committee?

Sure. I don't know that it was a formalized working group in that sense, but we did venture to try and get every stakeholder that's involved in Hawaii's mental health system, involved in the process, getting their concerns, getting their comments, getting their recommendations, to that end.

I think it's clear that we don't all agree on every single point with regards to this law. But I mean, certainly, efforts were made to try and achieve that.

Can you identify who were the stakeholders that you involved?

We spoke to, of course, the state entities like the Department of Health, those departments dealing with homelessness, those departments dealing with housing issues. We've spoken to Queen's Medical Center. I think we got ACLU. We spoke to them during this drafting process. HHSC, we spoke to them as well. IHS Institute for Human Services and a number of—there could be others, but, you know, those are the primary entities.

And no reports were completed or there was nothing from your working groups?

No, no, no.

Okay.

May I continue, Chair? What is the reasoning behind the removal of the liability and the citation to Wildfire general laws to take away the liability?

Sure. In our conversations with the providers that are dealing with individuals on the ground level providing treatment who are in crisis, you know, there were concerns raised about we want to act. We're not sure that we have the ability to do it. And I think that's, that comes part with the efforts to try and demystify this area of law and make things more clear.

So, in conjunction with that effort, the idea was to provide some level of protection for individuals, professionals working with these individuals, who essentially are unpredictable because of the state that they're in. They're facing mental health issues.

They may be facing issues with substance abuse. And that can lead to a very serious and unpredictable situation that professionals have to account for.

Okay. So, last, at the end of last session, I believe I had you in my office with individual David Day from Attorney General's Office, Dr. Fink.

I think some members from Department of Health, and we were kind of talking about this law, and I understand that this is a comprehensive change, but in the context of that conversation, the question that I was asking was the application of ACT to kind of the situation that Ms. Lusk mentioned. Right?

And that how individuals from the state hospital were not seeming to go through and getting the appropriate ACT orders and designations. And then there was this cycling of individuals in and out of the hospital, in and out of jails and back into communities. So, my question is—and you remember that conversation, right?

I do.

Okay. Do any changes in this Bill address the problem that we were identifying there? And then, can you respond to Ms. Lusk's comment about how, how ACT is being applied to substance use individual, people who subs—who are suffering from substance use disorder—and whether or not the changes that you're proposing are effective or going to actually be counterproductive.

Because we have worked on this ACT Law as long as I have been here, 18 years, and every time the Department of Health, in fact, has been the one that's kind of been throwing things that cause it not to be implemented. So, it's a broad question. You remember that conversation?

I'm open to anything that you might have to say.

Sure. To your first question, you know, it's a complicated answer. And there are provisions in the Bill that not only enhance, I guess, the consequences or the results of noncompliance for assisted community treatment, which can make it a more useful and viable tool for providers.

We've also added provisions in there to help streamline the legal process in obtaining these orders. You know, time constraints under the current system have a great effect on how quickly we can get those orders.

As to the issue of getting more ACT referrals in, as is in current law, I mean, we're available to, to help, I mean, not just state entities, not even just mental health providers, but any individual, even a family member, that's concerned about their loved ones and thinks ACT might be available.

I mean, we've really opened the door so that, you know, this program, for lack of a better term, is accessible and available to be utilized when the circumstances are appropriate.

We've even created a link, a portal, on our Department of the Attorney General website where anybody in the community can go take a look and understand a little bit about what the law requires and submit a referral to us that we can assess for legal sufficiency.

And if it is, then we're going to go forward with those petitions. To the second question, regarding individuals who might be vulnerable because of their issues with substance abuse and so forth, I think, if I'm understanding the concern correctly, is that you might have a provider that may not have the best intentions or may be seeking to take advantage of those types of individuals.

And so, in that regard, before an order for SISA community treatment is issued, that evidence is presented to the court. Right?

They know, they examine, you know, we present evidence at the hearing, they examine the individual, the subject. And in part with that comes, you know, an examination about the propriety of, of the designated mental health provider that's supposed to be providing this treatment to the subject.

So, you know, there are systems of checks and balances, you know, just within the legal framework of ACT that we would hope could ferret out, you know, individuals or entities who are not there for the best purposes.

One more question, and I'm hoping this is going to illuminate things. As I read the ACT Law, right, there's a lot of emphasis that the ACT Order is about involuntary medication. But the way it's written, the ACT Order actually includes and could be a treatment plan that encourages participation in community-based mental health services.

It could be placement in housing; it could be all of these other things. It could be attendance at a substance use program. So, given all of that, is there anything in this Bill that hinders that operation in any shape or form?

And then I'm looking at—and then I also understand that the ACT process, one of the things that we were doing with the ACT orders was to ensure that there could be movement between people, who might be picked up on the street, have an ACT Order, and instead of being taken to the hospital, they could be taken to the diversion center.

Are any of those systems that we had in place jeopardized by any of the changes in the Bill? And the reason I ask is because we are now currently building out, as I understand it, in the...a corridor, all of these different off ramps. So, I don't have enough time to dig into this.

But can you speak to that and how none of that is damaged by some of the things that you're requesting?

I mean, that's absolutely correct. None of that is affected. Treatment plans for assisted community treatment don't just have to be medication, long acting injectables, although that is a very effective part of the treatment plan. It includes outpatient treatment. It can include other modalities of treatment that are not medication based and so forth.

And this Bill attempts to really kind of enhance those things. So, everything about this Bill and Hawaii's existing mental health laws has been revised and written in a way to try and create stronger tools for the community to be able to utilize. So, that's right. None of that has been impaired.

Okay. And then, I guess one last follow up question, because in the testimony it seems like there is concerns that the courtesy transports are not happening or that the transports by law enforcement are not happening, even though we've given that kind of authority. So, what is the problem?

Or maybe, and that might not be something that you can answer, maybe it's something from Queens or Dr. Koinagi, I don't know, or it's the person who's—it's the person who the law enforcement is calling for the mental health worker to make the determination on the spot. So, is it part of that emergency diversion program?

So, if I may, when an individual is subject to an ACT Order and they do not comply with that order, noncompliance alone in and of itself is not sufficient to justify a detainment and a transport. And that's what's provided under current law.

Like many of the testifiers here today have testified to, there are constitutional, you know, limitations on detainment and transport. And so, before that can happen, you have to have that assessment about whether or not the circumstances justify it, typically dangerousness. Our revisions that we're proposing in our testimony is modeled after Kendra's Law in New York.

So, you know, it's a slightly different calculus that's a little bit complicated, in light of the fact that there have already been determinations about the predictability of an individual's likelihood of becoming in a situation where they are in danger because of the ACT Order. But you know, ultimately, that threshold has to be met.

And as to what is happening in practice when these individuals are not complying, I don't know that I'm the best person to speak to that.

Thank you, Chair. Thank you for the indulgence, Chair.

Certainly.

Yeah, I appreciate your questions. Other questions, Members? Representative Shimizu, please proceed.

Thank you, Chair. I have a question for the Hawaii Disability Rights Center.

Yes, thank you, Representative.

I'm, again, thankful for all the testifiers, and the varied viewpoints that you bring. My question is, do you see any good things that this Bill proposes that?

Any good things that this Bill does? Not that much, no. I don't think the, I mean, I say, I mean, for what it's worth, there's no law that says anybody's got to talk to me or the ACLU. But I saw Carrie Ann shaking her head and I'm glad to have the opportunity.

I mean, we weren't consulted. She wasn't consulted. I think this was a very insular process that the Administration went through. And then on day one on Bill intro deadline, they took a 70 page bill and dropped it in that a lot of us had not seen that we're still trying to figure out.

It's a choppy, messy, ugly bill that just repeals and replaces, that I don't think accomplishes all that much. I think if you didn't pass it, I don't think much would change necessarily.

I think there's no, there's no current, I mean, there's lots of current problems, as Representative Belatti is talking about, but there's no current problem that I'm aware of that this Bill fixes. It doesn't do that much. It's just, it's just a mess.

And which is all the more reason why I think the idea of a work group, I mean, these are serious issues that need to be worked through.

I think it'd be far better to set up a group and a true collaborative stakeholder group, not just a bunch of departments who are talking to each other and not talking to the advocacy community to get together and try to work on this problem. We're very committed to that.

I'm a collaborative guy, and so is Carrie, and so, I think we'd rather have that opportunity.

All right. Thank you. Thank you, Chair.

Thank you very much. Other questions, Members? Representative Belatti.

For Ms. Espinda. So, your proposed amendment would change the 48 hours of patient submission to 72 hours?

Representative, that's actually in the, the original admin bill. So, it was the previous Committee here that changed it to the 48. So, 48 is the current law. It was proposed to 72 in the admin bill, as introduced, and we're just asking for that 72.

Okay. What is the benefit of that additional 72 hours and I guess...

Stabilization.

...and I guess—I don't know if this is true for this, but in the event that someone is coming through the hospitals and is going through this and an ACT Order is able to be gotten, is it more likely that it's gonna happen in 72 hours versus 48 hours? I cannot remember, so, if you could refresh my recollection.

I don't know if there's—I mean, there's no prescribed more likely. It's, it's case by case. The individual comes in, you're treating that individual. If that individual is stabilized and ready for discharge in 24, the person should be discharged.

We're asking for that additional 24 hours per the law, because what occurs, especially on the neighbor islands, I guess more than perhaps the other, but they are stabilizing, and they run out of time. The clock runs out. So, you're making a choice.

Out, you're discharged because the clock has run out, a little more time, or you're applying for that MH 6 and then they stabilize, and they discharge. So, they're asking for that—our facilities are asking for that—additional 24 hours because it'll reduce for the AG, for us, that burdensome paperwork.

Thank you. Thank you, Chair.

Thank you. Thank you. Any other questions? If not, thanks very much. The testifiers. We have numerous measures on the agenda, so we're going to move on Senate Bill 1323, Senate Draft 2 relating to health care. This measure adopts the Uniform Health Care Decisions act of 2023 with amendments to replace chapters 327e and 327g. Hawaii Revised Statutes.

First up we have the Attorney General.

Good afternoon. Chair and Members of the Committee. James Walther, Deputy Attorney General. As you indicated, this takes two chapters of existing law and combines them into one.

We believe it streamlines and simplifies the process and makes it easier for the public to use this these advanced health care and mental health care directives and yeah, that's the goal of this whole thing.

Thank you. Thank you very much. Next we have the Department of Health, Behavioral Health Administration.

Aloha Chair, Vice Chair, Members of the Committee. Kevin Camisado, Department of Health, Abdominal Health Division. We stand on a written testimony and available for comments. We do support updating the Uniform Health Care Decisions Act. We adopted it in amended form in 1999 and they revised it in 2023 at the federal level.

So we are just trying to we're supporting the effort to update the current laws.

Thank you. Thank you very much. And then we've received written testimony from the Commission to promote uniform legislation. And is there anyone here from them? No, just for Members and the public.

They have requested to reinsert two provisions that were removed in the previous Committee, House Committee subsection C, Section 5, subsection C and subsection Section 19, subsection B. So that's what they recommend. Is there anyone else here wishing to testify In Senate Bill 1323? Yes. Mr. Erticek.

Yes, I think we submitted written testimony. Oh, sorry, sir. Yes, you did. Okay. No, that's fine. Thank you. I don't have any real objection to most of this bill.

I still have some concerns about this so called Ulysses clause that I've raised before and I've gone around and around with the Attorney General and even with Michael Champion from the governor's office to try to get to the bottom of what does the current law provide versus what would this bill do.

And so the current law says that you can consent to any kind of medication, but it's not really clear what happens if you change your mind that that at that moment if you're having a psychiatric episode of whether you can revoke your consent or not.

And so it's possible that maybe you can't, but this thing really makes it clear that you absolutely cannot. And I think that's a bit of a concern because under the current law, the normal way in which somebody gets involuntarily medicated is you Go to court, then you get a court order here.

What you're going to have is somebody potentially in that situation, and then the physician or healthcare provider is going to waive this paper and say, hey, we can drag you in, we can strap you down, we can shoot you up. We don't have to go to court.

We don't have to do anything because you agreed to this thing way back when. And so I question whether that's good policy.

And I would also say if the Legislature wants to make that the policy, I think it needs to be really clear in the statute and in the form so that whoever makes such a declaration, and if they want to do that, fine, but they need to know that they are potentially waiving some real constitutional rights.

So thank you.

Thank you, Mr. Erticek. Sorry for overlooking your testimony. Thanks for submitting it. Is there anyone else wishing to testify in Senate Bill 1323?

Hi. Malia Espinda, HHSC, on that surrogate. We had testified previously in our. In the Senate on the Senate side, and I'm just pulling up our test. We didn't testify on it this time because of the changes, but on the surrogate, the language is vague and contradictory.

It also fails to recognize that if a default surrogate is in place, that typically means that there's no guardian in place, which means there's no document that a healthcare provider or default surrogate can look to that would provide instruction what a guardian may and may not do for decision making as serious as this default surrogate, providers and individuals deserve clearly defined parameters dictating what a surrogate can and cannot do.

So I just wanted to address that as a counter to the Uniform Commission. Thank you.

Okay, thank you. Anyone else wishing to testify in this measure, if not. Questions? Members represent. Belatti, please.

Mr. Erticek I don't know what the Ulysses clause is and where is it in the bill?

I'm sorry, pardon me? What is the Ulysses clause?

The Ulysses clause, and where is it in the bill? Oh, I've got to get a copy, but it's towards the back, I think. I believe it's like.

If you look at page 20.

Could you go up the microphone, please? Yeah.

James Walther, Deputy Attorney General. If you look at page 20 of the bill, the subsections D and E relate to the Ulysses clause. And essentially what the Ulysses clause does is tell you now what I want you to do later. So you don't listen to later me, because I'm more competent now than I will be later on.

And that's the whole point of it, and what this bill adds to what is existing in the law is there's a provision to have a safeguard in that if I put this in my advanced health care or mental health care directive, I have to have two unrelated and independent people sign off on that so that later on when it becomes an issue, I haven't just waived my rights to it.

I did it knowingly, intentionally. And I want you to do later what I'm telling you now. Thank you. Back to you represent Belatti.

Actually, Mr. Walther, you can say that. Mr. So thank you. That's actually very helpful. And I think when we think about homeless people who may be suffering from mental illness, they may have these periods of time when they actually are capable and they might have family Members who are there with them.

Is this the kind of situation where they might, in their able state be able to consent to this and then maybe put put forward the mechanisms through which they will be able to receive treatment if for some reason they're not?

Yes, absolutely. That's exactly what this is for.

So this is a form of trying to get to not make sure people are medicated through the act process.

Right. And it's not necessarily involuntary the way Mr. Erdicek is saying. It's not that process of involuntary medication. I want you to medicate me. I'm telling you right now, I don't want to be in the middle of the street naked, walking around in traffic. I'm telling you all that now.

So, you know, I'll even write it down and you can all witness it. But that's the sort of thing I want to have in my advance directive, right? I'm telling you I'm competent, I'm stable now at whatever medication I'm on. It's not a psychotic break.

If I have a psychotic break, know that I want you to medicate me. That's what this does.

And is this. Well, first of all, this is part of the uniform law, but is this seen in other states as a way to address this issue? Yes.

Yeah.

Thank you. Thank you, Chair. And then just because I do want to let Mr. Odershek just respond, because hearing that, Mr. Odershek is then the Ulysses clause, hearing that explanation, then the Ulysses clause is harmless or less, less harmful if you hear that explanation.

Well, as I say, if somebody wants to consent, I mean, we're all for freedom of choice. I'm not saying nobody should ever be able to do that.

What I'm trying to envision, and I understand somebody may very well say now that, hey, if I'm ever in that situation, you know, don't pay any attention to what I'm telling you, then do this.

But what happens in reality when the person then is in that other situation where they're having a breakdown and they're kicking and screaming and they're fighting and they're saying, no, I don't want you to do it, what does the physician do at that moment?

Did they just wave the paper and do it or should they be required to go to go to court and follow the normal process? That's the issue that I'm raising. And so I think it's a little thorny. Representative, in terms of how it would play out.

And I'm mostly suggesting that if you want to reinforce that, I just think it needs to be really clearly spelled out because the other problem is that yes, there might be two witnesses, but I'm not sure in the end that's going to make that much difference.

If you got, I mean we do advance health directors in our office for people. If you got a 10 or 20 page document and buried in there is some clause to that effect, you may or may not really fully appreciate what you're consenting to.

So I think it needs to be in bold or flashed or something like that.

Thank you. Thank you. Chair.

Sure. Thank you very much.

Other questions, Members? If not thank you very much. The testifiers move on to the next measure. Senate Bill 1452, Senate Draft 1 relating to the Uniform Controlled Substance Act. This updates chapter 329 Hawaii Revised Statutes to make it consistent with amendments in the Federal Controlled Substances Act as required under Section 329, 11HRS.

And we have Department of Law Enforcement. Welcome. Deputy Director Good afternoon, sir.

Good afternoon, Chair, Vice Chair and Members of the Committee. I'm Jared Redulla. I'm the Deputy Director for the Department of Law Enforcement. Our Department is in support of this bill. This bill is the annual Controlled Substances Update. It does a number of important things.

First, it mirrors, it allows and harmonizes the state law to be harmonious with federal law. In doing so, it allows state and local law enforcement the ability to take action when new drugs emerge in our community.

Equally important, sometimes there are brand new medications that come out, medications derived from controlled substances, and it allows those medications to be used by patients who need it in Hawaii. So thank you very much for the opportunity. Also, I do want to address communication from the Committee after our department's review.

We believe that this bill is able to be passed.

Sir, as is as you're saying, okay, thanks very much. Appreciate that. Other question, other testifiers on Senate Bill 1452, House Draft 1. If not questions, Members seeing none. Thanks very much. We'll move on to the next measure. Senate Bill 228, Senate Draft 1, relating to excited delirium.

This measure prohibits excited delirium from being recognized as a valid medical diagnosis or cause of death in the state prohibits a local health officer or local agent of the Department of Health from stating on a certificate of death or in any report that the cause of death was excited delirium and prohibits law enforcement officers from using the term excited delirium to describe an individual in an incident report.

First up, we have the Department of Health.

Good afternoon, Chair, Vice Chair, Members of the Committee, I'm Wanda Naonishi with the Department of Health. We stand on our testimony in support of the latest version of the bill. Which places a Prohibition into Chapter 327C. Relating to death versus previous iterations of. The bill, which placed it into Chapter 338, which is relating to vital statistics.

So thank you for the opportunity to testify.

Thank you. We received written testimony with comments from the Judiciary. Next, we have testimony from the Office of the Public Defender.

Mr. Gannaden, welcome. Please proceed.

Good afternoon, Chair Tarnas, Vice Chair Poepoe, Members of the Committee, Sonny Ganaden, Deputy Public Defender. The Office of the Public Defender supports this bill. We respectfully disagree with the Judiciary's comments, not their opposition. We believe their testimony is just in defense of judges ability to basically call balls and strikes in evidence as they see fit.

This term has a terrible history of confusing juries regarding discredited science. We believe that discussing pseudoscience should not be in the rules of evidence. So allowing it into the rules of evidence would be already getting it too far. You're going to hear later from Mr.

Erticek as well as people who discuss best practices from California and other states, as well as the family of Mr. Halleck, who was killed a decade ago. And whose death was justified using this now discredited term.

For that reason, we believe that this shouldn't go to the ordinary appeals process, which is what would normally happen through a civil case, but should be instead ended by the Legislature. Thank you. Thank you, sir.

Next, Lou Erticek, Hawaii Disability Rights Center.

Thank you, Chair. Yes, we're in very much support. I don't need to belabor the issue. We've discussed this bill pretty thoroughly before and when you passed out House Bill 36. And I was very pleased to see that the prior Committee reinserted the contents into this vehicle, and I would urge you to follow suit.

Do that and hopefully stick to that position as this bill goes to conference. So thank you very much.

Thank you very much. Next, Nikos Leverins, Drug Policy Forum of Hawaii.

Aloha Chair, Vice Chair Members, Nikos Leverins, with Drug Policy Forum of Hawaii. We strongly support this bill. And I also want to specifically focus on this question of the evidence when Sheldon Halleck was killed.

The city and County of Honolulu successfully argued in civil court that this cause of death was excited delirium and instead of excessive use of force, despite the findings by the medical examiner that he died from a combination of factors stemming from his altercation and heightened State of physical and mental agitation from methamphetamine.

So to bolster its case, the city and County of Honolulu employed expert witnesses with ties to a company who have a pecuniary interest in pointing to exciting excited delirium as a cause of death. Now, when I first started advocacy in the California Legislature, there were very heated, contentious hearings around the Tasers.

So for the sake of folks like Sheldon Halleck and his family, please pass this bill. Thank you very much.

Thank you, Mr. Leverins. Next, Julia Sherwin.

Good afternoon, Chair Tarnas, Vice Chair Poepoe and Committee Members. Thank you so much for allowing me to testify with you today. I testified last month in favor of House Bill 36, which actually passed your House of Representatives with zero no votes and no opposition from the medical community or the law enforcement community.

Unfortunately, that bill died in the Senate. I'm very grateful that the House Health Committee has brought that, imported that language back into this Senate Bill that's before you today. And those amendments from the House Health Committee have cured several weaknesses in the Senate Bill that would have made the bill ineffective.

As I discussed in my written testimony, the bill before you today is based on the bill we have here in California on excited delirium, which I worked on and provided amendments for.

And our excited delirium bill here passed the Legislature with 113 yes votes, no no votes, and also no opposition from the medical or law enforcement communities here. So here in California, we're free of excited delirium. Now, the people of the great and beautiful State of Hawaii deserve no less. I respectfully disagree with the judiciary.

Rules of evidences, I guess. Commentary not in opposition to the bill. It's not unusual to have rules of evidence that limit or exclude certain kinds of testimony. And I gave you several examples of those rules in my written testimony. Rules like that do not violate the due process rights of litigants.

This bill is necessary to make sure that Hawaii. Hawaii never has another Sheldon Halleck case again. Even though excited delirium was not a cause of death on Sheldon's autopsy report or death certificate. And Even though the medical examiner found that his death was a homicide, which is death at the hands of another person.

The defense in Sheldon's case was allowed to bring in three expert witnesses, all of whom had very strong ties to the manufacture of Tasers, to testify that Sheldon died of excited delirium. And that's even with the General rules of evidence that the judiciary's Rules of Evidence Committee wishes to rely on.

It wasn't enough to protect the Halleck family. It's not enough just to have rules of evidence to protect families going forward. Five committees of your Legislature have now found that excited delirium lacks a medical basis and has been misused to excuse deaths in law enforcement custody by excessive force.

There's no basis to allow courts to continue admitting it into evidence in civil cases. By ending the use of excited delirium in Hawaii, you will protect Hawaiian families from the junk science that the Halleck family was sadly the victim of.

And so I ask you to please move this bill forward as you did last time, and protect the residents of your beautiful state from this junk science. Mahalo.

Thank you very much. Next, Liam Chinn, the organization Reimagining Public Safety in Hawaii Coalition on Zoom. Please proceed.

Yes, thank you. Members of the Committee. Much of my testimony, I'll cut you because it echoes what Mrs. Sherwin has said.

I just want to just point out, and this might already be known, but the term excited delirium has been disavowed by all major medical organizations, including the American Medical Association Association, the American Psychiatric Association, the American Academy of Emergency Medicine, the American College of Medical Toxicology, and the American College of Emergency Physicians.

When we think about that fact that all of these expert bodies have unanimously debunked that excited delirium as an actual thing. Again, I want to respectfully disagree with the judiciary's comments that somehow there needs to be space to allow this to be presented in court and that the judiciary can.

Can call the balls and strikes and make their own determination whether it's a valid. A valid excuse when officers have someone detained or in custody. So following California and Colorado, who have.

Who have banned it as a medical diagnosis and ban law enforcement from using the term in incident reports and making it inadmissible in civil actions, there's no reason Hawaii should not follow suit.

I just want to mention that per the first bill discussed today, there is a growing mental health crisis across our state that is spilling onto our streets and has increased contact with law enforcement. Research shows that people suffering from mental illness are 16 times more likely to be killed in and interactions with police.

And so with this in mind and understanding the undeniable fact that we're going to see more and more incidents where law enforcement are coming into contact with people suffering from mental illness to varying degrees, this law is an important bulwark to prevent further deaths as we move forward.

And per California and Colorado, which has successfully done so, I would gratefully appreciate you continuing to move this bill forward. Thank you so much.

Thank you very much. Next. Ilima Decosta, welcome. Thank you for being here today.

Aloha Chair, Vice Chair and Committee Members. I really do appreciate you holding this hearing and I'm grateful that the language was substituted out because we do need to make sure that the rules of evidence are very clear. I don't have a legal background. I'm not an expert in the law or in medicine or psychiatry. I'm a mother.

And I've also lost a child to preventable violence. And I have compassion for the Hallex. I don't think that anybody should lose a child just because they're jaywalking while in the midst of a mental health crisis. So I think we can all agree that we can do better. There are things that we can do.

We had an excellent conference yesterday at NAMI, and I think that Dr. Champion and the Governor are very interested in making sure that our community has better policing. And better policing does make does include making sure that police don't inadvertently end up with individual who is dead in their custody. So thanks again for holding this hearing.

And please move this measure down. I'm in strong support and I appreciate you all.

Thank you. Ms. DaCosta, we've received written testimony and support from the National Police Accountability Project. Next, we have testimony from the ACLU of Hawaii.

Good afternoon, Chair, Vice Chair, Members of the Committee, My name is Wookie Kim. I'm the legal Director at the ACLA of Hawaii, and we strongly support this measure.

You already have our written testimony, and I don't really want to belabor the point since so many of the other testifiers have already eloquently stated the strong rationale for this bill. And of course, the subject matter of this bill has been before this Committee before in essentially the same form, and this Committee passed it out.

So we would ask that you essentially do the same thing again. The only thing I would add is that from the ACLA of Hawaii's perspective, the evidentiary rule created by Section 3 is an essential component. And of course, others have testified to this already.

And truthfully, the reason is that Sheldon Halleck's case shows precisely why an evidentiary rule is, is required and why a prohibition on police reports, including the term and medical examiners using the term is insufficient. Because here, Sheldon's family's attorneys tried to exclude this testimony using the existing evidentiary rules.

And the court, despite those arguments and despite, you know, the evidence that this is not real science, admitted that evidence and, and that worked a great injustice on the family. And so as this bill moves through, we just urge that the evidentiary rule component be maintained as it is in its current form. So, thank you.

Thank you very much. Next we have Verdel Halleck on Zoom.

Good afternoon, Chair, Vice Chair and Committee Members. My name is Verdel Halleck and I strongly support SB228 relating to excited delirium.

I'm speaking for my son, Sheldon Halleck, who was a loving husband, father, son, brother, and who was honorably discharged from the Hawaii Air National Guard suffering from the stresses of his many deployments with PTSD, drugs and mental illness on March 17, 2025.

It marked 10 years ago since Sheldon died from an encounter with the Honolulu police in front of Iolani palace for jaywalking. He was unarmed, non aggressive, and he was having a mental health crisis.

He was pepper sprayed 12 times, tased three times, and handcuffed and hogtied with police officers on his back and a police officer with his knee to his neck where he became unresponsive and died. The Police Department claimed he died from excited delirium.

We filed a civil lawsuit against the officers involved and the defense expert witness said Sheldon didn't die from being pepper sprayed, from being tased, or from the excessive use of force by the police, but he died from excited delirium.

The jurors believed that this was a real medical diagnosis and found that the police officers were not responsible for Sheldon's death. In 2023, the American College of Emergency Physicians disavowed the white paper which was the backing for excited delirium used as medical diagnosis.

This injustice is what spurred our request for the introduction of Senate Bill 2 to 8 relating to excited delirium. California, Colorado, Minnesota and New York have already passed bills to ban excited delirium, and I hope Hawaii will follow their lead.

Our goal is not only for Sheldon, but for all the other people who have unjustly lost their lives while in police custody. Thank you for your time and I humbly ask for your support to pass Senate Bill 2 to 8.

And if this bill should be passed, I ask if it could be called Sheldon's law in honor of my son. So his death was not in vain. Thank you very much.

Thank you very much, Ms. Halleck. And I appreciate you being here to testify today after all these years after a tragic experience that your family had.

Thank you.

We've received a total of 30 testimonies in support. One with comments, none in opposition. Is there anyone else here wishing to provide oral testimony on this measure? If not, questions. Members, we have heard this bill before in extensive discussion. Okay, we'll move on. All right. Thank you. Thank you to all the testifiers.

We'll move on to the next measure, Senate Bill 1433, Senate Draft 2, House Draft 1, relating to harm reduction. This measure amends the distribution system of sterile needles and syringes under the Sterile Needle and Syringe Exchange program from a one-to-one exchange system to a needs-based distribution system.

It authorizes non-injection drug user participation in the program and modifies liability for program participants, staff, and law enforcement officers. First up, we have the Attorney General Nakamatsu. Welcome. Please proceed.

Thank you. Good afternoon, Chair, Vice Chair, Members of the Committee. Deputy Attorney General Tricia Nakamatsu, appearing on behalf of the Department of the Attorney General. We just submitted comments on this Bill. We do have concerns, not in opposition to the Bill itself, but with certain parts. In particular, Section 325-114C.

It's a new proposed section at the bottom of page 10 which would provide immunity for possession or delivery of used needles or syringes containing residue. Our concern is that it does seem to be overly broad and unwarranted. We're not aware of it necessarily being a problem with program participants or staff being arrested under these types of circumstances.

We feel there might be unintended consequences, particularly when individuals perhaps should be rightfully charged with these types of offenses, not related perhaps to their participation in the program. We do feel that there's also a problem with law enforcement officers being able to identify reliably who would qualify for this type of immunity. And I'm sorry, for that part, I meant the program participants who could actually have visited the program two months prior and still qualify for under the current language of this section.

As far as we know, there doesn't appear to be any reliable process of confirming the participant's identity for law enforcement officers. And we're not even certain that they, they don't appear to be asked for government issued identification or fingerprints.

Things that the law enforcement officers and the courts will typically rely on to make sure that someone's identity is exactly the same person as they purport to be. Also, we are concerned about Section 325-114B.

Also, on page 10, the top half. We just ask that the words "by rule" be added to page 8 because as it currently reads, basically we believe it would be unprecedented for any Department to establish what would constitute illegal activity just unilaterally by their own decisions, unless it's perhaps by some sort of public hearings process like rulemaking. Available for questions, if any.

Thank you very much. Next, we have the Department of Health.

Good afternoon, Chair, Vice Chair, Members of the Committee. Tim McCormick with the Communicable Disease and Public Health Nursing Division of the Department of Health. The Department of Health is in strong support of this measure. Syringe exchange has been a critical public health intervention in Hawaii for decades.

And this measure would allow some changes to the program to align it—to better align it—with current best practices. You have our written testimony, but I just like to underscore the importance of permitting need-based syringe access to reduce sharing and reuse to prevent injury and infections.

With need-based syringe access, providing liability protection for people to be able to hold onto their used syringes and return them to the program is critical. Without this protection, people are incentivized to get rid of the used injection equipment as quickly as possible and that is more likely to lead to improperly discarded needles and syringes.

Hawaii Syringe Exchange participants have reported moderate frequency of sharing and cite lack of access to sterile injection equipment as the reason they share.

When we're successful in getting people inject drugs to take the steps to get to the program and then we don't provide them the sterile equipment that they need, we're missing a critical opportunity to reduce risk of infection. Thank you for the opportunity to testify and available for any questions.

Thank you very much. We received written testimony from Hep Free Hawaii in support. Next, we have testimony from Nikos Leverenz, Hawaii Health and Harm Reduction Center.

Yes, thank you, Chair, Vice Chair, Members of the Committee. Heather Lusk with the Hawaii Health and Harm Reduction Center. As Tim indicated, we—the syringe exchange has been going on for over 35 years, first with the Chao Project and then through H3RC.

And while I know there has been some concerns with this Bill, I want to highlight that for 35 years we have successfully operated and according to the Hawaii Department of Health, kept HIV low in our community. As you heard, this is not only updating best practices, but this is also protecting my staff.

So, to be really honest, some of my staff are very afraid that if they, if anything that they're doing would be seen as illegal by giving out things to help people be safer, then they really deserve to have limited liability because it's not—they're trying to be good public health warriors and preventing disease.

They also—I want to be also be really clear that we are also a major treatment provider. So, in addition to providing access to this equipment, we also provide substance use treatment. We provide counselors at the service, we provide hepatitis and HIV services. So, this is a comprehensive service. Why—I understand the AG's concerns.

We have significant evidence that our participants are worried about bringing syringes with any residue to us. And the last thing we want and what we're working hard to do is to go and make sure that folks know how to dispose of them properly. We give out sharps containers, but without that exemption, it does incentivize people to unfortunately discard them in parks or in places that children or others might have access.

Lastly, I'm going to be a bit vulnerable. I just hit 29 years myself in recovery from injecting drugs. I would not be standing here today if it weren't for programs like this.

This program not only saves lives, but is the pathway to recovery. And I'm standing here as proof of that. So, really hope that you consider passing this Bill and really give the safeguards that are needed for both staff and folks to be on the path to recovery. Thank you.

Thank you very much, Ms. Lusk, and thank you for your personal testimonial. We received a total of 18 testimonies in support, one in opposition, one with comments. Is there anyone else here wishing to testify in this measure? If not, questions, Members? If not, thank you very much to the testifiers about this important program.

Let's move on to the next measure, Senate Bill 1447 relating to administrative orders. This measure requires any order to cease and desist issued by the Director of Health that is administratively appealed to remain in effect during the appeals process. First up, we have the Department of Health.

Thank you, Chair, Vice Chair, Members of the Committee, Justin Lamb with the Office of Healthcare Assurance from the Department of Health. The Department stands on its written testimony in support of this Bill. This measure will establish parity across all the facility types that my office licenses and I'm available for questions if you guys have.

Thank you very much. Next, we have testimony and support from Ted Bolen. Is there anyone else here wishing to testify on Senate Bill 1447? If not questions Members? Seeing none. We'll move on. Thank you very much. To the testifiers. Next Measure, Senate Bill 1429. Senate Draft 2, House Draft 1 relating to medical cannabis.

This measure authorizes the Department of Health to impose penalties and take enforcement actions for violations of the medical cannabis laws. It retroactively repeals the prohibition against primary caregivers cultivating medical cannabis for their qualifying patients. It authorizes primary caregivers to cultivate cannabis in an amount not to exceed an adequate supply apply for the qualifying patient.

It extends for two years the effective date of certain interim rules adopted by the Department of Health. And it extends for four years the sunset date for the exemption from civil service of personnel hired by or contracts entered into by the Department of Health. First up, we have Department of Health.

Mr. Gough, welcome. Please proceed.

Hello Chair, Vice Chair and Members, Andrew Goff with the Office of Medical Cannabis Department, Department of Health. This is an important Bill for us, and we appreciate you hearing it. It does restore the authorization for a caregiver to grow for their patient, and we believe that's an important access point for a patient's medical cannabis.

I would like to highlight from our testimony that the Bill also extends six positions, six exempt positions for my staff, and that's the entirety of my dispensary staff. And we have requested that the effective date be upon approval. Currently, the effective date is June 28, 2025 and their positions expire June 30, 2025.

So that gives our HR two days to process and extend. And it is imperative that we extend these. You know, with the federal job losses, I just want to make sure that all of our people are as protected as they can be in this instance. So, thank you for the opportunity to testify, and I'm available for comments.

Thank you, Mr. Goff. We received written testimony with comments from the Drug Policy Forum of Hawaii, also testimony from the Libertarian Party of Hawaii. Next, we have testimony from Jason Hanley, Aloha legislators.

Jason Hanley, Oahu Cannabis Farm alliance we're looking at this Bill right now, and this was obviously introduced, the presenter says the Governor is what it said it's introduced by, and it was supposed to be a simple caregiver Bill that was brought in to restore the caregiver program.

And it seems a lot of other stuff's been brought in there, like fines, suits and stuff like that, that once again is attacking the medical patient and the medical patient program.

I've been in this building now for five years fighting for the medical cannabis patient, trying to build laws outside of the dispensaries that will protect our medical patients to allow farms to grow for people, to allow patients to support supply cannabis for people. They're all medical patients. And it seems that we're just not being listened to.

A point of fact is just this caregiver law that got thrown out in January and then the caregiver laws for five people per grow site were just ignored for years and nobody ever came up with a solution.

Department of Health was awarded $50,000 in 2022 to look at what these grow site caregiver farms are doing for people and how we might move forward with better regulations in the medical cannabis world.

According to a poll done by Department of Health last year, that was a little bit shortsighted, but we'll give it a little bit of merit. Over 45% of people are not using dispensaries right now. So what are those people doing?

Where are they supposed to go if we're not building regulations and laws for these people to have more than one caregiver to have a grow site that has more than five patients on it? I mean, this is a huge problem. You're talking about 20,000 medical patients that cannot get medicine.

And this state is either forcing them on the black market or they're not getting their medicine.

Now we saw this similar thing happen in Colorado when they first passed their medical program and it took 200 medical patient citizens to push a lawsuit against the state to come up with better laws for the medical cannabis patients so they can move forward and not be stressed out from law enforcement and over regulations.

So we're asking you guys to really take a look at this Bill right now and see what's going on and why these things keep happening over and over. We introduced the Medical Cannabis Act last year and again this year. This Bill is a way forward for medical cannabis program.

It is not recreational, it has all the bells and whistles, it comes from Maine. It has all the rules and regulations for this medical command and cannabis community to move forward without law enforcement. These are medical patients. This is not cannabis. These are medical patients and they should be treated like such. Okay?

This law enforcement stuff has got to stop. Department of Health needs to step up and protect these people. This is why we signed up for this program. We identified ourselves. We need this medicine to get on with life. We don't need the extra stresses of law enforcement, ubiquitous laws, non data laws. Please help us.

Thank you. Thank you very much. Next, Dr. Cliff Otto on Zoom.

Aloha Chair, Vice Chair, Members of the Committee, Dr. Clifton Otto offering comments. You have my written testimony which I'd like to briefly highlight, this Bill is very important for patients who need assistance with cultivation.

And if your Committee wants to further improve patient access, then please consider adding back the amendment that would allow a primary caregiver to care for five patients for reasons that I've outlined in my written testimony.

I would also like to point out that in 2015, our medical cannabis program was moved from the Department of Public Safety to the Department of Health because we wanted to get the program away from law enforcement and focus on patients.

However, with the recent addition of law enforcement management, we are seeing a concerning trend in this year's medical cannabis bills. Patients already have to violate federal law to participate in our medical cannabis program.

So if we're going to focus on abuse and diversion rather than on patients, then more and more patients will decide that it's not worth the trouble and will go back underground.

We need changes that are patient centric, like expanding the number of patients per primary caregiver if there is to be any chance of rebuilding trust in the program. So thank you for considering my testimony, and I'll be available for any questions.

Thank you very much. And we've received testimony of comments from the Hawaii Cannabis Industry Association. Not present. Next, testimony from Tomoko Palmieri on Zoom. Not present. We received a total of 34 testimonies in opposition, three with comments and one in support. Is there anyone else wishing to testify on Senate Bill 1429?

Senate House draft two if not questions. Members seeing none. Thank you very much to the testifiers. We have circulated the testimony with everybody so they've had a chance to read it. Let's go on to the next measure. Senate Bill 1373. Senate Draft 2 House Draft 1 relating to administrative licensure actions against sex offenders.

This measure requires the Director of Commerce and Consumer affairs and certain licensing boards to automatically revoke and refuse to renew, restore or reinstate the professional licenses, registrations or certifications of registered sex offenders. First up, we have Department of Commerce and Consumer Affairs.

Good afternoon, Chair. Vice Chair. I'm going to move the mic down, please. Yeah. Thank you. For short people, Members of the Committee, I'm Nadine Ando. I'm the Director of the Department of Commerce and Consumer affairs and standing on our written testimony in support of this measure.

Briefly, as we point out in our testimony, the Department learned when we had encountered a situation where there was a professional who was licensed in acupuncture, and I believe it was massage therapy, but had been convicted of a crime which required that he register as a sex offender.

And we did not under our current laws have any provision in our statutes which would allow for immediate action to revoke those licenses or to deny renewal of the license.

And we learned that the State of California for those particular professions which this individual was also licensed for in California, had a statute that made it very clear that would allow our boards and our Department to act more swiftly to safeguard clients and customers whenever there was a convicted licensee who was required to register as a sex offender.

So that's really the impetus behind this measure that our Department seeks to have put into law so that we can move quickly. It does provide for in the bill for due process for licensees to seek immediate appeal or hearing administratively.

So there are provisions in the bill to allow for some appeal of any decision that might be made. I'm available for further questions.

Thank you very much, Director. Next we have testimony from the Honolulu Police Department on Zoom.

Hi, good afternoon, Chair, Vice Chair, Members of the Committee. I'm Carlene Lau, Major of the Honolulu Police Department. We are in support of this bill and we stand on our written testimony.

It's due to the nature of these professions, which involve close physical contact, that any delayed action in revoking licensure and preventing further practice by registered sex offender places consumer in unnecessary risk. So we urge you to support this bill. Thank you.

Thank you very much. Next, we have testimony from the Board of Dentistry.

Good afternoon, Chair, Vice Chair, Members of the Committee, Sheena Choy, Executive Officer of the Board of Dentistry. The board stands on its written testimony in support of Section 6 and 7 of this bill. And the amendments proposed to our statute will facilitate a more expeditious removal of registered sex offenders from practice than current LA allows.

Thank you for the opportunity to testify in this bill. I'm available for any questions and I'm also the next test.

Thank you. Yes, why don't you stay up there because next we'll hear from you with the Board of Massage Therapy.

Good afternoon again, Sheena Choy, Executive officer of the Board of Massage Therapy. The board sends on its written testimony in support of Section 11 of this bill. And like similarly the amendments to the massage board, the massage board statutes will facilitate a more expeditious removal of registered sex offenders from practice than current law allows.

And the board appreciates the intent of this bill to maintain the integrity of the massage therapy profession and safeguard against any inappropriate conduct. Thank you.

Thank you very much. Next, we have testimony from the Board of Psychology.

Good afternoon, Chair, Vice Chair, Members of the Committee. My name is Christopher Fernandez, Executive Officer to the Board of Psychology. I'm here to stand on the board's testimony. The board didn't note any significant concerns with the bill and supports this measure. Thank you.

Thank you very much. Next, the Board of Nursing.

Good afternoon. Chair, Vice Chair, Members of the Committee. My name is Alexander Pang. I'm an Executive officer for the Board of Nursing. The board supports section 15 of this bill and the board supports the swift verification of nurse licensure for registered sex offenders. Thank you.

Thank you very much. Next, the Hawaii Board of Naturopathic Medicine.

Good afternoon. Chair, vice chairs, Members of the Committee, Christopher Fernandez, Executive officer to the Board of Naturopathic Medicine. The board, similarly to the Board of Psychology, noted no significant concerns and supports this measure. Thank you.

Thank you. Next, the Board of Physical Therapy.

Good afternoon. Chair, Vice Chair, Members of the Committee, Rochelle Rocky, Executive Officer for the Board of Physical Therapy. The board supports this bill as it will enable the boards for a quicker process for taking action against the licensee while still ensuring that their due process rights are upheld. Thank you.

Thank you very much. Next, the Hawaii Medical Board.

Good afternoon, Chair, Vice Chair, Members of the Committee, Josie Fukunaga, on behalf of the Hawaii Medical Board. The board supports this Bill and the amendments to Hawaii Revised Statutes, Chapter 453 and 463E, which will provide enhanced protections for the public by facilitating the timely revocations of licenses for individuals found to be a registered sex offender.

And then I'll.

Thank you. Let me stay up there. If you would please stay up there because we're to hear from you. Representing the Board of Acupuncture.

Yep. The Board of Acupuncture will stand on its written testimony in support of this Bill. The board supports the amendments to 463E, which will enable the board to automatically deny, renew, restore or reinstate the licenses for individuals found to be registered sex offenders. Thank you.

Thank you very much. Next, the Hawaii Board of Optometry.

Good afternoon, Chair, Members of the Committee, Carrie Shahan, Executive officer for the Board of Optometry. The board supports section four of this Bill, as it helps to, ny brain just went blank. So sorry. As it helps to allow us to remove the licenses for those individuals that are registered sex offenders without imposing on their due process.

I think I'm next again.

And now we can hear from you for the Board of Barbering and Cosmetology.

Thank you, chair and Members of the Committee. I'm going to try to redeem myself. Carrie Shahan, Executive officer of the Board of Barbering and Cosmetology. The board supports section 21 of this Bill.

As it facilitates removing the licenses and not allowing the renewal of licenses for those registered as sex offenders without removing their due process under the law. Thank you.

Thank you very much. Next, we've received written testimony and support from Molly Montague with the Rape, Abuse and Incest National Network. Next, we have testimony from the Hawaii Board of Chiropractic.

Good afternoon, Chair, Vice Chair, Members of the Committee, Rochelle Araki, Executive officer for the Board of Chiropractic. In the same sentiment as the Board of Physical Therapy. The board also supports this Bill and have no problems. Thank you.

Thank you very much. Next, Hawaii State Commission on the Status of Women. Yasmine Cheney.

Good afternoon, Chair, Vice Chair, Members of the Committee, Yasmeen Cheney for the Commission on the Status of Women. I stand on my written testimony in support of this measure for the following reasons. While sexual violence includes folks of all ages and identities, the majority of victims are girls and women.

For effective and sustainable sexual violence prevention strategies, CDC recommends policy changes that improve safety, create protective environments and hold offenders accountable. This measure delivers on these community level sexual violence prevention best practices. Thank you. And I'm available for questions.

Thank you very much. Next. Hawaii Board of Speech Pathology and Audiology.

Thank you, Chair Members of the Committee, my name is Christopher Fernandez, Executive officer to the Board of Speech Pathology and Audiology. Like the other Bill or sorry, like the other boards, this board did not have any significant concerns and supports this measure. Thank you.

Thank you very much. Next. Shelby Billionaire on Zoom. Not present. Next. Derek Carlin in support. Not present. Is there anyone else wishing to testify on Senate Bill 1373, House Draft 1? If not. Questions Members? I have one question for Ms. Ando. Should the boards also be required to revoke or deny permits under 436E, the acupuncture intern permits?

I guess we had not looked specifically at that. I think we were looking at licensure.

But I would assume that if that is the overall intent, if someone is allowed to practice in a particular profession under color of state authority with a license or permit, but has been convicted of an offense such that they have to register as a sexual offender, then it would make sense that that would also extent to that circumstance.

Okay. And I have a list here. How about under 439A, which is the apprentice permits and temporary permits, general statute or.

Well, the measure has specific areas in the Bill that we had determined, I think involved either close personal contact and, or close physical contact with customers and clients in a private or semi private setting. And that's why in particular we had mentioned all the healthcare practitioners.

So acupuncture intern permit. Yes. You think that should be included, the 439A, the apprentice permits and temporary permits.

Or if it was in that area of practice, in that same area of practice that involves any kind of close physical contact. Okay. I think that's the overall intent of the measure.

How about under 452, the apprentice permit's there.

Or if it's. I'm sorry, I'm not versed with each particular statutory section, but I am aware of the particular professions that we had indicated, licensure would be. So if. Subject to revocation.

Okay, so if there's apprenticeship permits or other permits that are within those professions that you had identified in here, that they should be included.

That's what. That's the intent of.

How about pharmacy intern.

If it's.

Not included, I'm wondering if it should be under 461.

Yeah, I don't think. I think when I'm looking at the listing, we do have pharmacy and it.

Seems as if so, the pharmacy intern permit should be included?

I think we would say yes.

I mean, we kind of are trying to make it specific to those professions where there's contact. Yeah. And then 465 is your section on temporary permits.

For that same subject area of licensure.

You're the expert, so.

Okay. Well, I'm looking at particularly the list under the section one of the Bill.

So that's psychology. 465 is psychology.

So if it's psychology that's listed among that section of the Bill, that would apply as well.

Okay. Okay. Thank you. Thank you very much. Any other questions, Members? If not thank you very much to the testifiers. Let's move on to the next measure. Senate Bill 1421. Senate Draft 1, House Draft 1 relating to medical records.

This measure repeals the requirement for the Department of Health to approve a health care provider's arrangement for the retention and preservation of patients medical records prior to the provider ceasing operations, clarifies that retention and preservation of medical records must be consistent with federal and state regulations and requires providers to notify patients on how to access or request copies of their medical records.

First up, we have the Department of Health.

Wanda Naonishi with the Department of Health. We support this latest version of this Bill requiring providers to notify their patients should they be closing their practice on how to access records. Thank you for the opportunity to testify.

Thank you very much. And we also received testimony support from the Queen's Health Systems. Is there anyone else wishing to testify on Senate Bill 1421? If not. Questions Members? Seeing none, we'll move on. Thank you very much. Senate Bill 1496, Senate Draft 1, House Draft 1. Relating to Civil rights.

This measure establishes that it shall be an unlawful discriminatory practice for places of public accommodation to deny a person with a disability full and equal enjoyment of or information related to their goods, services, facilities, privileges, advantages or accommodations using information and communication technology intended for use by the general public as applicants, participants, customers, clients or visitors. And it also establishes exceptions. First up, we have Jack Lewin, State Health Planning and Development Agency, in support. Not present. Next we have Department of Human Services with comments. Not present. Next we have Disability and Community Access Board. Welcome.

Thank you. Good afternoon. Chair Tarnas and Committee Members. I'm Brian Mick here on behalf of DCAB and Executive Director Kirby Shaw. We did submit written testimony and support. So much of public life occurs in a digital format these days so, inaccessible information and communication technology presents a huge barrier to those with disabilities.

As noted in many of the testimonies The Department of Justice has issued standards that will apply to state and local governments and will require the State of Hawaii and the four counties to have accessible web content and mobile apps starting April 24th of 2026.

This Bill conceptually extends that to places of public accommodation ie private businesses and nonprofits. From a person with a disability's point of view, that seems very basic. Why should you be able to go online and pay your annual vehicle registration.

On an accessible website, but not be able to pay your monthly car payment or schedule an oil change in a similar fashion? There were a few points raised at the last hearing which I just wanted to touch on. One is the worry about a burden for small businesses and nonprofits with the compliance state.

It was noted that the DOJ regulations have two compliance states, one later, one for smaller government entities. So it's really a policy call by the Legislature if it wants to have two compliant states and how it would define that for a small business or nonprofit. I tried to look at if there.

Was a standard definition of small business, that there does not seem to be one, although I did find a state tax credit that defines a small business as 25 or less employees. Secondly, this Bill does not have any exceptions for a specific type of content.

In comparison, the DOJ regulations have four archive web content posted before the compliance date, pre existing electronic documents posted before the compliance date, individual documents that are password protected, and social media posts that were posted before the compliance date. I don't think anyone is intending for.

A place to have to go and remove their existing material in order to achieve equity. But that's exactly what some businesses might opt to do rather than trying to take the time to make existing things accessible.

So the focus really is on making future content accessible or making existing content that is interactive in nature accessible so that people can participate. Thank you.

Thank you very much for your testimony. Next, Hawaii Civil Rights Commission on Zoom. Yes, please proceed.

Aloha Chair, Vice Chair, Heather McVeigh with the Hawaii Civil Rights Commission, and the Commission has supported this Bill.

We also want to recognize that testimony from community stakeholders suggesting that perhaps an alternative would be to have a measure that would direct the Civil Rights Commission to draft rules that were a little more tailored to achieve the same result.

The Commission has not had an opportunity to take a position on such an amendment, but in the past they have consistently supported similar efforts to prohibit discrimination in public accommodations, and we feel it was likely that they would not oppose such a measure.

But we also wanted to note that, you know, Hawaii state law often does provide above and beyond coverage past that of the Federal Government. So the web content, except content accessibility guidelines 2.2, are adding on to the 2.02 and 2.1. So if, if it was something that we needed to discuss further.

Again, we don't have a position from that by the Commission at this time, but we feel it's likely they would not oppose such an action by this body. So thank you. I'll be here for questions.

Thank you very much. Next, Dantry Bartoldis, State Council on Developmental Disabilities in support, not present. Next, Hawaii disability rights center. Mr. Erdichik, for everyone on TV land, he raised his hand and said in support. Thank you, Mr. Erdechik. Next, James Gashell, National Federation of the Blind of Hawaii. Welcome, sir. Please proceed.

Thank you Chair, Vice Chair, Members, James Gashell here representing National Federation of the Blind of Hawaii. We want to stand on our written testimony in support. Just take a moment to reflect on.

I've been around long enough to have been involved in some of the original enactments of state civil rights laws going back to the 1960s affecting people with disabilities and also Americans with Disabilities Act in 1990. Now, Hawaii joined the parade of states with civil rights applicable to people with disabilities and the public accommodations law. In the 1980s.

Nobody was thinking about digital spaces. At that time. It was all physical spaces. And we've done a marvelous job of making our physical spaces accessible. But in the intervening time since the 1980s and 1990s, public accommodations also now have a digital presence that they didn't have when these laws were originally enacted.

I think the Civil Rights Commission eloquently spoke to the need to really update our law to bring into its coverage clearly the digital space as well as the physical space. And so I hope you do that. As to the question of whether you put it in the law or the regulations, we've checked on that.

Our attorneys say put it in the law. And what they say is, you know, the Supreme Court kind of said that last summer when they overturned the Chevron deference. And, and so now it's really better to put these things in the law because lawyers know how to the judges know how to interpret these laws.

And we're concerned that if you put it in the regulations, well, we're certainly happy to participate in that process, but put it in the law. And mahalo for considering this Bill.

Thank you very much, Mr. Gasheell, for testifying. Next person who said they wish to testify is Marie Kauthoft. So if you want to stand behind. Yeah, right. That's it? You're doing great. You're doing great.

He's just. Yeah, it's okay. Hi, my name is Marie Kauthoft and I stand on my written testimony. First of all, thank you for hearing me, Chair, Vice Chair, and Members of the, of the Committee. Now there is a mic here. Yeah. Yes, there it is. I'm in strong support of this Bill.

I stand on my written testimony, which subsequently was submitted via accessible technology. And that's really important. I was born sighted. I have a progressive eye disease, retinitis pigmentosa. And earlier on when I had vision, I didn't care about accessibility because I didn't think about it. And it's not that I didn't care that other people had access.

I wasn't aware of it. I didn't think about it. And then as I started to progressively go blind, I started realizing how difficult it was to function in a world that was not set up for me.

I am a retired Professor and entrepreneur and I have worked diligently to be independent, even though I had a hard time finding the podium right now. I work really hard to be independent. And much of that Independence has to do with just access. See, my brain's not dying right? My eyes are.

And what happens a lot of times is able bodied individuals, they don't recognize. I didn't recognize how difficult it is when the world is set up. Well, like I said, not for you. So this technology Bill is, it matters to me because just being able to come up here and talk means so much.

Hawaii does a great job, especially with the accessibility online and whatnot. Like I said, submitting my testimony, it's just phenomenal that I could do that with voice, I could do that with increased text, and I don't have any issues because someone put thought into what they were doing when they were setting up that design.

Because design without design. Seneca. Sorry, this is my psychology behind me. But Seneca, a stoic had once said that a life without design is just chaos. And when we talk about technology as we've developed, when we begin developing these sites without a design in mind, especially with accessibility, it creates chaos in my life real quick.

My son is a software engineer and he works with me a lot and helps me kind of navigate some of the issues. And sometimes the issues are tough.

You know, sometimes there are questions as to how this is going to be done because it wasn't necessarily put in the infrastructure of the design, but it can be done because we have the technology at hand.

So I just ask that you help us support this measure because it literally keeps me alive, keeps me going, keeps me generative and being able to give back to the community and do the things that I would have done otherwise had I not lost my vision. So thank you for hearing me.

Thank you very much for your testimony, Professor Kauthoft. Next we have testimony from Peter Fritz on Zoom. Mr. Fritz, please proceed.

Thank you. I'm an old lawyer. I've been involved with disability rights since the 60s when it was barrier free design and the Rehabilitation Act in 1973.

I support the intent of this Bill, but I've read a lot of the testimony and it seems that most of it is focused on a promise that it will provide accessibility without looking at the Bill or reading the Bill itself. And I may be the only person that has done so.

This Bill started with somebody reading the Department of Justice's regulations and then cutting and pasting and pasting it into Chapter 489, which was passed after the ADA in 1990. It wasn't passed in the 80s.

And so my issue isn't so much with the intent of the Bill, but how the Bill has been put together and the problems that are created by the language. The Department of Justice chose to issue guidance. Guidance tells me what I need to do in order to do something and how they're interpreting the law.

If there were 3,188 ADA website lawsuits filed across the United States in 2024, there is litigation that's been going forward and back on that. But this Bill says, and one of the problems that I start off with, that was touched upon by other people, that the standard is 2.1.

The Department of Justice froze the standard at 2.1 because people have to comply and you shouldn't move the target. But it's 2.2 is the latest one. The late effective date is July 1st, 2026. So by July of 2026, you're supposed to comply with these particular standards.

But what happens on July 15 when the recommendations come out for accessibility guidelines that are now 2.3? You have to comply immediately. And so this is part of the problem and part of the concern requiring the drafting. And these are things that can be addressed in regulations or rules. So that's an issue with the concern.

I am somewhat concerned by the fact that the Department of Justice decided that large states can comply faster and sooner than small states, so they staggered that line. Bank of Hawaii can comply relatively quickly. Island Insurance and other large companies.

But what about a small attorney like me that has a simple webpage and now I have to comply and do something immediately. Every one of. At the last hearing, there was a mention that I support. The Chair mentioned that she was involved in a small nonprofit and didn't realize that this law applies to her.

So there are remedies and any one of these people can go and assert many of these defenses or use them as guidance in any type of lawsuit that might apply.

If I would ask you to summarize, Mr. Fritz, that'd be great.

Sure. The concern isn't with the law itself and the principles. It's the way it's being done. If we were to incorporate all the regulations for every single law that was there, the Hawaii rabbi statutes would be maybe God knows how many hundred volumes.

The proper way to do this is to bring forth, as I proposed in my testimony, a definition that would include the digital presence and then a requirement for the Hawaii Civil Rights to write rules and regulations as they did for employment and as they've done in certain other areas, which allows there to be discussion by the public and other people.

Moving this Bill forward with some of the problems that I suggested is problematic, and that's happened with other definitions earlier and other bills in this Legislature where they've been deferred to allow time to address these particular issues. So I appreciate time and the opportunity to testify. I'm not opposed to the changes.

I think that the way that they've been incorporated in the law reflects drafting that becomes problematic.

Thank you. Thank you very much, Mr. Fritz. Is there anyone else wishing to testify in Senate Bill 1496, House Draft 1? If not. Questions, Members? Representative Shimizu.

Thank you, Chair. I was going to ask a question of someone that has subsequently left the room, but maybe I can ask the kind gentleman from the Hawaii Blind Federation.

Mr. Gascho, if you could come on up, please.

Yes, please. Thank you. Yes. You know, please educate me. I'm blind as far as the requirements of what this Bill is asking. And how does that look? Could you kind of explain what are some of the provisions that you are looking for? No pun intended.

Sure, I understand. I think I get the point. If you cannot access a website such as. Well, let me. I'll give you an example. Four years ago, when we were all supposed to get vaccinated for COVID 19, we could navigate every piece of Hawaii Pacific Health's website up to the point of actually making an appointment.

And at that point the website broke down. And that's when I called Luer to check and Hawaii Civil Rights and everybody else. I said, you know, I have to be able to access this website. Well, it's one example Hawaii Safe Travels Program. Although that was part of the state, not, not private, but Hawaii Safe Travels Program.

There were pieces of that program that we could not navigate to get back into the state if we left. And that's a problem. So these barriers actually prevent full access. And as Ms. Kautuf testified, our, our full participation in society, it's not just a matter of convenience, it's often a matter of necessity.

And that's what this Bill addresses. It tries to set a standard of access, full, equal equivalent accessibility to the same goods and services that other people can get because they can fully use the website.

Does that help? It helps in concept. I was looking more for specific nuts and bolts, but can I ask another question? Sure. Yes, please. Can I ask a question to Hawaii Disability Rights, who returned I have no problem with providing more access to our population that needs it.

The concern is how does it affect businesses that may have a problem with providing this provision?

No, I mean, that's a good question. I mean the reason I submitted pretty brief testimony and just said I support it, to be honest with you. I'm so old I don't fully understand all the technology. And so I think of this as kind of a modern.

I think of this as kind of a modern day Ada, which is what I think Jim was kind of getting at. And that even though I may not understand all the details, I think it's important to kind of come into the modern age. But I think you're right.

I mean, I think that there would be some potential issues for smaller businesses. Larger entities usually are a little better able to absorb some of the changes that come down, but it is possible. I think your point is well taken.

I don't know if I'm the one who's in the best position to answer exactly what the challenges would be or what the solutions would be.

But I certainly think the idea conceptually is worth pursuing and moving forward and then perhaps trying to figure that out or maybe carving out exemptions, you know, in terms of what's reasonable or size, sometimes the size of the business.

There's a lot of things in the law where if you're a smaller business, like Family Medical Leave Act, I think if you got under 25 employees, you don't have to comply. So that may be one option representative.

Can I have one last follow up question?

And I guess related to that there is wording here that is on page eight, starting from line four where it says that accommodation shall not be deemed to be in violation if this subsection, if compliance would impose an undue burden or fundamentally alter the nature of the information and communication technology. So.

Right.

I'm looking at that as some kind of exemption or exception which would be reasonably apply to a business that has undue burden. And I'm not sure how that is specifically defined.

Well, in the digital sense, I'm not totally clear. But in general, that is kind of the way the ADA works. I mean, in many contexts, whether you're asking for an accommodation in the employment context or the housing context, potentially it's a question of what's reasonable under this situation and the law.

Sometimes, you know, it says reasonable as a case by case determination. So if it is an undue hardship, then they, then that might be something that they could argue in terms of not having to undergo that exactly.

All right, thank you. And I want to thank James and April for coming and testifying. Thank you, Chair.

Thank you. Any other questions, Members? If not, thank you very much to the testifiers. Let's move on to the next measure, Senate Bill 1442 relating to mental health services for children and adolescents.

This measure clarifies and updates the responsibilities of the Child and Adolescent Mental Health Division of the Department of Health to reflect the current mental health systems of care that address the mental health needs of children and adolescents in the state. First up, we have the Hawaii State Council on Mental Health in support.

Next, we have the Office of Hawaiian Affairs in support. Ms. Woodward.

Aloha, Chair, Vice Chair and Members of the Committee, McKenna Woodward, on behalf of the Office of Hawaiian Affairs in support of this measure. OHA has historically supported policies that address mental health associated disparities and reduce health inequities experienced by Native Hawaiians.

It has been 50 years since the statutes governing mental health services for children and youth were last updated. This update is crucial to ensure children and adolescents receive the Mental Health Services they need. Services that have the potential to create long term benefits by breaking cycles of violence and intergenerational trauma.

The deliberate suppression of Native Hawaiian knowledge systems through the banning of ALelo Hawaii restricted access to the AINA and the degradation of culturally significant resources has exacerbated mental health risk factors and outcomes for Native Hawaiian youth. As a result, youth suicide ideation attempts and deaths are disproportionately high among Native Hawaiians.

Native Hawaiian youth are also more likely to experience depression than their non native peers and face an elevated risk for early substance use. Research and health experts agree that mental health programs aligned with Native Hawaiian cultural identity Values and beliefs can significantly increase the number of Native Hawaiians who seek and utilize mental health services.

In this regard, OHA appreciates the division's commitment to offering culturally sensitive child and family centered services. By ensuring the division's responsibilities and updated are updated to improve accessibility, coordination and effectiveness, the state can better address and alleviate mental health inequities. Mahalo for your consideration of this measure.

Thank you very much, Ms. Woodward. Next, the Hawaii State Department of Health, Behavioral Health Administration in support. Welcome.

Good afternoon. Chair Tarnas, Vice Chair Poepoe and Committee Members, my name is Kaylee Acaro. I'm the administrator for the Child and Adolescent Mental Health Division. I'm here to testify in strong support of this Bill which would update our statute. Our statute is 50 years old and still describes us as a branch of the Adult Mental Health Division.

This update would help reflect the work that the Child and Adolescent Mental Health Division currently does as the state's Medicaid provider of intensive mental health services for youth with serious emotional and behavioral disturbance. I would also just like to ask for a clean effective date.

I'm available if there are any questions and I appreciate the opportunity to testify.

Thank you very much for your testimony and thank you for your good work. Next, we have received written testimony from the Hawaii State, the Hawaii Substance Abuse Coalition and from one individual. Is there anyone else here wishing to testify In Senate Bill 1442 House Draft 1? If not questions Members? Quick question.

Yes, you have quorum. Thank you. I really appreciate this Bill. Question is about the timing of the reports. I'm very concerned about federal funding that's going to be occurring to our child and mental health services throughout the nation. And I'm wondering if the timing of that. But we're extending.

We're saying that we're going to get a report in 2027. Is that in the regular course? Is that why you chose that date and then thereafter five years? Because I also noticed in the other part of the Bill we drop the two year requirement. I understand how two years is far off, but I'm very, very concerned.

And as I look at the timeline and presidential elections and where we're going to actually need to have reporting to actuallly understand what's happening in our system. I'm very concerned that this is timing is not worked well. So can you give us some little background on that?

Sure. That the timing actually was to align with a comprehensive youth mental health needs assessment that we are contracted with University of Hawaii to complete. And so that 2027 date is actually aligned with when we expected to get the results of that comprehensive assessment.

But of course, that's not to say that we're not closely monitoring the health and viability of the service array that we've built. And so we can provide any information that the Legislature requires in order to make decisions. But, so that's what the 2027 date was for.

And then the justification for the five years versus four years. No. Okay. Thank you.

Sure. Thank you. Thanks very much. Any other questions?

If not thanks to the testifiers, let's move on to the last measure for which we will receive Testimony, Senate Bill 1520 Senate Draft 1 relating to family this measure establishes an exemption from mediation in paternity proceedings where there are allegations of domestic abuse and clarifies the exemption from mediation in divorce proceedings as it relates to domestic abuse.

First up, we have support testimony from Hawaii Children's Action Network Speaks. Next, we have testimony from Hawaii State Commission on the status of women. Ms. Cheeney.

Chair Vice Chair, Members of the Committee Yasmeen Cheney for the State Commission on the Status of Women. I stand on my written testimony in support of this measure for the following three reasons. The first, the majority of victims of domestic violence are women.

Secondly, research and best practices tell us that we can inadvertently do harm to survivors of traumatic events if we do not engage in intentional practices that take into account their history of trauma. This Bill provides survivors with an opportunity to prepare, plan and implement well being strategies to safely navigate legal proceedings.

Lastly, informed consent is a cornerstone of transparent, ethical and honest service delivery, and this measure improves informed consent efforts to the benefit of survivors. Thank you and I'm available for questions.

Thank you very much. Next, Angelina Mercado.

Good afternoon, Chair Tarnes, Vice Chair Poepoe, Committee Members, I'm Angie Mercado, the Executive Director of the Hawaii State Coalition Against Domestic Violence. We are the Association of nonprofit organizations serving survivors of domestic violence statewide, representing 25 Member programs. And we stand in strong support of this measure.

We know that this is imperative for survivors who often are terrified of facing their abusive partner in any kind of mediation scenario. We've heard it from survivors directly, we've heard it from our Member programs, and I've even heard it personally amongst my own community.

And I just wanted to point out that we did recommend a couple of amendments, basically the same amendment in two different parts of the section referring to contested paternity and also divorce cases. And because we really wanted to affirm a survivor's right to have access to a supportive person during the mediation process.

And we hope that the fact that we are already referencing the statute that allows this, we're not creating additional laws, we're referencing something, but we're putting it in a statute that's going to be visible for those who are working with survivors like their advocates and attorneys and other people who would be involved in these types of proceedings.

And I just also want to point out that I didn't exclude an important word in my testimony in my recommended amendments and is that either party may have an attendance in mediation of supportive person. Thank you for hearing this measure, moving it along.

We've been trying for the last couple of years and I'm available for any questions you may have. Thank you.

Thank you very much. Ms. Mercado, we've received testimony and support from three individuals. Is there anyone else here wishing to testify in Senate Bill 1520 House draft 1. If not questions Members? Seeing none. Thank you very much. Thank you to all the testifiers today.

This has been a lengthy hearing and I appreciate all of you taking the time to provide testimony. We're going to go now and move into decision making on all the bills that we have on our hearing today. Let's move to the the top of the agenda.

Senate Bill 1322, Senate Draft 2, House Draft 1 relating to mental health. Members I recommend that we move this out with amendments. I'd like to adopt the Attorney General's amendments, the Department of Health's amendments, Lou Erticek's amendments, Hawaii Health Systems Corporation's amendments, and the reporting requirement that ACLU had in their amendment.

I also want to make a few corrections on page 8, line 11. The word provider should really be health care provider, which is a defined term. On page nine, line one to four, this paragraph discusses ex parte orders, but yet this section does not specifically mention ex parte orders, so that's not necessary.

On page 14, line 11, the reference should be the reference that says 334-123 parens b should be changed to 334-123 parens c line. On page 18, line 18, the repealed language should read, where physician's is crossed out, page 19, line 6.

So we should not strike out the words or if none can be found, because other sections of the Bill leave this phrase intact. So I want to keep it consistent and if necessary we can make any other technical amendments for clarity, consistency and style. Those are my recommendations.

Members on Senate Bill 1322 Senate Draft 2 House Draft 1 with amendments. Questions or concerns Members? Representative Belatti.

I just appreciate your changes. I think this is a very complex area of the law and I think we really need to make these changes moving forward. So I really appreciate the work.

Yes, thank you for the affirmation. Appreciate that you've been working on this for a long time. Other comments or concerns Members if not Vice Chair for the vote, please.

Voting on Senate Bill 1322 SD2, HD1 with amendments. Chair and Vice Chair vote aye. Representative Belatti. Aye. Representative Cochran. Aye. Representative Hashem. Representative Kahaloa. Excused. Representative Perruso. Aye. Representative Takayama. Representative Todd. Representative Garcia. Aye. Representative Shimizu. Reservations. With reservations. Recommendation is adopted.

Thank you. The next measure Senate Bill 1323 Senate Draft 2 relating to health care. On this measure, I would like to move it out with technical amendments for clarity, consistency, and style. And I'd like to adopt the recommended amendments from the Commission to promote uniform legislation. They had two recommended amendments.

I'd like to include those questions or concerns Members? if not Vice Chair for the vote, please.

Voting on SB 1323 SD 2, HD 1 with amendments. Representative Kahaloa is excused. Are there any no's or reservations? Hearing none. Recommendation adopted.

Thank you. Senate Bill 1452 Senate Draft 1 relating to the Uniform Controlled Substance Act. We need to make technical amendments for clarity, consistency, and style, correcting statutory references. Questions or concerns Members? If not Vice Chair for the vote.

Voting on Senate Bill 1452 SD 1, HD 1 with amendments. Representative Kahaloa is excused. Are there any nos or reservations? Hearing none. Recommendation adopted.

Thank you. Next Measure, Senate Bill 228 Senate Draft 1 related to excited, excited delirium. I would want to just make a couple of amendments. We want to amend the title of Chapter 327C from Death in quotes to quote medical diagnosis, semicolon death. I think that would be more accurate.

We also on page two, line 10, I want to change the word existing to the words most current so that we're consistent with the language on page four, line 14. Those are the amendments that I wish to make to move it out. Questions or concerns Members? If not Vice Chair for the vote please.

Voting on Senate Bill 228 SD 1, HD 1 with amendments. Representative Kahaloa is excused. Are there any no's or reservations? Reservations for Representative Garcia. Recommendation is adopted.

Thank you. Next measure, Senate Bill 1433, Senate Draft 2, House Draft 1 relating to harm reduction. I'd like to make some technical amendments for clarity, consistency, and style. And also make a couple corrections on page 10, line 14.

The citation should be 712 12 48 parens 1, parens D, not what it is now 712 12 48 parens D. Then we need to make technical amendments for clarity, consistency and style. Questions or concerns Members? If not Vice Chair for the vote please.

Voting on Senate Bill 1433 SD 2, HD 1 with amendments. Representative Kahaloa is excused. Are there any nos or reservations? No for Representative Garcia. No for Representative Shimizu. Recommendation is adopted.

Thank you. Next measure, Senate Bill 1447 related to administrative orders. I'd like to move this out as is. Questions or concerns Members? If not Vice Chair for the vote please.

Voting on Senate Bill 1447 as is. Representative Kahaloa is excused. Are there any no's or reservations hearing none. Recommendation adopted.

Thank you. Senate Bill 1429, Senate Draft 2, House Draft 1. I would like to adopt the Department of Health's recommended amendments that we make this measure effective upon approval. Section 7, this act shall take effect upon its approval provided that Section 3 shall take effect retroactively to January 1, 2025. Questions or concerns?

Members, if not Vice Chair for the vote please.

Voting on Senate Bill 1429 SD 2 HD 2 with amendments. Representative Kahaloa is excused. Are there any nos or reservations? No for Representative Garcia. Recommendations adopted.

Thank you. Next measure, Senate Bill 1373. We need to make technical amendments for clarity, consistency, and style. We need to insert where in the Bill where it's throughout the Bill. It says, quote, deny an application to renew, restore or reinstate a license registration certification. We should insert the word issue.

So it would read deny an application to issue comma, renew, restore or reinstate a license/registration/certification. And we'll do that throughout the Bill. Next as it's currently written subsection A1 throughout the Bill. I'm concerned it might be outside the Bill title.

So, I want to clarify that the language reads sexual offenses described under Chapter 846E, end quote, so that we can make sure we're consistent with the title. Next, I would like under G2 throughout the Bill change from covered offense to covered sexual offense throughout the Bill.

Then I would like to ensure that the boards are authorized to revoke or deny permits under the following parts of HRS 436E, 439A, 452, 461 and 465 so that we're comprehensive here. And finally, technical amendments for clarity, consistency and style. Those are my recommendations. Questions or concerns Members? If not Vice Chair for the vote, please.

Voting on Senate Bill 1373 SD 2, HD 1 with amendments. Representative Kahaloa is excused. Are there any no's or reservations? Hearing none. Recommendation adopted.

Thank you. Next Measure, Senate Bill 1421. Senate Draft 1. House Draft 1 relating to medical records. I'd like to make technical amendments for clarity, consistency and style. Questions or concerns? Members not Vice Chair for the vote.

Please voting on Senate Bill 1421 SD1HD1 with amendments. Representative Kahaloa is excused. Are there any no's or reservations? Hearing None. Recommendation adopted.

Thank you. Senate Bill 1496, Senate Draft 1. House Draft 1 related to civil rights. On this, I just need to make an amendment so that we're consistent. The phrase of a place of public accommodation should be inserted after the word quote, accommodations for clarity, so the language will read.

It is a discriminatory practice to deny a person with a disability full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of a place of public accommodation or information related to the goods, services, facilities, privileges, advantages or accommodations of a place of public accommodation using information and communication technology intended for use by the General public as applicants, participants, customers, clients or visitors.

That way we can make sure that we are clear about what we're intending to do here. Questions or concerns, Members? That's my only amendment. If not Vice Chair for the vote.

Please voting on Senate Bill 1496 SD1HD1 with amendments. Representative Kahaloa is excused. Are there any no's or reservations? Reservations for Representative Shimizu. Recommendation is adopted.

Thank you. Senate Bill 1442. Senate Draft 2 relating to mental health services for children and adolescents. I just want to make a couple of what could be considered technical amendments to correct things. On page three, line 12. Part 11 should actually be part 15.

That's misnumbered page five, line 19, the word quote, other end quote should be inserted before the word public, as this is existing statutory language. So it's to correct a mistake in the drafting.

And then on page eight, line five, the word and should be repealed so that the sentence reads and crossed out and the new language which is inclusive of and then the word rehabilitation which is in the statute. And then conforming amendments appear to be needed.

They are needed for 321174 such as adding the word adolescent whenever the word children appears and also changing the word youths to the word adolescence so that we are conforming these amendments in other parts of the related statutes. And I would also like to insert a clean date effective upon approval. Those are my recommendations.

Questions or concerns Members?

Question and I'm really tired, so I don't know if I'm doing the math correctly. But I think when you look at the timing, if it's every four years after 2027, the report comes after a new Governor has been elected in 2030.

So what that effectively does is if we have the plan every four years instead of every five years, it's actually better information for both the Legislature and the Administration. But I can't. I'm just thinking that that's what it is.

I appreciate your suggestion. I think that as this moves forward to conference, which is likely to was where it will likely go, that let's look at that with fresh eyes and do the calculation. And if we need to make the change, we could do it in conference. I prefer not to make that right.

Now and then make a clean date still.

I would like to have a clean date effective upon approval. Yes, but if we need to come back, if we we can make the change in conference or heavens we can come back next session and make that change because we're still a ways away from 2031.

Yeah. Thank you. Thank you, Chair.