House Standing Committee on Health

This, I don't have to shout.

Welcome to this first hearing of the House Committee on Health. I'm very honored to serve as your Chair. And just for the record, today is Friday, January 30th, and it's 10:30 now, 10:31 AM, in Conference Room 329. I'd like to welcome all of you to hopefully a productive session of 2026.

And first of all, I'd like to introduce the House Members. First of all, I'm Greg Takayama. I'm Chair of Health and proud to represent Pearl City and we have a couple of constituents in town in the audience and, and Vice Chair Lee Loy.

No, I'm just saying that most people don't realize that the vice chair of any Committee is really the behind the scenes person who does lots of the legwork and actual handling of the bills and legislation before us. So, appreciation to Vice Chair.

And I'd especially like to welcome our brand new member of the House of Representatives, Representative Daisy Hartsfield, proudly representing Waipahu and this is, I believe, her very first hearing of any Committee in the Legislature. So, welcome.

And of course, Representative Amato from Maui and Representative Chair Marten, who is—Lisa Marten is Chair of the Human Services Committee as well. So, thank you all, and the other Committee Members are monitoring us on TV and will certainly show up in due time. Just a couple housekeeping measures—not measures, but pointers.

You'll notice that unlike last session, there are no microphones on the table. There actually are microphones in the room and they're the green light things you see in the roof so everyone can hear you. It's been tested, but our IT persons will focus the hearing.

I don't think focus is the right word, but anyway, we'll concentrate the microphones on those source speaking at the table or at the testifier podium. So, we still need testifiers to speak from the podium.

We also have members of—testifiers on Zoom, like last year, and just pointers that we don't allow any trademark items on Zoom and also, ask you to stay muted until it's time for you to testify.

And as all of you know that we're all on YouTube, so we're being watched by a potentially worldwide audience, except Iran I think, and some other countries. But anyway, so ask that all testifiers try and abide by a two-minute time limit. We'll have a little timer behind us. And I also like to welcome Representative Alcos.

Thank you.

Alright. Thank you very much. If there are no other questions, let's move on to the next bill, which is actually the first bill on the agenda, which is House Bill 218, relating to hospital surgical smoke. And first up, we have the Department of Health on zoom, I believe.

Yes. Good morning. Can you hear me okay?

Yes, we can. Please proceed.

Okay. Good morning, Chair, Vice Chair, Members of the Committee. My name is Paula Cerio, and I am the Chief for the Office of Healthcare Assurance for the Department of Health. The Department stands on his testimony in support of HB 218. Thank you for this opportunity to testify.

Thank you. Do you have more to say in your testimony, are you in support of the measure or?

Yes, we're in support of the measure and in support of HAH's amendments that they will propose when they testify.

Okay. Thank you very much.

You're welcome.

Let's see, we have the Healthcare Association of Hawaii, Paige Choi. Is she on Zoom?

I am. Thank you, Chair. I'm sorry I couldn't make it in person. We—I'm Paige Choi, Vice President of Government Affairs for the Health Care Association of Hawaii. We stand by our comments that we submitted asking for an amendment. We agree with the other testifiers that measures should be taken to ensure the safety of staff.

As some of the other testifiers have noted, there are standards set out by entities such as the Joint Commission and NIOSH around surgical smoke that our hospitals are compliant with.

But we do understand if the Legislature chooses to make sure that there are policies around the use of surgical smoke, understanding that of course, there is a spectrum of procedures that generate surgical smoke and ensuring that hospitals do address those issues on a case by case basis in ensuring the safety of our providers.

So, thank you very much, and available for any questions.

Thank you. We have the Association of Perioperative Registered Nurses, Jennifer Pinnock. Is she on zoom? No, but we have her written testimony in support, as well as testimony from Bernadette Il Di Fonso in support and Tammy Ueda in support. Have I missed anyone wishing to testify on House Bill 218. If not, questions, Members?

Chair.

Yes, Representative Marten.

I have a question for Paige. So, the language to me that your suggested amendment is a little confusing. Why wouldn't you leave in there to prevent exposure by using a smoke evacuation system as appropriate and just have it all to specify that that and maybe even go into, you know, for the duration of the procedure or something?

It seems like right now, the situation is that an individual there on the ground gets to make the choice whether, whether the hospital, whether the room is equipped appropriately and whether that equipment is used.

And so, I think the point of the law is to make it less of an individual choice and have more set guidelines. So, I don't know. It doesn't seem like this language achieves that goal.

Yeah, and I, I, I appreciate that. I think our hope with the language and what we were reading in the Bill is, as you noted, to have more of a policy, right, policies in place, standard policies in place, rather than leaving it up to individuals, which we acknowledge, right, I think is an issue that has come up in hospitals across the country, which is why I think AORN is really focused on getting this type of language passed in multiple states

I can bring that back. I can see if maintaining the current language is an issue.

Where our members, I think, were coming from was that there's a wide range of procedures that generate surgical smoke. So, for example, in laparoscopic surgery, right, you're going to have a lot of smoke. You're going to be using electrical or cauterizing equipment for the entire duration.

But there are times where you may use a cautery for a few seconds. Right? And I think the feeling was that if you had to use a smoke evacuation system, even for those few seconds of use of a cautery, it might not be clinically necessary.

So, our feeling was kind of keeping it flexible for those instances where there isn't necessarily a high risk of exposure. But as you noted, still maintaining a standard in terms of hospital policy, instead of allowing it to be up to one individual. So, we can take it back.

If the Committee would like us to reconsider the original language, we can, but that was the purpose of our suggestion, was to allow for that wider range of types of procedures and exposures.

You know, was that, do you have any other questions? Okay, if I could follow up with Chair Marten's question. How about if we changed your suggested language. In other words, keep what it currently says about using a smoke evacuation system, but adding in or other appropriate, appropriate measure for each procedure? Would that be?

I think that could work. I can always bring it back, but I think that that captures the essence of what we discussed.

Okay, we'll suggest that.

All right.

So, everyone can hold their breath.

Literally hold their breath. Okay, thank you.

Thank you.

Humor on our, thank you. Any other questions? Sure. Yes, Representative Alcos.

Hi. I just want to follow up on some of the questions as well. To the public, could you explain what is surgical smoke? Like what, what do you guys do on all that? Where the smoke comes from?

Yeah, and my understanding of where the smoke is coming from, it's essentially whenever an electrical tool is used on tissue, and that will release some kind of smoke because there's liquid. I don't want to be too graphic, but essentially, right.

When you're dealing with tissue, with other matter, if you use some kind of electrical equipment, usually to cauterize, then that's when that happens with the liquid in the body, that's where the smoke is generated.

When you guys do mostly surgery or some kind of thing that you guys need to work on the body, right?

Generally, yes. It would be a procedure that's happening in an operating room, which I would assume is largely surgery.

Thank you.