Senate Standing Committee on Health and Human Services

Calling the 1pm calendar for Health and Human Services. This meeting is being streamed live on YouTube. In the unlikely event that we have to abruptly end this hearing due to technical difficulties, the committee will reconvene to discuss any outstanding business on Friday, February 28, 2025, 1:00pm in room 225. Except for those where there is a lateral concurrent resolution.

Those need to be decided today. Your audio will be muted and video disabled until shortly before it is your turn to testify. Each testifier will have one minute to testify. If there's a technical glitch during your time to testify, we may have to move on to the next person due to time constraints. I will be reading a list of individuals who submitted written testimony for each measure.

We apologize if the closed captioning does not accurately transcribe the names. If you are interested in reviewing the written testimony, please go to the legislature's website. You will find a link on the status page for the measure. We appreciate your understanding and remind you that committee does have your testimony, that I reviewed them.

So I encourage you to use your time to either add additional comments or you can stand on your written testimony. First up, GM546, John Paul Moses III for the Hawaii Advisory Commission on Drug Abuse and Controlled Substances for term to expire June 30, 2028.

So for the nominees on the GMs, we give as much time as they need, but hopefully no more than five minutes because we have a long agenda. So for John Paul Moses, III. Are you present? Anybody here to testify in favor or again, John, is that. No. Anybody here to testify for John Paul Moses?

I see the Department of Health, Behavioral Health Administration in support. Department of Health, are you present?

Yes, Chair. Present. Standing on our written remarks in strong support of John, JP Moses re-appointment to our Commission.

Okay. Yeah. This is for the Drug Abuse and Controlled Substances Commission. Okay. Next up we have Lynnanoy Kawakawa in support. Anybody else wishing to testify on GM546. Members, I also have Senator Aquino, my Vice Chair present Members, Mr. Moses have provided us with his answers to his questionnaire.

So next up we have Cynthia GM 604, Cynthia Fowler, State Council on Developmental Disabilities for term to expire June 30, 2028. First up we have, is Ms. Fowler present? Okay. Okay. Thank you very much. Next we have State Council on Developmental Disabilities in support.

Thank you, Chair. Community Members. Dane Chupartoldis, Executive Director for the State Council. We stand in strong support. Cynthia has been serving on our board for the past year as an interim level because we weren't able to get her through last year and she's doing a fantastic job.

She's a parent from Kauai and we're really excited to have her on board. Thank you so much.

Okay, thank you very much. Next, we have Hawaii Self Advocacy Advisory Council in support. Anybody else wishing to testify on GM 604? Members, any questions? And I also have Senator Hashimoto also present. Next up, we have GM 607, Joshua Ige, also for State Council on Developmental Disabilities, from Lanai. Okay, first up, do we have Joshua Ige present?

Joshua, please proceed.

Yes, I'm here. I'm Josh. I'm Josh Ige. I'm a...advocacy. I believe in giving myself a great example to others, participating in my community. I strive to teach others about healthy eating habit. I teach others to speak to up to—for themselves. I am committed to work for people with disability.

I like to make people feel good about themselves. I'm, I'm serious about my commitment. I'm also a Chair—also a Member of the South Advocacy Advisor Council Shack. Thank you for this committee and submit my testimony is strongly support of GM 647.

Okay, thank you very much, Mr. Ige. Next up we have Daintry Bartoldus, also in support for state—Hawaii State Council on Developmental Disabilities.

Thank you, Chair, Committee Members. Daintry Bartoldus. Yes, we're in strong support of Josh Ige. This is his second time. He's served for us for four years and he's come back. We're very excited to have him on our council. He's lost over 85 pounds.

He took living healthy, being healthy to the next level and he supports other self advocates to make healthy lifestyle changes. He runs in half marathons and marathons now. He's really just exciting to be around and he's a strong supporter of our community. Thank you so much.

Okay, thank you very much. Hawaii Self Advocacy Advisory Council, also in support. Anybody else wishing to testify on GM 607? It's great that he practices what he preaches. Okay, any questions, Members? He also has provided us answers to the questions.

Okay, next up we have GM608, Alicia Kim, State Council on Developmental disabilities for term to expire June 30, 2028. First up, we have Alicia Kim. Are you present? Alicia, please proceed.

Aloha Chairman, Vice Chair, Committee Members. My name is Alicia Kim and it would be my honor to be appointed to serve on the State Council on Developmental Disabilities as the representative of the Individuals with Disabilities Education Act and the Hawaii Department of Education. I'm happy to answer any questions and appreciate your consideration.

Okay, thank you very much. Next we have Dane Chupartoldis, Hawaii State Council on Developmental Disabilities in support.

Thank you. Chair Committee mayors. We're in strong support of Alicia. She's been again for the past year serving with us and very strong advocate for our population within the DOE and it's been great working with her and collaborating in different events like Footsteps to transition throughout the state.

So it's been a great pleasure working with her and we just love to keep her on board. Thank you so much.

Thank you very much. Next we have Hawaii State Self Advocacy Advisory Council and support and also again, Alicia Kim. Anybody wishing else wishing to testify on GM608. Alicia Kim, Members, any questions? Also Alicia Kim has also kindly provided us answers to the questions we provided to her and that's also been put up in the legislative website.

Next up we have GM 609, Raymond Mamea, also for State Council on Developmental Disabilities for term to expire June 30, 2028. Raymond Mamea, are you present? Terrific. You're in person.

Thank you. And thank you. I am Raymond Mamea. Strongly support 609 confirmation of myself, Raymond Mamea, to the State Council on Developmental Disability for term to expire June 30, 2028. I am a strong advocate. I am great and grateful to others. I participate in my community. I am a team member for Special Olympics. I teach others to speak up for themselves.

I am committed to working for people with disabilities and like to make people feel good about themselves. I am serious about my commitment. I am a member of Self Advocacy Advisory Committee, SAAC. Thank you for this, for the opportunity to submit testimony in strong support of GM 609.

Thank you very much for putting your name in. Next up we have Daintry Bartoldus, Hawaii State Council Developmental Disabilities, in support.

Hi, Chair. Yes, we are strong support of Raymond. Again, he's been on our board for the last year as an interim. Also, we're very excited too because he's so involved in his community. He also lives in a care home, a foster home, and goes to adult day health program. So he brings a different perspective. So when we talk about waiver services and Medicaid funding, he's right there speaking up on behalf of himself and his peers, and we really appreciate that. Thank you for this opportunity to provide strong support for Raymond.

Thank you very much. We also have Hawaii Self Advocacy Advisory Council in support, and Michael in support. Anybody else wishing to testify in GM 609? Members, any questions? And thank you. Also, I'd like the committee to note that Mr. Mamea also provided us with his answers to the questionnaire, I believe.

Excuse me. No, we don't have your answers to the questionnaire, Mr. Mamea. Okay, so provide it to us when you can because I don't have it in my... Oh, you do have it. It's not here. Okay, you know what? We'll move on to GM 16. But it's not on. It's not on.

And, and the DM note says it doesn't have it, so. Okay, we'll look for it. Okay. Before DM. So GM610, Maria Christina Valenzuela, also for State Council on Developmental Disabilities for term to expire June 30, 2028. First up, we have Maria Valenzuela. Are you present, Maria?

Yes, I'm on Zoom. I'm for some reason unable. Okay, can you hear. Can you see me now? Okay. Aloha, Chair. Vice Chair, Members of the Committee. I'm Christina Valenzuela or Maria Christina Valenzuela, and I'm testifying as individual.

I just want to thank you for the opportunity to be able to serve on the State Council of Developmental Disabilities as a representative from the Executive Office on Aging. I stand on my written testimony in support. Thank you, thank you.

And thank you very much. We also do have your answers to our questionnaire. And next. And we have Hawaii State Council on Developmental Disabilities than two bicyllidus and support.

I thank you. Chair Dane Chupartoldis, Executive Director. Yes, we stand in strong support of Christina. It's like Maria. I didn't know her first name was Maria, but that's good to know. It's a mandated agency. She's part of the Elders Americans Act, so we're mandated to have a representation on our board. And she just works out perfectly.

Again, she has been there serving for a year now, and it's a great collaboration with the Executive Office on Aging. We're working very closely for our Aging and Disability Resource Centers, so combining and braiding aging and disabilities. And she's been just a great advocate for that. So thank you so much.

We look forward to having her serve longer.

Thank you very much. Next we have Carolyn Kadirao, Executive Office on Aging and Support, Hawaii Self Advocacy Advisory Council and support. Gary Simon for Hawaii Family Caregiver Coalition and support. And Christina Valenzuela, hurt again in support. Anybody else wishing to testify in GM610? Maria Christina Valenzuela. Members, any questions? Seeing none. Moving on.

For GM 611 we have Eden Watabayashi for State Council on Developmental Disabilities for term to expire June 30, 2028. And Eden, please proceed and disregard the timer.

Oh, hi. Good afternoon. No, thank you. I stand on my written testimony and thank you for this opportunity and your consideration.

Okay, thank you very much. So we also have for Eden in support we have State Council on Developmental Disabilities.

Thank you. Dane Chupartoldis as Executive Director, we stand strong. Support Eden. Eden will fill the requirement of a mandated agency for title V. And this has been a vacancy for like almost three years. So we're very excited that she stepped up and said yes, she will fulfill this role.

She used to work for the Department of Health Developmental Disabilities Division, so she's very inclined to know about our population as well. So we're very excited to have her and we look forward to her input for our council. Thank you so much.

Thank you very much. Next we have Hawaii State Self Advocacy Advisory Council and support. Anybody else wishing to testify on GM 611. Members, any questions? Thank you very much for putting your name on in. Next up we have GM 612, Sierra Whiteside. She spoke to us and a moment of contemplation for State Council on Developmental disabilities.

Term expired June 30, 2028. Sierra, are you present? I see that you're on Zoom. Please proceed.

Thank you, Chair and Vice Chair and Committee Members for having me. I have enjoyed being on the council this far. I believe in helping to make a change for the disabled community for the State of Hawaii. Thank you.

Thank you very much, Sierra. Next we have Daintry Bartoldus, Hawaii State Council on Developmental Disabilities in support.

Thank you, chair. Yes, the council stands in strong support of Sierra again. She came on last year. She is the interim. The board voted her as president. So technically she's my supervisor. So I strongly support her and we'd love to have her continue. Thank you so much.

Okay, thank you very much. Next we have Hawaii Self Advocacy Advisory Council and we do have Raymond Mamea's answers. Thank you. Hawaii Self Advocacy Advisory Council in support. Anybody else wishing to testify on GM612 Members, any questions? Thank you very much. Moving on. We have. Excuse me. Next we have SRSCR.

Since we have

Correction, Senator, one last GM 606.

606. Oh, you're right, 606. Thank you very much. So, 606, we have Brandy Lynn Makalani Hyden for State Developmental Disability—State Council on Developmental Disabilities—for term to expire June 30th, 2028. Brandi Lynn Hyden, are you present? Please proceed, Brandy.

I am. Aloha, Chair, Vice Chair, and Members of the Committee. I am a parent advocate, happily serving as Co-Chair of the Council. I'm also a community advocate representing other members of my Ohana and the community through my organization.

I very much appreciate your consideration of my nomination and looking forward to further contributing to the IDD community in this honored capacity. Mahalo nui.

Okay, thank you very much. Next, we have Daintry Bartoldus, Hawaii State Council on Developmental Disabilities, in support.

Thank you, Chair. We stand in strong support. And Brandy also brings to us, oh, she's a parent, but she also brings from diverse cultures and differences. So, being that Hawaiian. So, we have different point of views, especially from the Hawaiian culture. So, it's very important her nomination to keep our board diversified with different populations as well.

Thank you so much for this opportunity to testify.

Okay, thank you very much. Okay, next up we have Hawaii Self Advocacy Advisory Council in support. Anybody else wishing to testify on GM 606? Members, any questions? Okay. Since we have quorum, I'm prepared to do the advice and consent for all of our GMs before we proceed on to the SRs and SCRs.

So, for—Vice Chair, are you ready?

Yes.

Okay. For GM546, John Paul Moses III, Drug Abuse and Controlled Substances Advisory Commission. Chair's recommendation is to advise and consent. Any comments, questions, concerns? Saying none. Vice Chair for the vote.

[Roll call]

Okay, thank you very much. For GM604, Cynthia Fowler for State Council on Developmental Disabilities. Also Chair's recommendation is to advise and consent. Any comments, questions, concerns? Saying none. Vice Chair for the vote.

[Roll call]

Okay, thank you very much. Next we have GM607, Joshua Ige or Josh Igel, as he wants to call himself, or State Council on Developmental Disabilities. Chair's recommendations, advise and consent. Any comments, questions, concerns? Seeing none. Vice Chair for the vote.

[Roll call]

Okay, thank you very much. For GM608, Alicia Kim for State Council on Developmental Disabilities. Chair's recommendation is also to advise and consent. Any comments, questions, concerns?

Say none. Vice Chair for the vote. GM608 recommendation is to advise and consent. Three Members are present. Any reservations? Any no's? Recommendation is adopted.

Chair thank you. Okay, so Senator Keaho Kololi is also present. He's not. He's no longer excused. Okay, so for GM609, Raymond Mamea, I'd like to note that we do have the answers to his questions, so we're prepared to do a DM on him. And Chair's recommendation is to advise and consent. Any comments, questions, concerns? Seeing none.

Vice Chair for the vote.

[Roll call]

Thank you very much. For GM610 chair's recommendation for State Council on Developmental Disabilities, Maria Christina Valenzuela Chair's recommendation is to advise and consent. Any comments, questions, concerns? Seeing none. Vice Chair for the vote.

GM610 recommendation is to advise and consent. Four Members are present. Any reservations? Any no's? Rcommendation is adopted.

Chair thank you very much for GM611 for Eden Watabayashi State Council on Developmental Disabilities. Chair's recommendation is to also advise and consent. Any comments, questions, concerns?

Seeing none. Vice Chair for the vote. GM611 recommendation is to advise and consent. Four Members are present. Any reservations? Any no's? Recommendation is adopted.

Okay, thank you very much. For GM612 Chair's recommendation for Sierra Whiteside State Council on Developmental Disabilities is to advise and consent. Any comments, questions, concerns? Seeing none. Vice Chair for the vote.

Okay. 612612. Recommendation is to advise and consent. Four Members are present. Any reservations? Any NOS recommendation is adopted.

Chair okay, for the last GM for today. GM606 Brandi Lynn Hayden for State Council on Developmental Disabilities. Chair's recommendation is to advise and consent. Any comments, questions, concerns? Seeing none.

Vice Chair for the vote. GM606. Recommendation is to advise and consent. For Members are present. Any reservations? Any no's? Recommendation is adopted.

I would like to congratulate all those who we had advice and consent today and would like to thank you from the Legislature on your willingness to continue to volunteer. And as you can tell, State Council on Developmental Disabilities is super active and we do care about all of your input.

Every year they come up with you folks come up with proposed legislation that and we listen. So I'd like to call a five minute recess so we can have a photo with the one person who showed up is that okay? And then we can move on to the resolution. So, five minute recess.

Recalling the one o'clock calendar for Health and Human Services. First up, SR 53, SCR 69, requesting the Department of Health to convene a pharmacy benefit manager working group to determine the best policies to reform pharmacy benefit manager practices in the state to ensure transparency and fairness for consumers and in the pharmaceutical sector, lower drug cost to patient consumers, and increase access to health care.

First up, we have Department of Health providing comments. Is anyone here from Department of Health? Okay, next up, I see Jack Lewin here, State Health Planning Development Agency in support.

Yes. Thank you, Chair, Vice Chair, Members. Just a couple comments on this. As you know that the PBM issue is bewilderingly complex and nationwide problem. You know, I just kind of wonder whether this is heaping a lot on the Department of Health.

I'm, you know, in their defense if, you know, there may be some other way to get the same information and get this done, and I make some suggestions in my testimony to that effect. It's extremely difficult task to put on them. They're up to it, but I don't know if they, if they've got the bandwidth given all the other challenges they have.

Okay, thank you very much. Next up, University of Hawaii System in support. Next up, Corrie Sanders, Hawaii Pharmacies Association, in support. Corrie.

Hi. Good afternoon. Corrie Sanders, Director of the Hawaii Pharmacists Association. I just want to stand on my written testimony and provide maybe a streamlined vision for what I think the importance of this working group is with pharmacy benefit managers.

It seems like there was a lot of movement around PBMs about 10 years ago, and we've kind of been shifting responsibility of where PBMs have sat in our state. I think the number one priority of this working group needs to be determining who's taking ownership of PBMs so that we can start evaluating these contracts.

We can start enforcing penalties for breaches of contracts and looking at some of these medication cost issues and aggregate data over time. So I noted SHPDA's comments. I totally agree with what Jack is saying. It's purposely complex with PBMs. He did recommend that maybe this becomes a study under LRB.

I just wanted to note that that happened with one of our other bills, Senate Bill 1245, and that was deferred in CPC last week because LRB doesn't have the manpower or the specialty area to take that on. So just proposing some alternative options with how other states are looking at PBM reform. I think that needs to be the number one priority of this group. So for example, Florida's got an entire department of 10 people looking at PBMs. Colorado's got one...

Yes, Corrie, thank you.

Just coming together, comparing other states. Thank you.

Thank you very much, Corrie. Next up, Tiffany Yajima, Hawaii for Walgreens. Okay. Cathy Wilson for Walgreens... Or individual in support. Ronald Taniguchi, individual in support. Christina Requelman in support. Mia Tran-Cao in support. Alyssa Pang in support. SueAnn Yasuoka in support. Carrie Shibata in support. Jenny Higa in support.

Anybody else wishing to testify in SR 53? Members, any questions? Jack, come on up. You're gonna hate coming to my committee. So instead of Department of Health, how about we put in SHPDA and include an appropriation paragraph so that you would be able to contract it out. University of Hawaii seems willing to look into it. Would that be...

I think with an appropriation contract, this is certainly something we all know needs to happen. So with a bit of an appropriation contract to help, I think the parties will come together and I think we could do something particularly good as a state.

Okay, so Department of Health suggested $100,000 appropriation. You think you'll be able to do that within that amount of money?

I think that would, that would be sufficient.

That should cover it. Okay. Okay. Any other comments, questions, concerns? Seeing none. Vice Chair? Okay, we're gonna move on. Okay. Next up we have SR 56, SCR 73, requesting the Office of Wellness and Resilience to develop a report to address the developmental needs of children born during the coronavirus disease 2019 epidemic. So first up, we have...

Senator, we missed SCR 69.

Oh, no, I said that. SCR—SR 53—goes with SCR 69. So, SR 56, SCR 73. First up, we have Office of Wellness and Resilience.

Aloha, Chair, Vice Chair, Members of the Committee. Trina Orimoto for the Office of Wellness and Resilience. We stand in support of this measure. And want to highlight three things. First of all, thank you so much for proposing this resolution. And secondly, we're really excited to collaborate with local researchers, community members, develop evidence-based and community-informed recommendations for Hawaii on this issue. And lastly, we request an extended timeline to submit findings and recommendations to the end of 2026. Thank you so much.

Okay, thank you very much. To 2026. Okay, next up, we have Hawaii Youth Services Network, in support. Next, we have Association for Infant Mental Health in Hawaii, in support. Hawaii Community Foundation, also in support. And we have Danielle Goya in support. Dylan Armstrong in support. And anybody else wishing to testify on SR 56, SCR 73? Members, any questions? Okay, seeing none. Moving on.

Moving on. Next up we have SR69 SCR86 requesting a departmental fell to convene an Aeromedical Services working group. First up we have air methods and support. Thank you.

Department of Health and support in support.

Thank you, Dr. Ignacio, Hawaiian Medical Association in support of anybody else switching to testifying SR69 SCR86. Okay, Members, any questions? Seeing none. Moving on. Next we have SR99 SCR118 requesting Department of Health to convene a working group to assess the feasibility of allowing business owners in the state to utilize filtered water collected by water catchment systems or business activity.

First up we have Plumbing and Mechanical Contractors Association in support. Next we have Department of Health providing comments. Come on up.

Thank you, Chair. Vice Chair. Members of the Committee, Matt Carano, Department of Health Environmental Health Services. We absolutely support the intent of this. We recognize it impacts kind of rural areas more than urban areas. However, this is a really complicated subject. We're happy to do it, but I think we would need some support.

I think we offered amendments as such and to include Department of Agriculture since probably impact their Ag parks and Ag activities as well as part of the working group available for comments stand on our written testimony. Thank you very much.

Okay, thank you very much. Anybody else wishing to testify on Sr 99 SCR 118? Okay, Members, any questions? I got question. Department Health, come on up.

Yes, ma' am.

So University of Hawaii Hawaii in Hilo has testing supplies to test water catchment. Are you aware of that?

Yes, I am.

Okay. And yeah, that's with Department of Agriculture. I believe they Fund that. Why do you need $100,000 for a working group facilitator when there have already been studies? I mean water catchment has been around for a very long time, especially on the Big Island.

So why do you need $100,000 when it's been studied for a long time and in fact there is a testing ability for it.

Matt Crown and Department of Health. Department Health Services. Very good question.

The question was about to us was how would we kind of go forward with regulatory standards and controls particularly as if you allow water catchment for use for like food production going into manufacturing in particular, we were concerned kind of about two things and then this is where the facilitator would help.

One, we wanted to make sure that right now it's largely unregulated. There's no permit system to approve kind of what use of catchments for drinking water purposes as such. There's no regulatory standards for treatment. There's Recommendations, I think for personal use that are largely abided by the come out of University of Hawaii.

We would want to make sure whatever we put forward meets technical rigor so that it really does adequately protect in a production capacity. We think a lot about even like homemade food production as that's starting to grow. So it's really a bandwidth kind of question. It's standards and regulations and bringing a work group together.

But that, yeah, the funding would be used essentially to help bring people to help develop those standards so that we could roll them out as regulations at some point in the future.

Okay. Okay. Any other questions, Members? Okay, moving on. Next up, we have SR 140, SCR 171, requesting Department of Health to adopt rules or otherwise permit restaurants to allow dogs in designated areas of their establishment while adhering to health and safety regulations. First up, we have Hawaii Restaurants Association, in support. Next—I think that's it.

Anybody else wishing to testify on SR—oh and we have B.A. McClintock, an individual in opposition. Anybody else wishing to testify on SR 140, SCR 171? Okay, late testimony then, because I don't have anything from Department of Health regarding dogs. Please proceed. Identify yourself.

Matt Carano, Department of Health, Health, Environmental Health Services. I believe we submitted, but if it's not there, I'll have to check, and I apologize for it. We support it. We do not need extra resources to do this. And in fact, it's actually being done already. We have proposed regulations that include it, so we should be okay.

Thank you.

Okay. Thank you very much, and, and you're right. I see it on the SCR part and not on the SR but thank you. And we have Victor Lim providing comments. Anybody else wishing to testify on SR 140, SCR 171? And I'd like to, yeah, and Members, any questions? Department of Health. Department of Health, come on up.

So it sounds like you already have statutory authority to do this.

Yes, sir. Matt Carano, Department of Health, Department Health Services. We do.

So, what are the parameters that are being considered right now?

Right now, the rules being proposed—or in the process being proposed—have a few safeguards. One, including outdoor seating areas, not indoor seating areas. There is also specific requirements. So, it's an option in, it's not an obligation for restaurants, obviously, to allow dogs. If your restaurant doesn't want to allow dogs, that's fine.

If it does want to allow dogs and it's restricted to outdoor seating areas and there are certain other requirements like having dedicated entry and access ways, I think there are specifics in it. I have to look at the specific rule, but they're really sanitation requirements. So, you shouldn't have the dog at the table, for instance.

The restaurant itself can't be using its own cups and dishes for the animals. It should be single use.

So, who assumes the liability if there's some sort of adverse situation, bites the patron in a table next door or?

I defer to kind of our attorneys on that question, but my assumption would be it'd be the food establishment. The restaurant.

Yeah. Okay.

How—are you governing any rules around the dogs being allowed inside of retail establishments? Because I get questions about that, and it does seem like it's growing in the regularity, seeing people bring in dogs into grocery stores or the mall.

Yeah, I acknowledge that. I see that around, too. I mean, just anecdotally, people like to be.

But there's no rules, there's no authorization required for retail establishments to allow that type of?

You know, I can only speak kind of for the programs I'm aware of in our division, and our division is limited to right now, the food establishment areas. Because it's a real sanitation issue more than it's kind of, I think...

Right. So, I guess my question—because I don't want to deviate too much, grocery stores.

So, I have to go back and check the specifics. But grocery stores, I do think, are allowed, but food preparation areas and restaurant seating areas, like a food establishment. Because it's complicated, right? Things like Whole Foods have food establishments in that we regulate, others don't. So, there's kind of a line there.

I'd have to check with the program exactly. But I know definitely if when there's a food establishment permit, so it's a, you know, commercial operation, that's a restaurant, in essence, we would regulate that.

So, like Target, Walmart, all of them have.

Yeah. Where you see the placards, right, you know, the green placards, but then we have to—I have to do it because I believe that is restricted, and I apologize so I can get specific answers back to you in the future. This is a little bit more complicated because of the—where, like, the food establishment exists within the grocery store.

There's no rush. I mean, you are already considering it in the rules. So, that's why that question on my part. Okay. Thank you. Thank you, Chair.

Thank you. So, I do have a question. When do you think you'll be able to finish those rules?

So, we are in the process of it. We're aiming to get them as soon as possible. We went out to what ended up to be an informal public hearing. We're requesting authorization right now to go to a formal hearing.

We anticipate months, not years, of course, and at a really back end date towards later summer into the end of the year.

So, 2026?

Fingers crossed, working really hard to get it done. That's the anticipated target.

Okay, thank you very much. Okay, any other questions, Members? Okay, seeing none. Moving on. Next up, SR26, SCR43, strongly supporting and recommending the implementation of the revised 2025 Hawaii Patient Bill of Rights. And I'd also like to point out, Members, looks like the very exact thing on SR28, SCR45.

So anybody wishing to testify can testify to both or all four resolutions. Okay, first up, we have Shipta in support. State Health Planning and Development Agency.

Aloha Chair, Vice Chair, Members, Jack Lewin, Administrator of Shipta. We have a Patient Bill of Rights on the books. It's over two and a half decades ago. It needs to be updated. It's very important to doctors. It's very important to other health professionals, nurses and others. It's a complicated matter.

The proposal as it is now is going to take some kind of activity. Shipta is not volunteering to chair a work group on this topic, but we gladly participate.

Thank you very much. Okay, next up, Kirby Shaw, Decab and support. Kirby, is decab present on Zoom?

Not present on Zoom.

Chair Carolyn Cuterao, Executive Office of Aging, providing comments. Okay, I see Rachel Wilkinson, Hawaii Association of Health Plans, providing comments. Okay, thank you very much. Next we have Don Kurisu, HMSA, providing comments. I see Walden.

One day I'll read the name correct. Chair San Buenaventura, Vice Chair Aquino, Members of the Committee. Good afternoon, Grafton L. Walden. On behalf of HMSA, we appreciate the opportunity to provide comments on these four RESOs.

Throughout the course of this session, we've seen very spirited discussions about administrative burden, timely care access challenges, and ultimately safety and quality of care for our Members and residents across the state.

We would hope that an updating of a patient's Bill of Rights, similar to a working group, all stakeholders could come to the table to provide feedback and thoughts and ultimately craft something that could reflect all of the needs across the board as well as the sustainability of Hawaii's healthcare system.

For those reasons that we ask that potentially that you would defer this RESO in hopes of a working group. Thank you.

Okay, thank you very much. Next we have Elizabeth Ignacio, Hawaii Medical Association, in support. I see Dr. Ignacio on Zoom. Please proceed.

Aloha. Good afternoon, Chair San Buenaventura, Vice Chair Aquino and Committee Dr. Elizabeth Ann Ignacio, Hawaii Medical Association, Maui physician. HMA really does appreciate this resolution. It can update the Hawaii Summary of Patient Rights. And we do stand on our testimony. Of support with amendments for patient bill. Of Rights, including a work group. We're available for questions.

Chair okay, thank you very much. Next we have Dr. Gutling, Edward Gutling in support. Anybody else wishing to testify? SR26 SCR43 come on up, Kobe. Identify yourself.

Senator San Buenaventura, Vice Chair Aquino and Members of the Committee. My name is Kobe Chock with the Alzheimer's Association. We provided comments on this with a suggested amendment requesting that there's a component that gives patients the right to request a cognitive assessment using a validated cognitive tool.

Mainly because there are so many patients who go to visits and even when they request it, the Doctor kind of dismisses it or doesn't do anything about it and that will lead to long term patient not being able to access treatment and poorer health outcomes. So appreciate your time and here for any questions.

Thank you very much. Anybody else wishing to testify on SC on SR 26 SCR 43, SR 28, SCR 45 Members. Any questions? Seeing none. May we proceed with decision making? Okay, so first up for SR53 SCR69, we are going to pass this with amendments. This is the PDR.

We are going to amend every reference to "Department of Health" to "State Health Plan and Planning Development Agency." We're also going to add in an appropriation paragraph for Shipta, with a blank appropriation amount, in the CR.

We're going to note the request of $100,000, for which Shipta may contract out any or all portions necessary to convene the working group for Pharmacy Benefit Managers, and any technical, non-substantive amendments needed for clarity and consistency. Any comments, questions, concerns? Seeing none. Vice Chair for the vote — passed with amendments.

Okay, voting on Sr 53 SCR 69 recommendation of the chairs to pass with amendments.

[Roll Call]

Okay, so for SR 56, SCR 73, Chair's recommendation is to also pass this with amendments. The biggest amendment is going to be that the Office of Wellness and Resilience submit its report to the Legislator by December 31, 2026, instead of 2025. Any comments, questions, or concerns? Seeing none — Vice Chair for the vote.

Okay, SCR 56, SCR 73 — recommendation is to pass as a SD1. Four Members are present. Any reservations? Any No's? Recommendation is adopted. Chair.

Okay, for SR 69, SCR 86, we're just going to pass this with a technical amendment and any technical, non-substantive amendments, needed for clarity and consistency. The proposed amendment we're going to accept is that from AIR Method—changing the word fizzled to fixed. I don't think the introducer meant a fizzled wing.

So, I agree with AIR Methods on that. Any other comments, questions, concerned? Seeing none — Vice Chair for the vote.

Okay, SR 69, SR 86 — recommendation of the Chairs to pass with amendments. Four Members are present. Any reservations? Any NOs? Recommendation is adopted. Chair.

So, for SR99, SCR118, Chair's recommendation is we are going to pass it with amendments. We're going to add in Department of Health's proposed amendment to add in the working group — that a chairperson to add — excuse me, to add the Department of Agriculture into the working group. And also, we are going to add in an appropriation amount.

Blank appropriation amount to the — I guess it's gonna be — excuse me. We're going to make it to the Department of Health, make the Department of Health the chairperson of this proposed working group.

And on the Committee report, we are also going to note the request of $100,000 to facilitate the working group and any other technical amendments as necessary. Because of the amendments — any comments, questions, concerns? Seeing none.

Senator, we can't add an appropriation to the resolution.

We cannot.

Yeah.

So we can note the request.

Okay, we will not add in any appropriation. We will put in the Committee report the proposed request and ask the Department to ask for it in the budget. We are going to keep the Department of Health as the chairperson of the working group. So… okay, so…

But the other one also wouldn't have.

So, we're gonna need to re-DM that one?

Yeah, we just wouldn't put it in, but you can re-DM the mini cleaner.

Oh yeah. Because I put in the technical amendments anyway, so we don't need to re DM it and we'll just put it on the Committee report. Because I did ask. Add in the technical amendments as necessary. Okay, Pass with proposed amendments.

Department fails to propose amendment to add in the Director of Department of Agriculture and its request on the Committee report: $100,000 and any other technical amendments as necessary. Any comments, questions, concerns? SR99SCR118 — pass with amendment.

Okay, SR99SCR118—recommendation of the Chair to pass with amendments. Four members are present. Any reservations? Any No’s? Recommendation is adopted.

And I note on SR140, SCR171: I misspoke about the Hawaii Restaurant Association being in support. They only wanted comments saying no one is in support, and that the Department of Health is in the process of having the Rules, Chair’s recommendations to defer this. So, for SR26SCR43, we're going to pass this with substantial amendments.

We're going to note that prior authorization bills are moving along with their proposed working groups.

So, we are going to remove paragraphs 2, 3, and 6, or lines 8 to 17 on page 1; lines 1 to 5 on page 2; and lines 35 to 39 in the remainder of SR26/SCR43, but add in the right to cognitive screening per Executive Office of Aging in Chapter 3, 27H, and add also in the Patient's Rights Working Group per Hawai'i Medical Association request on pages 2 and 3, and any technical, non-substantive amendments as necessary.

Any comments, questions, concerns? Basically, a working group, but an additional right. Okay—Vice Chair for the vote.

Okay. Voting on SR26, SR43, as well as SR28 and SR45. Recommendation of the Chairs to pass with amendments. Four members are present. Any reservations? Any No’s? Recommendations are adopted. Sure.

Okay. But basically, for SR28 and SCR45, we're going to defer that in Lieu of the prior resolution. Okay, because they're exactly the same. Okay, thank you. Any other? And with that, we are adjourned. One more—sorry.

I apologize. The other one we should read. I got word from my director that it's basically me DM that one.

Okay.

It was a SR5003.

So do I need to do a reconsideration? We.

I would just dm just change it from DOH to ship and just don't say the appropriation part.

Okay. So, on PBR 53, on SCR 50, SR53, SCR69—Sheriff's recommendation. On that one, we are redeeming and clarifying per SMA’s technical requirements, and we are going to pass it with amendments.

We're not going to have an appropriation paragraph, but we are still going to have Shipta as chair of the Pharmacy Benefit Manager Working Group instead of Department of Health.

And we are going to note on the Committee report Shipta's request for $100,000 to be able to contract out, as necessary, any portions of the need for the working group. Any comments, questions, or concerns? Seeing none—Vice Chair for the vote on SR53, SCR69, and any other proposed technical amendments as necessary. Okay.

Vice Chair for the vote.

[Roll Call]

Okay. And with that, we are adjourned.

Calling the 1:05 agenda for Health and Human Services. First up, SR 142, SCR 173, requesting health insurers and managed care providers that provide health insurance in the state to provide insurance coverage for prosthetic and orthotic devices. We have no testimony for this, so we're going to move on.

For SR 4, SCR 8, requesting the Auditor to assess both the social and financial effects of proposed mandated health insurance coverage for percentage of the cost of intravenous ketamine therapy to treat depression. For this, we have testimony. Vicky Farmer in support. Anybody else wishing testify on SR 4, SCR 8? Members, any... Well, no one to ask questions, so we're moving on.

Next, SR 101, SCR 120, requesting the author to assess the social and financial effects of proposed mandatory health insurance coverage for continuous glucose monitors. First up, SHPTA, in support with comments. Next, we have State Council on Developmental Disabilities, in support.

Aloha, Chair, Committee Members. My name is Jay Silvert with the Hawaii State Council on Developmental Disabilities. I'm here for Daintry Bartoldus. We'll stand on our written testimony in support.

We just wanted to highlight that oftentimes individuals with intellectual and developmental disabilities are disproportionately affected by diabetes and they run out of the strips really quickly and pricking their finger and drawing blood, a lot of different intellectual disabilities have a lot of issues with that. It can have a lot of sensory issues with that.

So, that's why we're in support. Thank you.

Okay, thank you very much. Next, we have Hawaii Medical Association, in support. Next, we have Liberty Dialysis Hawaii, in support. Lisa Rance in support. Hilo Benioff Medical Center Foundation, in support. Anybody else wishing to testify on SR 101, SCR 120? Hold on, let me keep going. We have also Elizabeth Ignacio, Hawaii Medical Association, in support. And that's it.

That's the only one that's different. Anybody else wishing testify on SCR 120, SR 101? Members, any question of our only testifier? Okay, seeing none. Ready for decision making on this one. Okay. So, for—I have my DM notes. Okay. Thank you very much.

So, seeing that there is no testimony on SR 142, SCR 173, we're going to defer this to the next session. So, deferring indefinitely. For SR 4, SCR 8, Chair's recommendation is to defer the SR but pass the SCR with amendments. We're going to add SB, the number 967, for every blank SD amount.

We're going to add in the request to the auditor to consider various percentages of mandatory coverage for SB 967, noting the blank percentage in the SCR. And that's basically it. Any comments, questions, concerns? Seeing none. Pass with amendments.

[Roll Call]

So, for SR 101, SCR 120, because SR or sunrise analysis have no effect, we are going to defer the SR 101. We are going to pass the SCR 120 only with technical, non-substantive amendments, as needed for clarity and consistency. Any comments, questions, concerns? Seeing none. Vice Chair for the vote. Pass with amendments.

[Roll Call]

And with that, we are adjourned for the 1:05.