House Floor

Will the house come to order? Mr. Clerk, please call the roll.

[Roll Call] Madam Speaker, 48 Members are present. Two are excused.

Thank you. Item number two. Reading of the journal. Representative Morikawa.

Madam Speaker, may this matter be deferred.

So ordered. Item number three. Messages from the Governor. Mr. Clerk, are there any messages from the Governor?

Madam Speaker, there are none.

Item number four. Senate Communications. Mr. Clerk, are there any Senate communications?

Madam Speaker, there are none.

Okay, let's move to introductions. Members, are there any introductions? Representative Quinlan.

Thank you, Madam Speaker. In the gallery today we have some of my constituents, Dr. Nguyen and her daughter Surya, as well as her apprentice, Cecilia Rouvillois. Welcome to your House of Representatives.

Representative Pierick.

Thank you, Madam Speaker. In the gallery I see many advocates of people who believe in practicing birth with freedom. So I just wanted to acknowledge them.

Representative Cochran.

Mahalo, Speaker. And yes, I'd like to acknowledge. I'm very honored to acknowledge people here in the gallery. One group is Malama, Napuao, Ohamea. This would be Ki' I and the girls.

This is Kanaka Maoli birthing arts organization leading efforts to revitalize our rights of passage around our life cycles, perpetuating ceremony and healing knowledge to increase the Mana Kuleana healing and connection of Vahine in Hawaii. In turn, we have taken action to protect traditional midwifery from criminalization in the state and globally. And they are standing.

There's another some honorees that I'd like to mention to acknowledge these guests. Today we have Members from the Global Council of Indigenous Midwives. So please stand. I know there's lots.

There's worldwide collective of indigenous midwives from 17 indigenous nations, including Maori representing iwi across Aotearoa, Anishinaab Nabe Inuit, Inu, Cree, Cayuga, Metis, Kanian, Kehaka, Blackfoot, Samoan, Salish, Kanaka, Hawaii, Fijian, Filipino, Cowlitz, Pakistani and Puerto Rican.

This global council of indigenous Midwives are committed to remembering and practicing their customary skill alongside Western biomedical models to ensure continuity of knowledge transmission to maintain the health of indigenous individuals, families and communities around the world.

As background, the need for CGIM was first identified by indigenous midwives at their first inaugural meeting of Bali, Indonesia in June 2023. The first gathering of the CGIM was hosted in January 2024 in New Zealand. The second gathering will be held right here in Hawaii starting today and throughout the week. And this is Akua in action.

That the timing of this is incredible. Mahalo for being here. This house is scheduled to vote on HB 1194 relating to midwives today. And their presence and energy is filling this room. To address that, Global Council of Indigenous Midwives are standing with indigenous midwives from their allies in Hawaii.

They offer their support for midwifery licensure laws in Hawaii and other jurisdictions that protects traditional and cultural birthing practices and allows for care to promote the health of all indigenous people. Again, mahalo and welcome to the House of Representatives in Hawaii.

Representative Ilagan.

Thank you, Madam Speaker. I am proud and excited to introduce my amazing team. And from my right to left, we have Carrie Socer. She's our legislative aide. We also have a former Committee Clerk, Alexei Katko. If you could please stand. Thank you.

And then we have Charlie Schur, a Committee Clerk, and of course, the amazing Nikki Watts, who keeps our office grounded and make sure everybody is on their task. And of course, the person who I look make sure that everything is working and it's in order.

We have also Donnie Pogtis, who's our, uh, intern, and then two lovely couple who is actually Ariel Hall, our leg aide, and JB Arua, who is working over the representative in Hamakua. And I would like to introduce you this amazing group of people, Madam Speaker. And please, let's welcome them to the House of Representatives.

Representative Matsumoto. Thank you, Madam Speaker. I see friends in the audience and I'd like to introduce Nikeli Blanchard and her family, if you can rise and be. Welcome to your House of Representatives. And also my amazing chiropractor, Dr. Carrie Kwan. Thank you for being here and welcome to your House of Representatives.

Are there any further introductions, Representative Iwamoto.

Thank you, Madam Speaker. I'd like to take this opportunity to welcome legal Director of the ACLU of Hawaii, Carrie Ann Chirota. Please be recognized and welcome to your House of Representatives.

Thank you.

Recess, subject to the call of the Chair.

Will the House come to order? Order of the day. Item number five, Reports of Standing Committees. Representative Todd.

Madam Speaker, I move to adopt Standing Committee report numbers 2066 through 2088 as listed on pages 1 through 8, and that the accompanying Senate Concurrent Resolutions, as may be amended, be referred to their designated committees. Representative Morikawa.

Madam Speaker, I second the motion. Any discussion on these items beginning with HSCR number 2066. Representative Pierick.

Thank you, Madam Speaker.

No vote, so ordered on the top of page two. Standing Committee report number 2067, 2068, 2069. Representative Pierick, thank you. No vote, so ordered. On the top of page three. Standing Committee Report Number 2070, 2071, 2072. On the top of page four. Standing Committee Report 2073, 2074, 2075. On the top of page five.

Standing Committee Report Number 2076, 2077, 2078. At the top of page six. Standing Committee Report 2079.

Representative Pierrck, thank you, in opposition.

Please proceed.

So this resolution is asking for an expansion of the government, creating an office of resiliency and Recovery. When the government increases, usually the people's livelihoods decrease. So I think the smaller the government, the better. So I'm voting no.

Moving on to standing Committee Report 2080. Representative Amato, reservations so ordered. Representative Peruso. No vote, so ordered. Signing Committee Report 2081-2082-2083-2084 at the top of page 8. Standing Committee Report 2085. Representative Amato no vote, so ordered. Standing Representative Peruso, Same request, so ordered. Standing Committee Report2086-2087-2088. Members, we will be taking a voice vote.

All those in favor, say aye. All those opposed say no. The motion is carried. Representative Todd.

Madam Speaker, I move to adopt Standing Committee report numbers 2089-2103 as listed on pages 9 through 13, and that the accompanying Senate Concurrent Resolutions and House Resolution as may be amended, be adopted.

Representative Morikawa. Madam Speaker, I second the motion. Any discussion on these items beginning with HSCR number 2089-2090-2091-2092 at the top of page 10. Standing Committee report number 2093-2094-2095 at the top of page 11. Standing Committee report 2096-2097-2098. Representative Garcia. No vote, so ordered. Representative Pierick.

Thank you.

No vote, so ordered. Representative Shimizu.

Thank you, Madam Speaker. No vote, please.

So ordered. Representative Muraoka. Same request, so ordered at the top of page 12. Standing Committee Report 2099. Representative Garcia no vote, so ordered. Representative Pirek no vote. Representative Shimizu.

Thank you, Madam Speaker. No vote, please.

So ordered. Standing Committee Report 2100. Representative Garcia.

No vote.

So ordered. Representative Pirek.

Thank you. No vote.

So ordered. Representative Shimizu.

Thank you, Madam Speaker. No vote, please.

So ordered. Signing Committee Report 2101. Representative Garcia.

No vote.

So ordered. Representative Pierick.

Thank you. No vote.

So ordered. Representative Shimizu.

Thank you, Madam Speaker. No vote, please.

So ordered. Representative Moraoka. No vote. So ordered. Representative Alcos. No vote. So ordered. Moving on to standing Committee report 2102, Representative Iwamoto.

Thank you, Madam Speaker. I rise in support with reservations and comment.

Please proceed.

Thank you. My reservation stems from some community testimony opposing the solutions that are being considered in this measure. However, I support this measure because, as it was confirmed in.

In our hearing on Water and Land, that even though we support this resolution, the work that this resolution seeks to achieve will not be done without the consent of the County of Maui. They will have final say on this, and I support that based on home rule and other issues. So this is why I'm supporting this measure.

Thank you, Representative Amato. No vote. So ordered. Representative Cochran.

Thank you, Speaker. And I've been tracking this. Your position. Yes. In support. Please proceed with comment, though. Because this issue has been happening for decades, and as a Council Member, when this first started and all these condos that are literally falling into the ocean today are.

Have come together, supporting each other with their own funding to do studies, come up with answers, solutions, and reports. And I've been very supportive of their efforts. And yes, we're facing, you know, degraded sandbags and seawalls and all these things which unfortunately are there, and they're just trying to move forward.

So I feel like, because this has been in. The efforts have been occurring for years, we're going backwards to get back to the table and urge these people to talk once again. I'm kind of like, well, what happened to some of these solutions? I recall on the table that were doable and the community did have buy in.

So if we have to do this, then great, continue the conversation again. So those are just my comments in reflecting on this, the, you know, the evolution of this issue. Thank you.

Moving on to standing Committee report 2103, Representative Souza.

Thank you, Madam Speaker. No vote. So ordered. And permission to insert written comments into the journal.

So ordered.

And just a brief comment. Please proceed. I'm just not certain if the Committee report is an accurate reflection as far as the robust discussion and full scope of what transpired during the Committee Hearing. Thank you.

Representative Muraoka in support.

Please proceed. Thank you, Madam Chair. I rise today in strong support of this resolution. A resolution born from a very real, very urgent need in the Waianae coast community. Waianae has nothing. No plan, no escape route, no clear way out in the event of a natural or man made disaster. This resolution is not just paperwork.

It's the first step towards ensuring that the over 50,000 residents of the Waianae coast are not trapped physically or politically by inaction. We are hopeful, we are optimistic, and we are ready to work together to make sure no community is left behind when the next emergency comes.

Because we all know it's not a matter of if, but when. Thank you, Madam Speaker.

Representative Iwamoto.

Thank you, Madam Speaker. I rise in support and ask that the words of the representative from Waianae be entered into the record as my own, with a few additional comments. And I want to echo what he. What he said, which was, no community be left without egress in case of emergency.

I am in full support of every community having that access to government resources to flee when there is a crisis that could cost lives. Thank you very much.

Representative Souza, for the second time.

Thank you, Madam Speaker. Second time still in opposition. And I would like the words of the representative from Kakaako inserted into the record as my own, so ordered. And I do want to just reiterate that, but I do support an egress and ingress route for the Hawaiian I Coast.

It's important that in the event of an emergency, especially a wildfire, that route residents have the means of escaping. And I also feel that it's important that every single community has this opportunity to save their residents. And so I do hope that as we move forward, we can also do the same for the residents of Makakilo.

Thank you. Members, we will be taking a voice vote. All those in favor say aye. All those opposed say no. The motion is carried. Item number six. Final reading. Members, there will be three motions.

One to agree to the Senate amendments, one to suspend the rules for final reading by consent, and one to pass the final bill of the House Bill on final reading. Representative Todd. For the motion to agree.

Madam Speaker, I move to agree to the amendments made by the Senate to house Bill number 1194 HD2. Representative Morikawa.

Madam Speaker, I second the motion. Any discussion?

Members, we will be taking a voice vote. All those in favor say aye. Those opposed say no. The motion is carried. Representative Morikawa.

Madam Speaker, I move to suspend the. Rules of the House in order to consider a certain House Bill for final reading by consent calendar. Representative Garcia.

Representative Todd Madam Speaker, I second the motion. Any questions? All those in favor signify by saying aye. All those opposed say no. The motion is carried. Representative Todd Madam Speaker, I move that.

House Bill number 1194 HD2SD3 as listed on page 13 pass final reading. Representative Morikawa.

Madam Speaker, I second the motion.

Any discussion on this item it recess subject to the call of the chair. I'd like to call this meeting back to order and I ask the audience to please refrain from any language outbursts that will disrupt the deliberations and proceedings on the floor. Thank you very much. Let's see. Representative Todd. You did okay.

So we're going to move on to discussion of this item. Any discussion.

Representative Cochran thank you Speaker. And so you can feel the energy in this room in reference to the I stand in opposition.

Please proceed.

Thank you.

And I just want to justify just some points and flaws in this bill as to why I completely do not agree with it in its current form. I didn't agree with it in its original original form and wish that HB 1328 had been in this position instead of this one.

Anyways, so one I just want to acknowledge again the 17 countries here and the midwives associated with their respective traditional cultural customary practition of midwifery. This is an accepted practice worldwide, globally and and why it is so difficult to acknowledge and put into practice here just boggles me to no end.

Anyways, so you know, if we were to look at the 17 countries here today in their title and role profession as midwives and they moved here and wanted to do their job that God has elected them to do, they would be subject to heavy fines with this bill, $1000 a day for practicing their indigenous midwifery, you know practice our women here in Hawaii would not be able to choose them as their midwives.

So they should choose and a woman has all the rights, must have, should have all the rights and option and choice of who will be with them in that time of birthing, touching their bodies, being with them. So it's a matter of reproductive rights and choice.

Also this restricts access for all Wahine in Hawaii to receive care from two types of midwives, Western trained and pale keiki yet have removed the choice to all these other indigenous midwives sitting again in the chambers here behind me. Reproductive rights have been removed in this bill.

You cannot choose someone knowing the care they will give you could result in financial burdens that could devastate their livelihoods. This is not a choice. This is not freedom of choice. I also think that other main points can be expanded on, you know, the PEP.

I want to thank I do appreciate the change with the Senate adding in the PEP pathway. That was a really big move. And I and I applaud the Senate and ACLU and all the efforts that moved that body to put in the PEP pathway. But PEP students are not clearly recognized in the exemption language.

And also qualified midwife preceptors does not include the ability for licensed midwives and professionals in this state to legally precept student midwives into the pathway that we have added into this bill.

So there was talk, I mean, if we could have just done some simple amendments of this kind to make the bill have more sense, because as written, it is severely flawed still. And I'm really afraid that this body is going to face litigation in the future, as we have already.

And I was hoping we could address those things collectively in a unified voice moving forward. That has not happened this year, as I understand, you know, revisit it next year.

So I guess that's what we're going to have to do because I don't think any of us in this room is going to leave and forget this, this issue for a long time coming. So hopefully we can move forward. But those are my comments, speaker, and reasons for in opposition.

Representative Muraoka in opposition.

Please proceed. I just wanted to point out to our colleague from Hawaiian Paradise Beaches that we are in this room today because we're voted to serve the people. And I'd like everybody to take a look in the gallery today. Those are the people we were elected to serve and their voices should count and should be heard.

We are not here for ourselves or the people who donate to us or stand behind us. We are here for the people who elected us.

Representative Iwamoto thank you, Madam Speaker.

I rise in opposition and I ask that the words of the representative from Lahaina be entered into the record as my own. And if I make so ordered. And may I make a few comments? Please proceed. Yes, I am concerned. We say that we welcome everyone.

We acknowledge indigenous families who are here in Hawaii, indigenous families, not just Hawaiian, but also from Otaroa, from New Zealand, from, you know, various, from Samoa, from various parts of the Pacific. We have a multicultural tapestry. And to not allow a family who's experiencing this birth to have attendance from their own practices, their own cultural practices.

In fact, if we now put them in a position to be fined and financially harmed, it is offensive to what is natural, to what is custom. And for those reasons, I oppose this version of the bell. Thank you.

Representative Garcia in opposition. Please proceed.

And I'd like to adopt the words of the representative from Lahaina and Waianae as my own with a few comments.

Please proceed.

Madam Speaker, midwives have been in existence, well, ever since humans have really, for thousands of years on Earth. And I find it very, very troubling that we think in 2025 of 6000 years of documented human existence, we can then decide arbitrarily who's licensed and who's not while also violating people's religious rights. Forget the whole licensure aspect.

What about the religious aspect of this? As a human being in this country, every citizen is entitled to practice the tenants of their faith, and that includes the birthing practices. I believe this bill is a clear violation of our First Amendment rights to practice freely with our religions. Therefore, I urge my colleagues to vote no. Thank you.

Representative Reyes Oda.

I rise in opposition. Throughout the course of this bill's movement through the Legislature, the various committees had multiple opportunities to adopt language pertaining to to broader religious exemptions as seen in Chapter 457 of our current nursing licensing laws, but has failed to do so. This is a balancing act between birthing freedom and consumer protection.

Protection for consumers and healthcare certifications should not come at the cost of limiting a mother's choice in whom she decides to be present at her child's birth. In addition, I'm concerned that Native Hawaiian practices are not fully recognized within the current language. For these reasons, I rise in opposition.

Representative Amato.

Thank you, Madam Speaker. I rise with reservations. This is a complex topic. Balancing public health needs, cultural rights, constitutionality and more. I greatly appreciate the author's intent and recognize that many parts of this bill are intended to protect the public.

I also appreciate that significant progress has been made in amending the Bill to fix issues to remove midwifery criminalization and to allow a path for licensure for midwifery without leaving Hawaii.

I feel it is a significant concern that the teaching preceptorship path, as stated in the bill, will effectively limit opportunity for licensure for teachers, possibly limiting or virtually phasing out midwifery in the future.

I also have concerns about potential violation of Article 12, Section 7 of the Hawaii State Constitution and ensuring that we preserve Native Hawaiian traditional and customary practices. As a result, I fear an unnecessary continuation of the lawsuit against the state. As I said, it is complex to balance these issues.

At minimum, we have a quadruple obligation, foremost to protect public safety and yet to stand up for an industry providing much needed health care where so many of us live in a health care desert here in Hawaii and to protect the state and to protect practitioners rights.

As no floor amendments are being considered yet, progress has been made on this bill after careful consideration. I vote with reservations.

Representative Takayama.

Thank you Madam President. In support.

Please proceed.

Madam President, this bill before us today is the product of many, many hours of hearings and debate in both the House and Senate.

When the House passed this measure as the HD version, I said that the purpose of this measure is to enact professional standards of training, experience and knowledge for midwives so that all expectant mothers can be assured of a safe quality of care when they utilize the services of a licensed midwife.

That is still the reason I ask my colleagues to support the measure before us today. The Senate amended HB 1194 in three key areas. As has been mentioned, it added the portfolio evaluation process known as PEP plus the bridge certificate as a pathway to receive a midwifery license in Hawaii.

Secondly, it added an exemption for persons invited by a patient to be present at a birth in the community as long as they are not using the title midwife or practicing midwifery. Finally, it added that nothing in this measure should be construed as establishing a criminal penalty. The provisions regarding certified midwives did not change at all.

This bill allows certified midwives to practice to their full extent and training, including providing prescriptive authority. Also, it's very important to note that that this bill preserves the constitutional right of Native Hawaiians to exercise traditional and customary practices regarding childbirth.

Let me say again, this bill preserves the constitutional right of Native Hawaiians to exercise traditional and customary practices regarding childbirth. For all these reasons, I ask my colleagues to support the measure before us today. Thank you.

Representative Pierick.

Thank you Madam Speaker and opposition, please proceed. Thank you. So this bill would basically limit people be allowing to give birth at home with midwives. And then the term midwife is becoming very restrictive. You know, my dad was for all intents and purposes the midwife for my mom.

When I was birthed my same with my two older brothers and my younger sister. It carried on to my sister and her four kids and soon to be fifth kid in June. So this is a common practice amongst multiple states and it goes back thousands of years.

In fact, in the Bible, in Exodus chapter one, there's midwives mentioned that were helping people give birth. Jesus was born without a licensed midwife. President Joseph.

Please proceed.

Thank you. So I think the standards of Jesus are good enough for us, and I recommend we vote no on this bill.

Again, Members of the public, there is disruption of our proceedings and it's not appreciated. Please conduct yourselves and respect our process and our deliberate and our rules in this chamber. Thank you.

Speaker. Can we have a quick recession?

Will the House come back to order? Any further discussion? Representative Matsumoto.

In opposition. And permission to insert written comments into the journal. So ordered. Thank you. Representative Alcos.

In opposition. Over the past year.

Proceed.

Over the past decades, midwives been giving birth. As all our colleagues say right now, they were the heroes. They were the one helping and going out and saving people's lives and being able to help our community.

And all of a sudden we put in bills in and I can see the intent that we want the best for our families. But the practice always has been there. You know, like when is it. We. Got to reach out and go get another certificate to save someone, to help someone, to get a fine.

If you're trying to help someone just because you don't have a certificate, you know, these ladies been out there, husbands been out there and giving, doing this for many, many years. I oppose to this bill.

Thank you, Representative Garcia, for the second time.

Second time, yes. Still in opposition. Madam Speaker, I did hear. Please proceed. Thank you. I did hear a previous speaker mention that the Bill does carve out protections for Native Hawaiian religious practices. But my question is why just native Hawaiian religious practices?

Why not all the other religions in this country, Asians, some Orientals have their birthing practices, Jews have their birthing practices. Why just Native Hawaiians? I think that in and of itself is. Is discriminatory. No vote.

Representative Cochran, for the second time.

Thank you again, speaker. And I rise once again in opposition. Please proceed. Thank you so much. I concur with all the opposition testimony thus far. And I just want to add, I heard a comment about how this bill sitting on the floor, it was vetted and had all this work being done.

I want to point out one of the biggest things I am in opposition because there was a side by side bill that was presented from day one that in particular took thousands of hours of people that are actually sitting in this gallery right now, days and weeks, days after last session.

Because the word back to the group was, well, let's work on it next year. Which here we are that year and now they're being told again next year, again and again. So this is my third year here and I've been hearing it over and over. So this is not the first time other bills have been worked down.

So what's come to the floor to me isn't worthy. The other bill totally was. It had 700 in opposition. No, sorry, In. In support. None in opposition. This bill that moved through, 75 in support, 300 in opposition of testimony. The other bill was just deferred and killed with no discussion, Right?

And so, yes, this bill moved forward, lots of discussion and what have you, but that this is not the. The vehicle that should have been, as far as I'm concerned. And so to me, we did not listen to the people and their voice.

And because it had vetted through literally globally global buy in medical profession, buy in from all walks of life, yet this bill that we're sitting on went instead. So those are more of my reasons for opposition. And if there's a time for me to ask for a roll call vote on this.

Any further discussion? Representative Shimizu?

Thank you, Madam Speaker. I rise in opposition with comments. Please.

Please proceed.

First of all, I want to thank the chairs and the committees for the work that was put into this bill to get it to this point. I really don't want to frame this as a us versus them argument. I would rather see it as a win win situation.

And what I see is, although the purpose of this bill is to provide public safety, on the other hand, we are disenfranchising a great part of our population. Their culture, their freedom to choose what they feel is best for themselves, their families, their bodies.

And what I am afraid of is as we pass bills like this, if it does in fact pass, and I hope it doesn't, but if it does pass, we are heading in a direction where we are moving away from taking away people's rights, the freedom to choose. And that is a dangerous precedent, Madam Speaker.

And I would really encourage my colleagues to think about that, to realize that we represent everyone, not just one side of the argument, but we need to pass bills that consider everyone's rights. Thank you, Madam Speaker.

Any further discussion? Representative Perruso in opposition. Please proceed. I'd just like to request to insert written comments. So ordered, Representative Belatti.

Thank you. Madam Speaker. In opposition. Request to insert written comments.

So ordered. Representative Souza.

Thank you. Madam Speaker, I rise in strong opposition to this measure. Please proceed. Thank you. I do think that this particular bill could go further in protecting Native Hawaiian customary rights and practices. And I will point to the Native Hawaiian Legal Corporation's testimony from the Senate hearing on April 1.

From the Commerce and Consumer Protection and Judiciary Committees. They provided three proposed amendments which the Office of Hawaiian Affairs also supported in their testimony. And to quote from the Office of Hawaiian Affairs testimony, they support the Native Hawaiian Legal Corporation's stance in that.

First, they need to make explicit the Legislature's intent not to regulate traditional and cultural practices under the proposed chapter by adding language to the preamble to this effect.

So basically in the preamble we should be explicitly stating about the Native Hawaiian cultural practices and that the Legislature intends to avoid infringing on Native Hawaiian traditional and customary practice rights.

Second, to amend the traditional and cultural practices exemption to read that the proposed chapter will not apply to persons practicing Native Hawaiian traditional customary practices, including, but not limited to, practices related to pregnancy, birth or infancy as protected under Article 7, Section 7 of the Hawaii Constitution.

And three, to remove duplicative language from the definition of the practice of midwifery. As the above amendments make clear, the intent not to regulate traditional customary practices. With all of that being said, we did have 48 hours basically to try to figure out what the the comp. The comparison was between the House version and the Senate version.

And even for someone with my legal expertise, it was very difficult to do that this weekend to try to really parse out the differences between the House Bill and the Senate Bill.

And I do feel that perhaps if this bill were to be discussed further in conference, we would have had more of an opportunity to truly understand the ramifications of this legislation.

And I also want to say to to that the Star Advertiser did have it on the front page yesterday and it's pretty sad when I have to read in the Star Advertiser on a Sunday about this particular measure just to try to gain some bearings as to what this legislation actually means in its effect.

My grandmother, a full blooded Native Hawaiian woman from Walapui, Molokai, was born here on Oahu to a midwife. And a few days after her birth she ended up going back to Molokai on a ship called the Hualalai. And, and it was good enough for my grandmother back in 1935. And, and here I am today.

And so I really do feel that we need to protect our cultural practices, our Native Hawaiian cultural practices and our indigenous cultural practices. Thank you, Madam Speaker.

Thank you. Any further comments, Representative Hussey?

Actually, Madam Speaker, I'll defer to the Representative from the North Shore.

Representative Quinlan.

Just a brief point of order, Madam Speaker. Not related to the merits of the question, but I wonder if the minority floor reader wouldn't mind retracting his remark about Orientals.

Recess subject to the call of the Chair. Hussey. Please proceed.

Madam Speaker. Thank you very much. In opposition.

Please proceed.

First of all, I'd like to have the remarks of the representative from Lahaina entered into the journalism I own. So most recent remarks, if I may, regarding HP 1328.

Please proceed.

And the second thing that I wanted to say is simply himahalo nui maku ehine apao I hiki mai ike ahaolalo mana hearings apao Mana Komiki Apao. I think it's important for all of us to remember that, you know, we.

We think a lot about the work of the Legislature, but there is so much work that happens outside of our chambers, outside of our committees. There was tremendous amount of work put into the other vehicle.

And, you know, we have tried, I think, in both bodies, our body and in the Senate as well, to take a lot of that additional work, that work that happened by many of the people here and to try to apply it to this measure. But, you know, frankly, the constraints of our.

Of our schedule have made that work insufficient. And this measure will move forward, I don't doubt, and I look forward to subsequent amendments and modifications to it in the sessions to come. Thank you, Madam Speaker.

Is there any further discussion? If not, Representative Souza.

Thank you, Madam Speaker. Still in opposition. And just permission to request written comments into the journal. So ordered. Thank you.

Speaker.

Representative Cochran.

Thank you. Speaker, at this time, is there a way to request for a roll call vote?

Yes, there is.

Thank you.

A roll call. Can I get a quick, quick recess. Recess, subject to the call. I'd like to call the meeting back to order before we get on to the roll call request. Would like to ask if there's any further discussion. Representative Hussey, for the second time, actually.

I'm sorry, I just forgot to ask for the opportunity to submit written remarks into the journal, if I may.

So ordered. Thank you, Representative Poepoe.

Thank you. Speaker in opposition. Wanted to request for written comments into the journal.

So ordered. Thank you, Representative Ichiyama.

Thank you, Madam Speaker in support. Permission to insert written comments that to the journal.

So ordered.

And I have just two brief points that I wanted to share about why I support this measure.

Before I do that, though, I would like to thank the chairs of the committees on health, consumer protection and finance, as well as the Senate chairs, Health and human services, Consumer Protection, Judiciary, for the many hours that they spent listening to the testimony on this bill and the work that they did to improve it.

The first point that I wanted to emphasize about this Bill and why I support it is because will remove the sunset date on Chapter 457j and fully establish midwifery as a profession in the State of Hawaii, implements the recommendations of several auditors, reports that the profession of midwifery should be licensed and it I also.

The second reason I support it is because it amends a flawed definition that we had in the prior law, Act 32, which was passed in 2019. The definition of midwifery. It was too broad, it was confusing, and it swept too many people into that definition. And this bill fixes that.

And I wanted to emphasize for the Members that the definition of the practice of midwifery that we are adopting in this bill is starts on page 24, and I'd like to read it so that everyone understands what exactly we are regulating by passing this bill.

The practice of midwifery means the independent provision of care, including initial and ongoing comprehensive assessment, diagnosis and treatment during pregnancy, childbirth, the postpartum period, and for healthy newborns, sexual and reproductive health, gynecologic health, family planning services, including preconception care according to the midwife's scope of practice for all persons seeking midwifery care in all settings through the performance of professional services commensurate with the educational preparation and demonstrated competency of the individual having specialized training and skill based on the principles of the biological, physical, behavioral and sociological sciences and midwifery theory, whereby the individual shall be accountable and responsible to the client for the quality of midwifery care rendered.

Practice of midwifery does not include Native Hawaiian traditional and customary practices as protected under Article 12, Section 7 of the Hawaii State Constitution. That is the definition of the practice of midwifery, and that is what we are trying to say is covered under this bill.

It does not include lactation consultants, it does not include doulas, it does not include support people such as family or friends that you would like to have present at your birth.

I also appreciated the amendment made by the Senate to clarify that there are no criminal penalties for any violations of this chapter, but fees and fines would still apply, such as HRS457, date J13 for violations of this chapter. So overall, Madam Speaker, I think this is a good bill that will protect the consumers of Hawaii. Thank you.

Are there any further comments? If not. Representative Kila.

Mahalo Madam Speaker. In support. I'd like to adopt the words of the previous speaker as if they were my own. So ordered and brief comment, please.

Please proceed.

Madam Speaker, this bill before us, I want to clarify that does not restrict, criminalize or interfere with Native Hawaiian trad and customary practices. On page three, the bill affirms the practice of midwifery under this act does not include Native Hawaiian traditional customary practices.

On page 32, it goes further by exempting and practicing Native Hawaiian traditional customary practices as protected under Article 12, Section 7 of the Hawaii State Constitution. The language is not vague. It is intentional constitutional and rooted in the respect for our people and the ways of our knowing.

This comes after consultation with practitioners, birth workers and voices who wanted to make sure that they have that exemption. And I want to mahalo every single person that has submitted testimony, questions and manao. Also on page 25 we reaffirmed the same thing and on page 4 as well.

Articles 12, section 7 of constitution protects natifying traditional and customary practices. And we see that reaffirmed throughout everything that we do in legislation here. And it is modeled off to some of the same things that exist today, such as the Department of Hawaiian Homelands. Madam Speaker, I was born and raised in the community of the Waianae coast.

And birth is not just a medical event. It is spiritual, ancestral and sometimes in most times very sacred. The Bill was never attended and will not criminalize the tradition. It makes sure that our families who choose clinical midwifery involves medication, diagnostic and medical interventions that are being cared for and trained by licensed and accountable providers.

In the district I serve, we have some of the highest birth rates in the state with the deepest disparities in access to care. The Auditor's report unregulated practice in midwifery poses a clear and significant risk to public safety where 45% of some of these births are covered by Medicaid.

These families deserve the care that is competent but also culture where it's safe. I think this bill strikes the balance that it affirms. The traditional practices are not subject to licensure. It ensures midwives and provisional midwives have the education and training standards as set forth with the pap and it allows for the authority under clear guidelines.

I think this bill shrinks the practice of traditions while keeping it protected and respected. I also want to think about some of the stories that have come through from my community Hawaiian homestead that was built in Nanakuli. On Nanakuli Ave. There is a family that gave birth in their house not because of just practicing traditional midway free.

They also could not afford medical and licensed care. I think moving forward, should they continue to practice that with this bill they have that right to do so. But I also want to give our communities opportunity that should they want to pursue a different birth practice, it is allowed and exempted.

I think this bill strikes the balance of both and I understand that the curse concern. But I do not want this bill to cause division and to tear our communities apart.

It is grounded in respect and I think it is building on trust And I go back to reaffirming that when we were sworn into the Legislature to reaffirm the Constitution. In the Constitution, we have carved out rights for Native Hawaiians. And for those reasons, Madam Speaker, I support the bill today.

Any further discussion? Representative Marten, thank you.

I rise in support. Thank you. I'd like to adopt the words of the Health Chair, the Transportation chair and the Vice speaker as if they were. My own, so ordered. And add to that, as somebody who represents the Hawaiian community, it was very important to me and I spoke with a lot of people about the language.

And I do feel that this. This allows the Native Poan community to regulate themselves as they see fit or not regulate themselves at all. And the state does not weigh in on that. The state does not comment on that. The state does not set standards for that. However, for other people, the state does set standards.

And that is a safety issue for our moms and our babies. And that is not something that we are doing for no reason. That is something we are doing because there are cases and we have heard a lot of testimony from healthcare providers where people who are providing traditional birth or midwifery services do make bad choices.

And it is our hospitals and our obgyns that have to try to save the mothers. Record deaths in the hospital of unborn babies that died before they reached the hospital or care for babies in the NICU who will be permanently developmentally disabled. And our state will have to Fund those for the rest of their lives.

It is for this reason that we need accountability. And that doesn't mean that all traditional birth attendants make poor choices. But by asking for no regulation, it does not allow us to hold accountable the few that do.

And so for those that want to provide safe services to our community, there are now pathways that are very low barrier to become licensed.

And I would encourage everyone because I believe our mothers and our babies deserve not only the richness of cultural practices, but also some of the safety that comes with training and the ability to use different medications, distant screenings that go with that license so that they can offer their patients the best of both worlds. Thank you.

Any further discussion? Representative La Chica?

Thank you. Madam Speaker in support, please proceed. May I also adopt the words from the vice speaker as if they were my own? So ordered. Just brief remarks. I in support of this measure because I don't. This bill is not about exclusion.

It's really for those families who do want to choose midwifery, midwifery care, and to do so safely and confidently. And you know, we know that many Local families, including many Filipino Pacific Islander communities. You know, I'm a Filipina.

We look through cultural guides, through different traditions, but we want to be able to do that through trust and be able to do that with somebody who can provide that safe, quality care. I know that, you know, somebody who also believes in like public health and prevention. We want to be able to. Public health is about,

is about prevention. It's about protecting people. And I think that this bill is just really something that can do both. I believe that we are able to both have that choice and as well as be able to have also be able to make sure that families are also safe. So in support. Madam Speaker.

If there no further discussion, Representative Cochran has asked for a roll call before we go to the vote. Let's go through this request. All those in favor of a roll call vote, please signify such by raising your hands and keep them up until the Clerk has finished counting.

Madam Speaker, I second the roll call vote.

Thank you. You can put down your hands. Mr. Clerk, is there a sufficient number of votes?

Yes, Madam Speaker, there is a sufficient number of votes.

Members, vote. I recess calling this meeting back to order. Members, we have enough. Vote for the roll call. Members, vote aye if you are in favor of this roll call. Excuse me. Of the bill. HB number 1194 HD2SD3. Vote no if you are opposed to the bill. Mr. Clerk, please call the roll.

[Roll call]

[Roll call]

Madam Speaker, there are 34 ayes and 16 noes.

Said bill passes. Final reading item number seven. Announcements. Members, are there any announcements? Representative Takayama.

Thank you. Madam Speaker. I just want to take this opportunity to thank my colleagues for your generous, generous donations to this year's Dress for Success women's clothing drive benefiting the YWCA. We collected 80 bags of clothing, which is the most ever.

So I'd like to thank House and Senate members, as well as their staffs and support agencies, for being so generous in this drive. I might also mention that in my frequent meetings with health organizations, several representatives, after the meeting, came back the next day with donations of their own. So this was a very widespread effort.

The important thing is I want to invite members to a photo opportunity tomorrow in the lieutenant governor's office upstairs at 11:00 a.m., and all members are invited, 11:00 a.m. tomorrow, whether you donate it or not. If you just want to admire the number of donations we've had, please come. And thank you very much, Madam Speaker.

Any further announcements? Representative La Chica. Representative La Chica.

Members. Members. Hi. Can look at me over here. Okay. The moment the day has arrived. Good news. I have good news to share. To those who have placed orders, house jacket orders. They have arrived, so they are in my office today. My staff is sorting through them. If you.

My staff will be placed, giving your offices a call when they are ready for pickup. So, thank you to all of you for being so patient as our vendor has been stitching through them the last couple of weeks. So, thank you all. Stay tuned. We'll get a call in the next couple days for pickup.

So, thank you all.

Any further announcements? Representative Hashem.

I just want to make an announcement that it's the birthday for my staff member Jane Taylor today. Thank you.

Any further announce? Representative Kong.

Thank you, Madame Speaker. Tomorrow is April 15th, and it marks the purple up day. So in order to honor our dependence of the military, members wear purple. Thank you.

Thank you. Representative Shimizu.

Thank you, Madam Speaker. I just wanted to congratulate our La Chiclets for winning the talent show. And it was a very inspired performance. Thank you.

Thank you. Representative Kapela.

Thank you, Madam Speaker. I just wanted to thank every single member who participated in Art at the Capitol. I would also like to shout out Arlo Chiclets. They were wonderful, and they won first place at our legislative talent show.

But thank you to the staff who stayed late, to the legislators who stayed late, and opened up your offices. I think Art at the Capitol was a great success, and it was only because of all of you. So thank you again.

Thank you for your leadership in coordinating that effort. Any further announcements? If not for the motion to adjourn. Representative Morikawa.

Madam Speaker, I move that this House stand adjourned until 11:30 a.m. tomorrow.

Representative Garcia.

Madam Speaker, I second the motion.

Members. All those in favor say aye. All those opposed, no. The motion, this house stands adjourned until 11:30 a.m. tomorrow.