Senate Standing Committee on Health and Human Services

I don't have my thing. Okay. Calling the 101 calendar for health and Human Services. This meeting is being streamed live on YouTube. Likely event that we have catastrophic failure. This meeting will not be reconvened. We're going to just do the best that we can, okay?

Because conference starts next week and we may not be able to have a room. So for those on zoom, your audio will be muted and video disabled until shortly before it's your turn to testify. For those familiar with Health and Human Services, you will have one minute to testify.

If you can stand on your written testimony, we appreciate it, and otherwise. And we apologize for those on zoom if the names are not or the closed captioning does not accurately reflect your testimony. So first up, HCR28 requesting the. Oh, no, we did that wrong one.

First up, HCL 190 requesting the Department of Health to convene a demolition waste reduction work group. We have Department of Health providing comments and we have DAGs, Department of Attorney, Accounting and General Services in support. Anybody else wishing testify in HCR190 Members? There's nobody to ask questions of, so we are going to move on.

HCR 91 first requesting the health insurance insurers and managed care providers that provide health insurance and state to provide health insurance coverage for prosthetic and orthotic devices. First up, we have Dr. Lewin of SHIPTA State Health and Support Planning and Development Agency.

Aloha Chair. Vice Chair, Jack Lewin, SHIPTA. We're in support of this. We realize there's a great deal of expense attached to it, so we defer to the cost implications for insurers. But clearly residents of Hawaii who do not and cannot afford these kind of things. Prosthetic legs can cost up to $70,000 if they're the new mechanical.

I mean, the computerized versions. But orthotics are really relatively inexpensive for people that need those. So I think that this is worth studying and coming back with some real solid recommendations. Thank you very much.

Okay, thank you. Next up, we have David Ball in support. Megan Severn in support. Megan, are you present?

Yeah.

Come on up. Please proceed. Identify yourself.

Oh, I'm Meg Severin and. Go ahead. Okay. My name is Meg Severin and I'm a 14 year old amputee. I'm a local representative of. So everybody can move. The resolution before you is asking insurance companies to provide sports prosthetics and orthotics for people with limb loss and limb differences.

As an athlete and an amputee, I've experienced What it is like not to be able to participate in certain sports. I lost my leg two years ago due to a rare cancerous bone tumor. Insurance companies say it's only medically necessary for me to be able to walk and therefore only provide me with a walking prosthetic.

Do you think this is fair? The only way I'm able to participate in any sports or PE at school is because of other people's charity. If not for the generosity of others, I would be sitting on the side watching my peers be physically active and running.

Eight states have already passed similar bills to this resolution and I would love to have your support to introduce it in Hawaii. This legislation is not just about prosthetics. It's about ensuring people with limb loss or limb difference can thrive, not just survive.

It's about promoting physical and mental health and reducing long term health care costs and ensuring a full and active life. By supporting so everybody can move, you'll ensure that no one in Hawaii is held back from participating in fiscal activity. I respectfully ask you to support this resolution and in doing so, people like me.

Thank you very much, Megan. Anybody else wishing to testify on HCR 91? Members, any questions? Okay, moving on. HCR 174 requesting the Department of Human Services, Office of Youth Services and Juvenile Justice State Advisory Council to examine the availability and utilization of Ina based learning programs offered to youth in the juvenile legal system.

First up, Leanne Gillespie, Department of Human Services, Office of Youth Services providing comments. Next we have Darcia Foster, Office of the Public Defender, State of Hawaii and support Melissa Pavlicek, Opportunity of Youth Action Hawaiian support. Brian Brittany Kealoha. Now a PO Bye bye Youth Council of Ekolume Nui in support. Okay, all three of you.

Okay, come on up. Identify yourself.

Aloha. Mahalo for having us. We stand on our submitted.

Introduce yourself. Aloha. I'm Zoe Jolie. Zoe. Aloha. I'm Oakland. Oakland.

What your names are?

Aloha. I'm Haile.

Oh, Hailey. Okay, go ahead.

Mahalo for having us here. We stand on our submitted testimony, but we wanted to share in person.

Aloha Kakou. We are a youth council of Ekolome and we are called Naopio Waipai. A collective dedicated to uplifting native Hawaiians youth ending intergenerational incarceration through culture and advocacy. As young leaders grounded in values of Aloha, Aina and Ohana, we aim to empower justice impacted communities and transfer harmful systems.

We are submitting testimony and strong support to our resolution.

A question that us as OPO that we usually get asked is what is Ina based learning? Ina based learning is culturally rooted rooted form of education that connects people, especially students, to the land, community and Hawaiian values.

It often involves hands on working in gardens, lo' I, which is tarot patches, fish ponds and forests and forests integrated with lessons and ecology, history, language and stewardship. A short term impact versus long term impact of community service so for example, picking up trash on the side of the road has a short term impact you.

Yes, it is important for us, but a week later the trash just comes back. While Ina based learning has a long term impact, it teaches you a sense of belonging to your culture and roots.

Why is Ina based learning learning meaningful and impactful? When you participate in Ina based learning, you learn while you do. Using your culture and land based practices can help Native Hawaiian youth feel more connected, proud of who they are and and stronger inside.

They are not only putting in the work, but they are also able to see a meaningful outcome that helps benefit their communities. When communities focus on healing through the land and culture, it helps both people and the whole Hawaiian community stay healthy and strong. Why we felt so impelled to create this resolution.

Having firsthand relationships with people being incarcerated, we see the impacts that the justice system has on Native Hawaiian families. And we feel that if we can make a meaningful impact and be able to help the appeal when they are young, we can lower Hawaiis incarceration.

Having experienced the beneficial impacts of Ina based learning, from starting as OPIO to now becoming OPIO leaders in just three years in a program called Kapahuhoku Oka Wainui, we were able to reap the benefits that learning on through and from the land has. Mahalo.

Thank you. Okay, thank you. Next up, Jamie Miller, co Executive of Ekolomainui in support. Come on up.

Aloha, Jamie Miller. Thank you for having us and giving us this opportunity to be here in person. I just wanted to share that I stand on my submitted testimony, but also that the youthful voice is very important and between Hula Sports School. These folks wrote this resolution.

It's their words from their experience and we just need to support them in what they believe is good for their communities. Mahalo.

Thank you very much. Cameron Clark, Debt Free Justice Hawaii and support. Cameron Clark, are you present on Zoom? Please proceed.

Aloha Chair and Vice Chair Members of the Committee, I'm Cameron Clark, co coordinator of Debt Free justice, the national campaign to eliminate youth fees and fines. We stand on our written testimony and are proud to work with Okolomeya Nui and Naopio Waivai. In moving forward this resolution, I just want to add really quickly.

This is a part of a larger project that is moving forward in Hawaii and around the country to eliminate youth fees and fines and look at alternatives that are more rehabilitative and more restorative and also actually achieve accountability for youth.

The Senate has already considered Senate Bill 1028, which is looking at the elimination of youth fees and fines.

And so we believe that this is a part of the next step of creating a new generation of juvenile justice in Hawaii by looking at Ina based learning and investing in that further so that instead of focusing on punitive fees and finds, we can actually achieve better outcomes for youth in the state. Mahalo for your time.

Thank you very much. Next we have Carla Allison in support. Anybody else wishing testifying? HCR 174 Members. Any questions? Okay, moving on. HCR 171 requesting the Auditor to assess the social and financial effects of proposed mandatory health insurance coverage for continuous glucose monitors. First up, we have Dr. Lewin in support for SHPDA State Health Planning and Development Agency.

Aloha Chair, Vice Chair and Members. SHPDA is strongly in support of this. We're actually a bit disappointed that it's a resolution rather than some legislation. However, I really think that this whole effort is going to help move the insurance companies to voluntarily move forward with this.

Patients who are on insulin really these days need these kinds of devices to notify them when the blood sugar is too low or too high. You've heard all this testimony before and we'll work with the insurance companies to try to get it going, but we certainly need to expand the use of this in Hawaii. Thank you.

Thank you very much. Next we have Hawaii Medical Association, Dr. Ignacio, Elizabeth Ignacio in support, Palani Smith, Liberty Dialysis and Phinesis Kennedy Kidney Care and support. Anybody else wishing testifying? HCR 171 Members. Any questions? Okay, seeing none. Moving on.

HCR 146 requesting the Department of Human Services to apply for and implement the Elderly Simplified Application Project in the state. First up, Director Yamani providing comments. Thank you. Next we have Dainty Bartotos, Hawaii State Council on Developmental Disabilities and Support.

Thank you, Chair, Vice Chair, Committee Members. Savannah Peskin with the Hawaii State Council on Developmental Disabilities on behalf of Daintry Bartolds. We'll stand out our written testimony and support. Thank you so much.

Thank you. Daniela Spoto, Hawaii Apple Seed and support. Genevieve Muma, Hawaii Hunger Action Network, in support. Nate Hicks. I see that you're here Hawaii Public Health Institute in support.

Chair, Vice Chair, Members of the Committee, Nate Hicks, Hawaii Public Health Institute in support. We recognize that the certification is far too short. Being able to expand it can help tremendously. We know there are hiccups with the current system to be able to automate this, but we think starting the application project now can be very helpful.

Who knows how long it might take for the Administration at the federal level to really approve this project. And so getting the ball rolling now so we're ready to participate if and when that eligibility system is upgraded is, I think, very important. We would love for us to participate even before that.

But getting the ball rolling now, I think is really important. Mahalo.

Thank you. I see Betty Lou Larson on Zoom. Catholic Charities of Hawaii in support. Please proceed. Betty Lou.

Aloha Chair, Vice Chair Members, I'm Betty Lou Larson with Catholic Charities Hawaii. We'll stand on a written testimony because we feel this would really be a win win situation both for DHS and the Administration, and especially the participants who are seniors and disabled. Thank you.

Thank you. Next we have Shay Chan Hodges in support. Anybody else wishing testify in HCR146 Members, any questions? So I have a question. Can you come on up? DHS. DHS. Sorry, yeah. This is for no continuous glucose on. Okay, so I know you folks have some software updates going. If we pass this resolution, would you folks be.

Are you folks able to alter or are you folks already thinking about putting this elderly simplified application for SNAP as part of your software update?

Good afternoon, Chair. Scummer Shige, Administrator for Benefit Employment Support Services Division, the Department. As we've explained in our testimony, I think we could implement ESOP. Now, the challenge is that we would have to extend the certifications manually.

And our worry is because we are in corrective action for timeliness and also for payment error, having to do the manual work could further exacerbate our issues with timeliness and also the accuracy of payment for the workers.

So we are continuing to work hard on development of our new BES system, which is still on schedule to be implemented statewide in October 2026. But the concern about implementing ESAP earlier is just having to do it manually. It's going to be very challenging.

Okay, so Nate Hicks, others, what about just applying to do asap? Is there like an application process? Can you start that instead of starting to implement the ESAP application?

Well. We could start the process, but typically you would do it when you're actually ready to implement. So our plan right now is to request to start the Waiver once our system is able to support it.

Which you're not able to do.

Yeah, and again, that's the concern. We could do it, but it's additional time for the worker because the way our system is, our system that's nearly 40 years old is just what require a lot of manual steps beyond what the workers do now. And already they're doing a lot to just process applications as it is.

Okay, so what if we amend this resolution to request that you apply and implement the ESAP as soon as you are able to? Are you okay with that?

Yeah, we're okay with that. Thank you.

Okay, any other comments, questions, concerns? Saying none. Are we ready for decision making? Okay, so first up, HCR190, no one to ask questions of. All we have is written testimony and Department of Health is unable to do the Demolition Waste Reduction Working Group without an appropriation. So for those reasons, Chair is going to defer HCR190 for HCR91.

We are going to pass it as is. Okay. Basically we're going to request that they provide such insurance coverage. We're not going to mandate it at this time. Time. But request that they look into possible possibilities of providing especially the most affordable ones. Okay. Any comments, questions, concerns, as is.

Okay. HCR 91 recommendation of the Chairs to pass as is. Chair and Vice Chair vote aye. Senator Hashimoto. Senator Keohokalole is excused. Senator Fevella is excused. Recommendation is adopted.

Okay, thank you very much. So for HCR171, Chair's recommendation is to pass. 174. Excuse me. 174. Sorry. 174. Chair's recommendation on that is to pass with amendments.

We are going to amend the title to say, requesting a Department of Human Services, Office of Youth Services and Juvenile Justice State Advisory Council to continue the use of Ina based learning programs offered to youth in the juvenile legal system.

We need to acknowledge the fact that this is actually starting occurring with OIS with the monies that they already have. And with that we are also going to change on page two, the last. Whereas to reflect that change so that. Excuse me. So that it will be.

Whereas the state has used Ina based approaches with collaborative partnerships at Kawailoa Youth and Family Wellness Center. And the resolution on page 2, lines 2324 will also be changed, be amended to say that the Advisory Council is requested to continue the use of Ina based learning programs offered to you in the juvenile legal system.

Any comments, questions, concerns? My concern is we need to acknowledge the fact that OIS has done a terrific job and in fact they actually had zero inmates at one time. Okay?

So they are using these services productively and unless we give them more money they would they won't, they will be able, they won't be able to do more so. Any comments, questions, concerns? Seeing none Vice Chair for the vote.

Pass with amendments. okay voting on HCR 174 House Draft One, recommendation of the Chairs to pass with amendments. Three Members are present. Any reservations? Any NOS recommendation is adopted.

Chair so for HCR171 Chair's recommendation is to pass this with amendments. We are going to note that we are going to correct the description of the Statute on page 2, lines 23 to 26 as recommended by SMA to accurately depict the statute but otherwise as is pass with amendments. Any comments, questions, concerns?

Seeing none Vice Chair for the vote.

Okay HCR 171 recommendation of the Chairs to pass with amendments. Three Members are present. Any reservations? Any noes? Recommendation is adopted.

Chair okay. For HCR146HD one Chair's recommendation is to also pass with amendments.

We are going to amend the title to add when able to the title and also reflect the resolution to state at the on page two, first paragraph of the be it resolved at the very end to say it's requested to apply for and implement the Elderly Simplified Application Project in the state when capable Any comments, questions, concerns?

Saying none by stair for the vote.

Okay HCR 146 House draft one recommendation of the Chairs to pass with amendments. Three Members are present. Any reservations? Any noes? Recommendation is adopted sir.

And with that we are adjourned.