House Standing Committee on Human Services & Homelessness

Today we are meeting for the Human Services and Health resolutions. Go ahead and read this for the date and location. So Thursday, March 202025 at 10:15am in room 329 and on Zoom. In order to allow as many people testify as possible, we don't.

We're not going to set a time limit right now, but please be courteous so that everyone has time to speak before I think we should have enough time to get through all of this. For those on Zoom, please keep yourself muted and your video off while waiting to testify.

After your testimony is complete, the Zoom chat function will allow you to chat with technical staff only. Please use the chat only for technical issues. If you are disconnected unexpectedly, you may attempt to rejoin the meeting. If disconnected while presenting testimony, you may be allowed to continue if time permits.

Please note the House is not responsible for any bad Internet connections on the testifier's end. In the event of network failure, it may be necessary to reschedule the hearing or schedule a meeting for decision making. In that case, an appropriate notice will be posted. Please avoid using any trademarked or copyrighted images.

Please refrain from profanity and uncivil behavior. Such behavior may be grounds for removal from the hearing without the ability to to rejoin. With that, we'll go into our first measure of the day. HR140 HCR146 requesting the Department of Human Services to apply for and implement the Elderly Simplified Application Project in the state.

First up to testify in person, Dantry Bartotaldes, Hawaii State Council of Developmental Disabilities. Good morning.

Thank you. Vice Chair, Chair, Committee, Danesh Bartolos, Executive Director for the Hawaii State Council on Developmental Disabilities. We are in strong support of this resolution. Although it's called the Elderly Simplified Application Project, there is a little clause in there that also would apply to individuals with disabilities. So we're really stoked about this.

This is something we've been looking at for about a year now. I just like to highlight the last paragraph for those people in Zoom land that here's this recording.

We strongly support developing a uniform benefits application system allowing individuals with IDD intellectual and developmental disabilities to fill out a one comprehensive form that can populate across multi benefit programs at a county, a state or a federal level.

This would significantly reduce administrative burden, improve access to essential services, and ensure that individuals with IDD are not repeatedly forced to provide the same information across multiple agencies and make mistakes and get held up and sometimes even counseled. Thank you so much for this opportunity to provide testimony and thank you for hearing this.

Thank you and there's no cost action allocation, so I don't have to bring that up.

Thank you.

Next up, we have Nate Hicks, Hawaii Public Health Institute. Testifying in support, in person.

Aloha Chair, Vice Chair, Members of the Committee. Nate Hicks, Hawaii Public Health Institute, in support. Definitely want to echo the unified application too. That would be an amazing thing we could do to help our folks.

I also want to highlight that extending the certification period from the current one year to three years would be a huge, tremendous benefit. It helps our current participants do less paperwork. It also helps our Department of Human Services do less paperwork. Right. In a year, if someone applies now, they have to reapply again.

The current DHS staff has to work with those people, work with those individuals, process their paperwork and extend the certification. And so if we move to once every three years, if they have to manually do it in a year's time, it's still less paperwork on their behalf. Right. It's currently manual. It would continue to be manual.

We're very excited for the implementation of the new benefit system as well. That can maybe automate it, but we think we should move forward with this before the system becomes online as well. Mahalo for the opportunity.

All right, thank you. Next up we have Genevieve Muma, Hawaii Hunger Action Network, in person, in support. She here. Okay. Next up, we have Department of Human Services Ryan Yamane with comments on Zoom. Okay. In person. Thank you.

Good morning, Chair and Committee, Jeanette Hayes, SNAP Administrator. On behalf of Director Yamani, we would like to stand on our testimony and are available for questions. Thank you.

Thank you. Would anybody else like to testify on HR140, HCR146 Members? Any questions? Okay.

If you don't mind. Coming up. Thank you so much. First of all, I too am incredibly excited. You know, it's a conversation we had just shortly a year ago. I just wanted to hear a little bit about one, the number of application forms that some of these individuals have to apply for just to get resources and services.

That's one question. But two, we also heard testimony about the reapplication process and just paint done for me what a universal application would look like, how many application, how many resources we're touching. But also what that length of kind of timeline that application will live for.

I'll do my best at that. I apologize. I'm not ready for that. But from the top of my head, we have applications for the Developmental Disabilities Division, so somebody could receive services. The Department of Health, we have applications for the Department of Human Service for Department of Vocational Rehabilitation Division, excuse me, of Vocational rehabilitation.

You have a snap, which stands for Supplemental Nutrition Application Program. Then you have your Medicaid application. So that's three right there. Then you have low income housing, there's applications for that. So just right there, that's already five. Each of these application process for the Developmental Disabilities Division could take up to six months to get something.

Then you have to do follow up for Medicaid MedQuest. That's an easy two months, three months online, it can be pretty quick. But if you don't put in the proper things, you don't get to the online one and you hit the disability button that could pop you out.

And then you're not certified, they have to go back in because you missed that certain thing. So there's certain forms that if you hit disability, it provides an opportunity for you to be rushed, for lack of a better word. But if you miss that button, then it takes that much longer, two to three times.

And often a denial. Then you have to go reapply again. You also have your voters registration. Sorry. So that's right there, six. And so then with vocational rehabilitation, those are other services there. So you're looking at three to six months minimum to getting these support services.

And often denials happen because you've missed that one button that says disability.

Great. Then Dantry, talk to me a little bit about, because I'm just super excited about this. You know, the conversations that we've had offline. There's a lot of things that are provided to us within HRS, but then there's also kind of agency policy work where they often kind of conflict a little bit.

How do we encourage agencies to modernize their policies? Because there's a lot of flexibility within HRS and how do we kind of scrape out old or archaic information on both sides, not only within the agency policy work, but also within HRS and then just do some General housekeeping.

Yeah, I think that's very important because many times you'll hear agencies say, for example, we were working with the Developmental Disabilities Division and the way they did intakes, their policy said one thing, the Hawaii Administrative Rules said something else. And it took us a better part of almost two years to get them realized.

For 10 years they've been doing their intakes wrong. And then they said, you're right. But it's, you're right, we should have been following that. So it's a matter of people working with each other, just reminding agencies, go look at the HRS, go ask the Ag.

Can't we interpret it this way because a lot of times that's that discussion with the Ag. I know that my colleague Chase Silvert is working with other departments on the AG's working together to understand the interpretation and how we can interpret things and make them different for a policy standard.

Great. Yeah. I'm just really looking for info support, but I would love to see that crosswalk as far as areas of HRS that we can modernize, areas of Hawaii administrative rules we can modernize and then really come to a universal form that works for everybody. Gantry, thank you so much for all your great work. Thank you.

Thank you. Chair Yield.

Members, any more comments, questions? Okay. We also have Hawaii Appleseed in support and two individuals in support. We'll be moving on to our next resolution.

HR170 HCR174 requesting Department of Human Services, Office of Youth Services and Juvenile Justice State Advisory Council to examine the availability and utilization of ʻĀina- based learning programs offered to youth youth in juvenile legal system. First up we have Richmond Luzar, Opportunity for Youth Action Hawaii person in support.

Hey, Chair. Vice Chair. Members of the Committee, Richmond Luzar testifying on behalf of Opportunity for Youth Action Hawaii. OYA is a collaboration that works on equity in the justice system, particularly for young people. We testify in support of HCR 174 and HR 170. We'll stand on that written testimony.

I would just add that, you know, I think this is a really good opportunity, no pun intended.

You know, it's an opportunity really in the in the justice system for young people to not only recover from times of times where they made a made a mistake, but really an opportunity to connect with the land, work the land and really deepen the relationship with it.

So thank you to the introducers and thank you guys for hearing the measure.

Thank you. Next up we have Cameron Clark, Debt Free Justice Hawaii on zoom in support.

Aloha Chair, Vice Chair and Members of the Committee. My name is Cameron Clark. I'm co coordinator of Debt Free Justice, the national campaign to eliminate youth fees and fines. Also coordinator of Debt Free Justice Hawaii, our statewide coalition in partnership with nonprofit ‘Ekolu Mea Nui.

We stand in support of HR 170 HCR 174 and stand on our testimony that we've submitted in written form. I just wanted to add really quickly that we lovingly are calling this the NOW resolution. It was drafted by Youth for Youth.

It's led by the Youth Council of ‘Ekolu Mea Nu Nā ʻŌpiʻo Waiwaii youth organizers who in between volleyball practice and homework have found time in their evenings and on weekends to learn more about community service, about aloha ʻĀina work, about ʻĀina based learning and about the legislative process.

And so I worked with them in drafting this resolution, answering questions for them and getting it before our sponsor, Representative Grandinetti. We give thanks to her for sponsoring this. And we really believe that this is a part of a larger kind of shift towards a more restorative criminal justice system.

This Committee has already heard both HB 129 and Senate Bill 1028, both of which are seeking to eliminate youth fees and fines in the juvenile justice system. And if that Bill is successful, ultimately the legal system and the juvenile justice system will want to move to these restorative alternatives like community service.

And so we want to make sure that those programs that courts are moving towards already are keeping in mind aloha ʻĀina work, keeping in mind aloha based, excuse me, ʻĀina-based learning and are implementing that when youth are given the opportunity to achieve rehabilitation and accountability through community service. So we stand by for any questions.

Awesome. Mahalo.

We also have testimony from the Office of Public Defender in support. Lynette Cruz from Mālama Mākua in support. Nā ʻŌpiʻo Waiwai in support. 'Ekolu Mea Nui in support. Would anybody else like to testify on HR170, HCR174 Members, any questions? Okay. Awesome. Moving on to our next resolutions.

HR133, HCR139, requesting the office of Wellness and Resilience to develop a report to address the developmental needs of children born during the coronavirus disease 2019 pandemic. First up, we have Danesh Bartolos, Hawaii State Council on Developmental Disabilities in support.

Thank you, Vice Chair, Committee Members, we're going to stand our testimony and strong support of this. We've noticed that during the pandemic, individuals. Well, I'm sure all children did, but our primary focus was individuals with IDD, the trauma that they faced and their residual from that and the fear of returning to places. So.

So I think this is really good. And so we're in strong support. Thank you.

Thank you. Next up we have Trina Orimoto, Office of Wellness and Resilience, Office of the Governor in support.

Aloha Chair, Vice Chair. Members of the Committee, thank you so much for hearing this resolution. We'll stand on our written testimony in strong support and wanted to highlight two additional things. First of all, we're requesting an extended timeline to submit findings and recommendations at the end of 2026.

Give us a little more time and really I want to highlight that we're excited about the opportunity to partner with local researchers to develop evidence based and community informed recommendations in Hawaii, specifically on this topic. Thank you so much again for hearing this.

Thank you. Next up we have, excuse me if I mispronounce the name. Siobhan Clark in support, in person. Good morning.

Good morning, Chair and Vice Chair. My name is Siobhan Clark. I am an undergrad student at UH Manoa in the Public Health Department. Currently, what we're seeing is that certain demographic information is becoming almost illegal to consider. Yet still vulnerable populations depend on truthful, accurate information in order to develop effective interventions.

So that this report and others like it, it's important that we keep this information and we keep looking at those vulnerable and those vulnerable indicators that are now becoming illegal to consider. Thank you.

Thank you very much. Next up we have Justina Acevedo Cross, Hawaii Community Foundation in support on Zoom.

Aloha Chair Martin and Vice Chair Olds. I'm Justina Acevedo Cross with the Hawaii Community Foundation and we're testifying in strong support of the resolutions. We really come to this from a couple different angles in support of our change framework that prioritizes health and wellness for all people.

And over the last six years we've had the great honor of helping to facilitate the Promise Minds Initiative, which is about improving early childhood behavioral health across Hawaii. Through that we've worked with numerous childcare providers, preschool providers, and those who really work closely with families with young children.

So we're talking about our babies, infants and toddlers, and really the ones in this, if you think about this resolution, who are just beginning to age into that kindergarten or elementary school age range.

And the more we can focus on the preventative factors and look at like what are really those developmental needs early on, the better off will be because there's long term costs associated with trauma from the COVID 19 pandemic.

Long term costs, not just, I mean, I think this, what's nice about this resolute, these resolutions is that they encompass how multidisciplinary this is. It's not just about our Department of Education. It's not just about what our Health and Human Services agencies and domain does, but really the Kuleana sits across multiple and inter agencies for this work.

And that's why situating this type of report through Office of Wellness and Resilience makes a lot of sense because of the way that they can bring together agencies and also community partners to look at those developmental needs. And I think I'll stop there.

I added some additional kind of research and findings and some of the information that we've learned through our program providers. We've worked within the Promising Minds Initiative about the impact of COVID because they really are seeing an increase in behavioral issues coming up.

And that has costs that can down the road lead to real health impact costs, physical health and mental health. Mahalo for considering moving this Bill, this resolution forward. Aloha.

Thank you. Okay, so we have the Department of Education in support, Early Childhood Action Strategy in support, Hawaii Children Action Network Speaks in support. Parents and Children Together in support and four individuals in support. Would anybody else care to testify on HR133? HCR139 Members, any comments, questions? All right, so we'll move on to our next item.

HR88, HCR92 requesting the governor's Coordinator on Homelessness and the City and County of Honolulu to establish a two year homelessness sanctuary pilot program. First up today we have Laura Nakonelua in support in person. Laura, you here? Okay. Next we have Daniel Chinin in support. Daniel, that's all we had for testimony today.

So we also had the Hawaii State Commission. Please.

Good morning again. This is very difficult for me to do, so I'm going to try to keep it together.

I stand in strong support of this resolution because I sleep in my car. I'm a UH student and I'm also an intern here at the state Capitol and I'm active in many of these organizations. Currently I receive CCS services from North Shore Mental Health. Forgive me, I'm sorry. And I have for the past three years.

I currently have CIS services from CARE Hawaii. I'm sure you guys are familiar with those organizations. I am this person and I don't have drug addiction and I don't have kids. I fall into an intersection of invisibility with our vulnerable populations.

And I have for a long time, needing a safe place to sleep has made me a victim of sexual exploitation. And the only safe place I have is my car. But to sleep in your car is illegal.

And it's very, very scary to be sleeping at night and hear a very loud knock on your window with the bright blue lights and the fear of a ticket. Right? So I'm begging, please consider passing this revolution resolution as swiftly as possible because I'm currently waiting for help.

But help takes a very long time to come for some of us. Thank you.

Thank you very much for your courage, for sharing that powerful testimony.

I apologize. I think my testimony list is out of order. My next page is 103. So I don't know if 180 down here. And I don't think these are connected. This is not the same. Yeah. Okay. So I don't have. Okay, thank you. Apologies for that, everybody.

Next, we have the statewide Office on Homelessness and Housing Solutions providing comments.

Chair Martin, Vice Chair Olds, Committee. We stand on our comments. One thing I just wanted to kind of highlight. We like the intent of the language, but the thing that we wanted to kind of keep in everybody's mind is that as somebody who's still in a sanctuary, they're still unsheltered and unhoused.

And so the goal of our office here is to try to encourage individuals to move from a place of unsafe or unsheltered situations into a more permanent space. So that's ultimately what our comments are. Thank you very much. All right, thank you.

Would anybody else like to testify on HR 88, HCR 92? We also had five individuals in support and one individual in opposition. Members, any questions? All right, we'll be moving on to the next measure.

HCR180, requesting the statewide Office on Homelessness and Housing Solutions, Department of Law Enforcement, county homeless coordinators, county law enforcement and social service providers to work collaboratively and effectively to address the homelessness in Hawaii. We have Jun Yang, Statewide Office of Homelessness and Housing Solutions, providing comments.

Yes, Chair, Vice Chair and Committee. Ultimately, when we're looking at the issues highlighted in this resolution, it looks like these are more items that are done locally. And we do have some of these services already being done by some of the service programs that are coming out of the Department of Transportation.

I'm not speaking on behalf of them, but I do want to let you know that some of these issues are being resolved as we speak. Thank you. All right, thank you.

We had one individual providing comments and three individuals in support. Would anybody else like to testify? HCR180 Members, any comments, questions? Okay, moving on to HR103, HCR107, requesting the state. The Hawaii State Commission on Status of Women to convene a working group to develop measures to strengthen protections under Title IX.

First up, we have Keith Hayashi, Department of Education, in person, providing comments. No DOE. Okay, next we have Yonghee Overlee, AAUW of Hawaii, in support, in person. Good morning.

Good morning. My name is Yonghee Overlee. I'm the Public Policy Chair for, I volunteer as Public Policy Chair for AAUW of Hawaii. Title IX is dear to our Heart because our mission is equal access to education.

And when you think about Title IX, I'm sure when Peci Mink wrote it, she had students in mind and they are the main stakeholders. So I put it in my testimony.

But I came here to say we emphasize how important it is that we have a student voice in this work group, especially in number eight and number nine. I put 7 and 9, but 8 and 9 would be critical in addition to having nonprofit organizations such as AAUW an opportunity to participate because we bring different perspective.

Thank you for consideration. And by the way, thank you for hearing this.

Thank you very much. Next up, we have Michael Golojuch Jr., Hawaii State LGBTQ Commission in support on Zoom.

Good morning. Michael Golojuch Jr., Vice Chair of the Hawaii State LGBTQ Commission. He, him, pronouns. We stand in strong support of this measure. We do ask that the Commission be given a seat at the table because far too often do queer voices be ignored or not, if we're not at the table, we don't actually have a say.

And this is a strong position that we support Title IX, but we need to ensure that the queer voices are heard when any of these kind of measures are taken up. So we encourage you to pass this resolution with the inclusion of a queer voice at the table.

So mahalo for hearing this resolution and we ask you to amend it.

Mahalo. All right, thank you. Next up, we have Anna Ezzy, Every Voice Hawaii in support on Zoom.

Aloha. Sorry, my video is loading.

We can hear you.

Okay. Aloha, Chair, Vice Chair, Members of the Committee. My name is Anna Ezzy. I am State Director of Every Voice Hawaii. We're a student and survivor led organization working to address gender based violence on college campuses. And I stand on our written testimony in full support of this resolution.

We want to emphasize that the recent return to 2020 Title IX rules at the federal level desperately requires state level action because those rules effectively tie school administrators hands behind their backs to be unable to address sex based discrimination. And our one request is to please consider adding student representatives to this working group.

And that's just because Title IX policies can look one way on paper, perhaps look very straightforward, but it's really through the eyes of students who are going through these procedures where we'll be able to understand the gaps and pitfalls of current Title IX. Mahalo for hearing this bill and for supporting students access to education.

Thank you so much. That's all we have in supports, we have Lasman Chain, Hawaii State Commission on the Status of Women in support and Amy Zao IMU Alliance in support. Would anybody else would like to testify? Please, if you could state your name.

Morning. Yasmeen Cheney for the Hawaii State Commission on the Status of Women. I just wanted to say that I stand on my written testimony and support and. And I'm available for any questions. Thank you.

Thank you, Members. Any questions? Okay, we'll be Moving on to HR95, HCR99, requesting the state LGBTQ Commission and the Commission on the Status of Women to review the Hawaii Revised Statutes, make recommendations for gender neutral language terminology. Today we have Michael Gulagic Jr. Hawaii State LGBTQ Commission in support on Zoom.

Aloha. Again, Michael Golojuch Jr., Vice Chair of the LGBTQ Commission. He him pronouns. We encourage you to move this measure forward. While we.

We recognize we may not be the most brightest minds in the room when it comes to addressing the issues that are raised by this resolution, we do recognize that we will be calling on those that can and help make this resolution come to fruition. It is beyond time to ensure that all voices are heard and that we.

We encompass everybody in our Hawaii Revised Statutes. So we encourage you to pass this resolution and move it forward. Mahalo.

Thank you. Next we have let's Hawaii State Commission on the Status of Women in support.

Good morning again, Chair, Vice Chair, Members of the Committee. I stand on my written testimony and support and just ask that you consider the amendments that I suggested. I just want to be able to be set up for success in this effort.

And I'm worried that six months is not enough time to go through all of the statutes to land at the place that you're seeking for this resolution to accomplish and a date for when we would be dissolved. Thank you very much. I'm available for any questions.

Thank you. There's nobody else to testify. We'll be moving on to our Senate Bill.

All right, so we are now moving to SB 1520 SD1 relating to family, which establishes an exemption for mediation in paternity proceedings when there are allegations of domestic abuse. And first up, we have. We heard this bill previously, an 8HB in this Committee and did pass it over to the Senate.

First up, we have Angelina Marcado with the Hawaii State Coalition Against Domestic Violence on Zoom. Go ahead, Angelina.

Good morning, Chair, Vice Chair, Committee Members, I'm Angie Mercado, the Executive Director of the Hawaii State Coalition Against Domestic Violence. We are this Association of domestic violence programs throughout the state, and we represent 25 member programs statewide. We stand in strong support of this measure as it is originally drafted.

I did see the testimony submitted by the Attorney General's Office and one other party making suggestions to the to the bill. Unfortunately, as the lead organization behind this endeavor, the Hawaii State Coalition Against Domestic Violence was not consulted about these amendments and we haven't had the opportunity to really look through them.

You know, one of the reasons why we've been leading this effort for the last several years is because many of our programs still apply for federal funding.

And one of the Department of Justice's required certifications in their discretionary grants is that we do not have policies that require mediation or counseling involving offenders and victims, victims being physically present in the same place where cases of domestic violence, dating violence, sexual assault or stalking is alleged.

So I respectfully request this Committee pass this measure as is and let the Judiciary Committee and Housing and Hawaiian Affairs Committee take this up as subject matter experts, allowing us, the coalition, to work with the Attorney General's Office to consider these recommendations. Mahalo for your time. Thank you.

Thank you. Just for the information of our Committee Members. The recommendations were exactly what we passed in our HB in previous hearings. And so that language has been out there. We had also the comments from the Attorney General's Office.

We had written testimony and support from the Commission to Promote Uniform Laws with the same recommendation as the Attorney General from the Hawaii State Commission on Status of Women from Hawaii Children's Action Network speaks and from two individuals. Is there anyone else wishing to testify on this measure? Seeing none. Members, are there any questions or comments?

All right, we'll move on to our next measure then, which is a resolution which urges the Governor to determine a course for action for the state should the Federal Government cut funding for Medicaid. And we have in person [unintelligible] from the Hawaii State Council on Developmental Disabilities.

Thank you, Chair, Vice Chair, Committee Members, thank you for hearing this reso. Medicaid is dangerous. Bartolo is Executive Director for the Hawaii State Council on Developmental Disabilities. Medicaid is more than just a healthcare system for individuals with intellectual and developmental disabilities.

It is actually a way of their life to be able to live in our community safely, to be able to go out with their friends and access just the things you and I take for granted. It also prevents institutionalization.

We're very proud that we closed our institution because of the home and community based services through Medicaid that could support our individuals in their community, which has been very beneficial. So thank you so much for hearing this and appreciate able to provide testimony and strong support.

Thank you very much. We also have the Hawaii Primary Care Association Eric Abe in support.

Hi, Eric Abe for the Hawaii Primary Care Association, I'd also like to thank this Committee for hearing these two resolutions. I want to just stress that the transition between the Biden and the Trump Administration has created a lot of fear, fear among Medicaid providers throughout not only the state but the nation.

There is a lot of uncertainty right now on what the future has in store for these very critical programs. And the kinds of cuts that are being discussed on the national level is staggering.

Be that as it may, if these cuts do come to fruition, if those things should happen, it would require the state to have to reevaluate the manner in which it provides funding for this essential program.

In a recent study by the Kaiser Family foundation, they anticipate that over a 10 year period, should the Federal Government eliminate Medicaid expansion during the Affordable Care Act, it would result in the State of Hawaii having to increase its General Fund outlays for Medicaid by $3 billion over a 10 year period.

You know, if you divided that out by 10 years, that comes out to $320 million in addition to $1.1 billion in general funds that goes to Medicaid every year. You're not going to be able to do that just by raiding the Community Health center special fund. You know, it's going to require a fundamental shift.

And so one of the good things I had a discussion with the Vice Chair in the hallway yesterday is that these kinds of challenges serve as opportunities. This could serve as an opportunity for the Legislature to take a really close look at Medicaid and see how we can make the program leaner and more effective to more people.

And right here we have Jack Lewin. He's back in the Administration. He is the architect of the corporate program. And when it was established during the Waihee Administration, it was always intended to be the first step in creating a universal healthcare system in the nation.

Main way of doing that is basically expanding the benefit package that is provided under Medicaid to a larger constituency, the GAP group. And so with that said, I thank you for your attention.

Thank you very much for being here. Next up, we have in support, do we have Waianae Comp.

Yep.

Ian Ross, thank you.

Thank you very much. Hello Chair Martin, Vice Chair Olds, Members of the Committee. I appreciate the opportunity to testify and I especially want to thank the chair for introducing this very important resolution.

In communicating and during the drafting of this resolution, working with Eric Abe and others, there was some discussion about whether or not there was adequate communication currently between Agencies, federally qualified health centers and beneficiaries of Medicaid. There's a lot of uncertainty. I think Eric really put it well.

You know, we know that the House budget for Congress might have contained within it up to $800 billion in Medicaid cuts. We're not sure what the Senate is going to be doing at this time.

The concern that we have at the Waianae Coast Comprehensive Health center is that by the time we get the clarity, we might not have adequate time to then make plans that allow for the more comprehensive look at what we want to achieve with the Medicaid program, as Eric so eloquently put it in way of this resolution.

Of course what it's calling for is, is a report to the Legislature before the next session. That's of course also going to be too late. We do recognize that. But we do hope that by continuing to move this resolution we'll be enabled to better have these conversations around the specific concerns.

So we would like to ask you to pass it. Eric's testimony and our testimony both request a small amendment just to clarify something from the Kaiser Family Foundation. But we do ask that you pass this resolution. Thank you very much for your time.

Thank you. Next up we have DHS on Zoom.

Aloha Chair, Vice Chair, Members of the Committee this Judy Moore Peterson, MedQuest Administrator. We stand on a written testimony and I apologize for the late testimony, but we stand on a written testimony definitely appreciating the intent of the resolution.

I would just add on that the types of federal reductions and the types of ways in which we as a Medicaid program and as a state respond to these cuts will depend on the specifics of the cuts that are being considered.

For example, you would respond very differently for a change in the federal matching rates for the expansion population than you would for work requirements. And then if both of those things go through, that would be different than again, so we are at the Medicaid program level.

We are looking at the various different proposals and trying to model what we think the effects would be. We definitely don't want to take any actions or preparations without that sort of engagement and communication with the community, community stakeholders, providers, members, etc., but again, there are no specific cuts that are present right now.

So thank you very much for this opportunity to testify and available for any questions.

Thank you very much. Next up, we have, in support on Zoom, Olivia Davis or Davies.

Good morning, Chair, Vice Chair and Members of the Committee. My name is Olivia Davies. I'm a current graduate student living here in Hawaii. And I wanted to say that I'm in support of HR180 and I stand on my written testimony and kind of just wanted to highlight some of my own experience working with Medicaid.

I worked with the homeless youth population over the past two summers and I have seen firsthand how like essential the government funded health services are especially to youth and individuals facing financial instability.

And I think major cuts to Medicaid can exacerbate in a lot of different areas which could increase like mental health challenges, higher mortality rates, things like that, when people cannot seek the services that they need. So again in support and I thank you for taking the time and consideration.

Thank you. We also had Executive Office on Aging with written support. Is there anyone else wishing to testify on this measure?

Aloha Chair Martin, Vice Chair Olds and Members of the Committee. Jack Lewin, administrator of Shipta here. Somehow or other we didn't get the announcement of this, of this hearing today until this morning. So I apologize for not having testimony and I will get in, I'll get late testimony to you.

We think that HCR187 is critically important as you heard from from Mr. Abe. We stand to potentially have a 300amillion dollar a year cut coming out of the Medquest program. Hopefully that won't happen. Hopefully the some of the red states will reassess their position and put some pressure on the Administration. But we don't know.

So I think it's a very important resolution. I've spoken with the Governor about it. He's certainly aware and thinking with Judy Moore, Peterson and me and others about what we're going to do if this does come to pass. Will be working on trying to avert these kinds of cuts at the same time.

So thank you for the responsibility and at least putting this forward.

Thank you.

Is there anyone else wishing to testify on this measure? Seeing none, Members, are there any questions or for our testifiers?

Thank you. Mr. Lewin, if you don't mind stepping up. I really do appreciate your and Mr. Abe's comments here loud and clear. Nothing's happening now but this is a great drill to take a look at, you know, what kind of impact we will really have.

I was just really curious in addition to that work about what that impacts were. Is it possible to indicate back to us as policymakers other pathways to help shore up funding in other areas and other resources that we might need to start looking at so that we can begin to backfill this potential loss?

Are those some areas you could explore for us with this work?

Also Representative Keho Kapu Liloi, thank you for that question. We are certainly beginning to contemplate what are the options there?

As I think most of you know, Administrator Judy Peterson from MedQuest and I were recipients of the ahead grant, which isn't going to solve this problem, believe me, but it does modernize healthcare across the state in a way that will make services more efficient, save money and improve population health at the same time.

So we're, and that's the only major grant in the CMS Innovation center that hasn't been cut. So it's really kind of an amazing thing.

We were, we were kind of holding our breath there for a while, but they're going to, they're going to have, we're going to have to look for other ways to save money and be more efficient and more effective because this, and yet on the other hand, let's hope we can also work through the delegation and a lobbying effort to prevent this from all manifesting in the way it's been proposed.

88 billion a year, $880 billion is, you know, devastating. But not just to Hawaii, to every state.

Thank you, Mr. Lewin. Thanks for putting all your heads together and coming up with solutions. Thank you.

Thank you, Ayil. Any other questions? Seeing none. We're moving on to our last Measure, which is HR 34, HCR 39, which requires requests Jack Lewin's team to look at the numbers and potential cost of covering all children universal health care for children in our state. And we have testimony on Zoom from the Department of Human Services.

Aloha Chair, Vice Chair, Members of the Committee, Junimore Peterson, on behalf of the Department Human Services. MedQuest is actually also included on this resolution to review costs of how much it would cost to provide benefits for children who are currently not eligible for Medicaid or underinsured, etc. And to work with Dr.

Jack Lewin on that and coming up with some policy recommendations. And we're just noting that we're happy to do that. We started some of that work a couple of years ago and provided a report to the Legislature on children who don't qualify for Medicaid based on their immigration citizenship status. And so we're happy to work with Dr.

Lewin on expanding that to others. Thank you.

Thank you very much. And I did not mean to exclude you. I know that we are, despite how busy you are with so many other things now asking you to do something additional. So I, I did not mean to make light of your, your work or what was being Asked, is there anyone else wishing to testify?

Please come on up.

Aloha. Again, Chair, Vice Chair and Members, I actually brought with me today a report from the Health Data Advisory Council, which you're free to enjoy after this if you want. It does reflect our best estimate now of the current status of the uninsured in Hawaii.

We're a very fortunate state in a sense that we have only 3.3% of the total population without health insurance, which puts us with Massachusetts as the best of states. On the other hand, as we all know, that workforce shortage creates problems with access. So having health insurance doesn't mean you have access to care.

And meanwhile, this report has some disturbing features in indicates that there are 9% of the keiki on the Big island of Hawaii that apparently lack health insurance in terms of unable to pay claims when they appear for health care services, and 6% on the island of Maui. We don't, we're confirming whether that's completely accurate or not.

We believe these people are, these kids are presumptively eligible. As you know, under age 6, Administrator Peterson has done an amazing job in the 1115 waiver to get us as much possible coverage as there is available. So presumptive eligibility, even if Mark Zuckerberg's kid needed coverage, we'd probably be able to get him covered.

On the other hand, from age 6 to 18, there are only two years of presumptive eligibility available with the most generous benefits. So there will be gaps that we're going to have to address and consider. And we should certainly start with this.

And the governor's feeling is let's get, let's go back to 1990 and say everybody will be covered in Hawaii and let's do it again and now and permanently. But start with Keiki, certainly. So this resolution is a welcome one to me and I look forward to working with Administrator Peterson on this effort.

But, but I believe we're going to really need to put our heads together in terms of how this will actually work if we're going to really mean it and make it happen. So we'll be back next year with the request. They'll be very specific in that regard. And thank you very much.

Thank you. Is there anyone else wishing to testify on this measure? Seeing none Members, are there any questions? Go ahead.

Thank you, Chair. Question for Jack Lewin. Thank you, Doctor, for being here and. For your excellent work on, on this program. As you know, I'm a firm believer that healthcare is a human right. I wouldn't be here if I didn't have access to Quest. So I'm a huge proponent of expanding coverage for all.

My question is, can I receive a digital copy of that report, please?

Absolutely.

And how often is that report updated?

That report is going to be updated annually. But we are looking now to actually confirm with other sources of data the, you know the details. We want to know if, you know, this comes out of census data. We'd like to go beyond the census data and look at the claims.

We have the all payer claims database that will be going live this year. And so we're going to actually have much better information coming to us that's going to be very helpful. And we also want to know why, you know, why is somebody not insured?

I mean in many cases maybe we need an educational campaign for the parents of many of these keiki to make them aware that their kids are eligible for insurance coverage. So that's, that's obviously a first step, but we want to make sure you have the data.

We will track this perennially so that we make sure that every citizen in Hawaii has access to high quality, equitable. I'm happy to say that. And affordable health care for everyone.

Thank you. Thank you.

Chair, now we are. Let's recess for decision making. We're waiting for one Member to come.

Here we go.

Decision making. Starting first with HR140, HCR146, we're going to pass this forward with HD with technical amendments needed for clarity, consistency and style. Members, comments, concerns if there's none. Chair for the vote.

[Roll call]

All right, thank you. Next. HR 170, HCR 174. Chair's recommendation is to pass with amendments. Technical amendments needed for clarity, consistency and style. Members, questions, comments, concerns? If there are none. Chair for the vote.

Okay. Seeing. Recognizing the excused absence of Brett Takanuchi. Are there any no votes? Any reservations? Seeing none. Your recommendation is adopted.

Thank you. Moving on to HR133, HCR139. With this we are going to go ahead with the recommendation to change the date to the end of 2026. Members, questions, comments, concerns? Okay. Chair for the vote.

Okay.

Voting on HR133 and HCR139 with amendments. Did you say with amendments? With amendments, yes. Are there Any no's? Are there any reservations seeing? None. Your recommendation is a chance. Adopted.

Thank you. And Moving on to HR 88, HCR 92, I'm going to go ahead and move this forward with an HD for technical amendments needed for clarity, consistency and style. Members, comments, concerns, questions with that Chair for the vote.

Okay. Voting on HR88 and HCR92 with amendments. Are there any nos. Any reservations seeing? None. Your recommendation is adopted.

Thank you. Moving on to HCR180 with this, I'm recommending moving it forward with an HD one with technical amendments needed for clarity, consistency and style. Members, any questions, comments, concerns? If none, we'll move on to the vote. Chair.

Okay, sorry.

So this is. This is Judge.

HCR 180 issues. This is.

Yeah, this is a single one. Just didn't want to make a mistake. With amendments.

Okay, so voting on HCR180 with amendments. Members, are there any. No votes. Are there any reservations seeing? None. Your recommendation is adopted.

With amendments.

Thank you. Okay, we're moving on to HR103, HCR107. We're going to move this forward with an HD1 using some of the. From the testimony provided today. We want to include queer representative and student representatives and we want to change the wording to be invited to participate by the Chairperson at ends of paragraph seven through nine.

And also some technical amendments needed for clarity, consistency and style with extending the date to 2026. Members, any questions, comments, concerns? Yes, sir. Thank you. Chair Diamond.

I support the intent of this resolution, but I do not agree with page one, lines 19 through 21. It says, whereas the current federal Administration has signaled its intent to weaken certain civil rights and protections and shift shift responsibility to the states, I think that is an inaccurate clause. So I'll be voting no.

Thank you.

Any Members, comments, concerns? With that, we'll move on to the vote.

Care. Thank you. So voting on HR103 and HCR107 with amendments noting the no votes from Representatives Alcos and Garcia. Are there any other no votes. Are there any reservations seeing? None. Your recommendation is adopted.

Thank you. Moving on to HR95, HCR99, we're going to move this forward with the HD1. We are going to do some technical amendments needed for clarity, consistency and style. And we are going to change the date to the end of 2026 with that. Members, any questions, comments, concerns? Yeah, Rep. Diamond.

Thank you. Chair. I Disagree with page one, lines nine through 12 that says whereas the use of gender neutral language in legislation promotes inclusivity and ensures that all individuals are equally recognized and protected under state law. The, the, the equal protection part is, is common sense for all.

But I disagree that gender neutral language in legislation promotes inclusivity. This simply means that we're no longer allowed to draft bills using terms like mother, father, husband, wife, auntie, uncle. It then turns to spouse, parent, child. I think that's ridiculous. I think our legislation should be written in plain English.

And, and that includes the use of gender language when appropriate. So no vote. Thank you. Thank you.

Representative Garcia, any of the Members comments, concerns with that? Chair for the vote.

Thank you. Noting the no vote from Rep. Garcia, Are there any other no votes. No vote. Rep. Alkos, are there any reservations seeing none. Your recommendation is adopted.

Thank you, Chair.

Okay, we are going to switch roles and for SB 1520, SD1, chair recommends replacing the language with HB 1283, which was a companion Bill that has already been amended in the way proposed by the AG's office and other testifiers to get rid of a conflict between existing law that addresses participation in mediation, the Uniform Mediation act, and also unlike the hb, to maintain the clean effective date upon its approval that is in this current Bill.

Members, are there any questions or comments seeing none. Vice Chair for the vote.

This is amended.

Yeah, as amended.

Members voting on SB 1520, SD 1. Chair's recommendation is to pass with amendments noting the excused absence of Representative Takeno Uchi. Any Members voting no with reservations. Chair, your recommendation is adopted.

Thank you very much. Next up we have HCR187, HR180 and on this one I want to make a correction that was picked up by some of our astute testifiers.

Whereas according to the study, if Hawaii picked up new expansion costs under scenario one, the anticipated loss of federal funding per fiscal year that would need to be offset over a 10 year period would be 320 million per year. Just correcting that number. And with that, are there any questions or comments? Go ahead Rep. Garcia.

Thank you, Chair. I think right now there's lots of fear mongering that's going around around federal cuts with Medicaid services. The President and his team has made clear that there will be no cuts to Medicaid, Medicare or Social Security. So I think this resolution is not needed. I'll be voting no. Thank you.

Any other comments seeing none. Vice Chair for the vote please.

Thank you Chair. Voting on HCR187, HR180, Chair's recommendation is to pass with amendments noting the excuse absence of Representative Takeno Uchi and the no vote from Representative Garcia. Any other Members voting no.

No.

With reservations. Chair recommendation is adopted.

Thank you very much. Our last measure, HR 34, HCR 39, which is looking into data for possibly having universal health care for children. Chair recommends passing as is Members. Are there any questions or comments? Seeing none. Vice Chair for the vote, please.

Thank you. Chair voting on HR 34 and HCR 39, a chair's recommendation is to pass as is. Noting the excused absence of Representative Taken, Uchi and any Members voting no with reservations. Chair, your recommendation is adopted.

Thank you very much. We are adjourned.

SA.